When Kishana Taylor enrolled her 3-year-old son, John, in preschool last fall, she figured COVID-19 immunizations for kids under-5 would arrive before the start of classes, and that he’d begin the year with solid immunity in tow. Since then, she has delivered two more children—fraternal twins, now almost six months old—and there are still no vaccines any of her three kids can take. John also caught the coronavirus a few weeks ago, after his day care dropped its mask mandate, and infected everyone at home. John and his siblings have now had to duel the virus entirely unprotected—a reality that Taylor, a virologist at Rutgers University, never wanted them to face. “The only reason we put John in public school was because I thought he was getting a vaccine,” she told me. “I would have made different decisions, if we had known it was going to be put off this long.” Next week, the FDA and CDC are expected to finally, finally green-light two vaccines for kids under 5—a milestone that millions of parents have been waiting for since their own adult shots came through. But reality won’t match the vision many once had of this moment. Closer to the pandemic’s start, when the vaccines were fresh and inoculation lines still stretched impossibly long, an idealized version of herd immunity still seemed possible; maybe, just maybe, vaccinating some 60 to 90 percent of Americans—including a hefty fraction of the nation’s 74 million kids—would quash the outbreak for good, or so the thinking went. “When we talked to parents last year, I think there was a perception that it would be over by now,” says Jessica Calarco, a sociologist at Indiana University. It is, of course, not over by now. [Read: Don’t wait to get your kid vaccinated] For months, the number of Americans who opted for their initial doses has held stagnant, at just above 250 million, or about 79 percent of the population. And this last windfall of eligibility seems unlikely to make that number substantially or rapidly budge. A recent Kaiser Family Foundation poll found that less than a fifth of parents are eager to vaccinate their infants and toddlers right away, with the rest unsure about the shots or outright opposed. “I’m usually a much more positive person, but I don’t believe this is going to change much,” says Robin Cogan, a school nurse in New Jersey’s Camden City School District. In her county, just 20 percent of 5-to-11-year-olds have gotten their first two doses. During the delays in rolling out COVID vaccines for infants and toddlers, doubts about the shots ballooned, and misinformation seeped into data gaps. Parents watched SARS-CoV-2 hopscotch through their families. Now nearly all other mitigation measures—along with much of the fear that clouded the pandemic’s early days and the social incentives that nudged many adults to sign up for shots—have vanished. “Parents are feeling like, if my kids don’t need to be vaccinated in order to go back to school, back to child care, then what’s the point?” Calarco said. The opening up of American society in advance of these vaccines sent a message: The youngest children don’t need to be immunized for things to be all good. Infant-and-toddler vaccination is now manifesting as yet another symptom of the U.S.’s hyper-individualistic approach to crisis containment—a prioritization of personal choice over collective well-being. Wear a mask or don’t; nab a shot or don’t. Vaccinating the youngest kids will change many little lives, one by one by one. But with so many weights stacked against pediatric vaccination, America will struggle to eke out its biggest benefits for the population at large. The primary perk of getting a COVID vaccine is still simple. The shots “help the body do its thing faster,” says Nathan Chomilo, a pediatrician and health-equity advocate in Minnesota: speeding the process of booting the bug, shortening symptoms, and keeping them from turning severe. Vaccinated kids are more spared the tolls of debilitating and deadly disease, such as long COVID, MIS-C, and more. Children can also easily contract the coronavirus and spread it around; “if we’re even halving the amount of kid-prompted transmission we’re having, it’s going to make a substantial difference in day-to-day life,” says Emily Martin, an infectious-disease epidemiologist at the University of Michigan. Vaccinated children would be less likely to catch the coronavirus and pass it on; parents, siblings, and grandparents, in turn, would be less likely to be pulled out of work and risk losing income. Schools and daycares would be safer. Entire neighborhoods and counties could be better buffered against future outbreaks and the associated toll on education, child care, employment, and social pursuits. All that’s certainly likely in particular parts of the country, where parents are already “waiting at the door,” Calarco said. (As a parent to a 4-year-old son, she’s one of them.) But such a rosy scenario won’t play out everywhere. “We’re going to see a separation of communities”—a patchwork map of immunity across the United States, Martin told me, exacerbating existing disparities. Uptake has lagged spectacularly in other age groups: Only 60 percent of 12-to-17-year-olds, and 29 percent of 5-to-11-year-olds, have gotten their first duo of doses. “It seems like the younger the kids are, the more hesitant parents have been,” says Lanre Falusi, a pediatrician at Children’s National Hospital in Washington, D.C. And communities that have struggled to muster support for the shots are likely to see the same pattern, repeated more dramatically, for the under-5s. Which means that they’ll also maintain the status quo of having teachers and parents constantly out sick, exposed to gobs of virus, or caring for ill children, many of them too young to mask or isolate. Educator shortages will persist; classroom closures will go on. Spread, too, will further surge. “The household is really where the activity is” when it comes to viral spread, Martin told me. To have the youngest kids “stay our susceptible group will continue to drive infection into the rest of the family.” [Read: Why a three-dose vaccine for kids might actually work out] Martin, for one, is “not completely pessimistic about uptake” in the youngest age group. Kids under 5 are tightly tethered to the pediatrician, and in that alone, “there’s this regular structure,” she told me, including a trusted expert to advise decisions on immunization. Vaccination for kids this little is already a norm. Even flu shots, which in most parts of the country aren’t required to start school, are more popular among infants and toddlers than they are among adults under the age of 65. But in the eyes of many parents, the COVID vaccines don’t fit neatly into that roster of shots. “A lot of my families trust other vaccines on the traditional vaccine schedule,” says Sanjeev Sriram, a pediatrician in Maryland, where he treats a predominantly low-income, Black, and Latino patient population. Some of the parents he talks to are vaccinated against COVID and still balk at the notion of dosing their young kids with a shot hurtled through a program nicknamed “Warp Speed”—which, Sriram told me, sounds like a euphemism for unvetted and totally rushed. The vaccine—marketed as free and ultra-effective—also feels like a suspicious departure from many of his patients’ typical experiences with health care. “They’re like, ‘Where were you with the free, helpful stuff before?’” Sriram said, as if families are worried there’s a catch. With time, the conversations have only gotten more fraught. Suresh Boppana, a pediatric infectious-disease specialist in Alabama, the state with the lowest rate of COVID vaccine uptake among 5-to-11-year-olds, told me that, in some cases, the families he works with—even some of his colleagues—are so against vaccinating their kids that they refuse to partake in discussions at all. “They just don’t even want to engage,” he told me. To one way of thinking, the time it’s taken to authorize these vaccines should signal their solidity. The COVID vaccines have been safe in every age group tested, including infants and toddlers, who receive smaller doses to minimize side effects. “We have a year and a half of data from adult and now adolescent vaccines to show it’s safe,” Falusi told me. But that time also left a gap for misinformation and disillusionment to creep in, and seize on parents’ fears. Pediatricians across the country told me that they still regularly receive questions about whether the vaccines could make their kids infertile (no), implant microchips (no), magnetize their children (no), or were part of a conspiratorial government plot (no). The shots have also become hyper-politicized, cleaving divides in immunity along party lines. “That’s been one of the hardest things,” says Gilbert Goliath, a pediatrician based in West Virginia, a state with one of the lowest rates of pediatric-COVID-vaccine uptake in the country. “Hopefully,” he told me, when it comes time for parents to vaccinate their infants and toddlers, “they’ll listen to me.” Parents have also grown disillusioned over pediatric shots after watching scores of their adult friends and family get vaccinated, then contract COVID anyway. Reports of postvaccination infections, illnesses, even hospitalizations and deaths have made it seem as though the shots have lost their luster—even, perhaps, that the people who got them early on were roundly duped. “They’re like, What’s the point when it doesn’t seem like they work anyway?” Cogan told me. That incorrect assumption, compounded with misinformed notions that COVID’s no worse than a “bad cold,” especially for kids, have made risk-benefit conversations especially tough to have. Recent estimates of the proportion of American children who have been infected by SARS-CoV-2—some 75 percent by February, according to a CDC study—also planted false ideas that COVID-recovered kids “don’t need to get vaccinated,” says Anne Sosin, a public-health researcher at Dartmouth College. In reality, vaccines do reduce the chances of bad outcomes, and immensely improve upon the defenses left behind by infections. (For that reason, Taylor, the Rutgers virologist, remains eager to vaccinate all three of her recently infected kids.) And the outcomes among kids are indeed bad. Infected children can die from COVID; they develop severe inflammatory conditions, such as MIS-C; they can suffer the chronic symptoms of long COVID, for which there is no cure. Low levels of population-level immunity have also dragged the pandemic on, disrupting education and socialization, and wreaking havoc on kids’ mental health. “That aspect of this pandemic has been horrific,” Goliath told me. “The amount of mental health I’ve treated in the past two years has surpassed my previous 28 years.” [Read: Why kids’ COVID vaccine results don’t look like adults’] And yet, the kids are okay has been “a big part of the messaging” for more than two years, Calarco told me, and was especially tantalizing “for parents of young children, who are heavily reliant on child care and schooling.” This narrative has been that much more appealing as of late, as the U.S. has hurtled back toward reopening in full. “There is a general feeling that people tend to feel, like the pandemic is over,” Falusi told me, and few parents who have adopted that mindset want any reminders that it is still around. The signs of COVID’s coda are, after all, everywhere: Masks are all but gone; in-person meetings are back; travel is bumping; end-of-spring gatherings are in full swing. All that happened in advance of the green-lighting of infant-and-toddler vaccines, reinforcing the idea that the shots just weren’t necessary for normal life to resume. The delays and bungled messaging from Pfizer, which had to put off the debut of its under-5 shot because of lackluster results, didn’t help; nor did the sluggish submission and review of the data out of Moderna’s under-6 clinical trials, a process that has taken far longer than the FDA’s vetting of Pfizer’s 5-to-11 shot. Now that shots sized for the littlest kids are finally poised to drop, much of the motivation is sapped, and will be very difficult to reclaim. “As things open up, vaccination has gone to the back burner, especially in communities that are under-resourced,” Chomilo told me. “Can I put food on the table?” takes precedence over “Can I get my kid their shot?” New, logistical hurdles to vaccination have also been raised. Community immunization sites have disappeared, removing visible reminders of the shots’ importance, and stripping access from families who might have nowhere else to seek a shot. And although the Trump administration greenlit pharmacies to vaccinate kids as young as 3, federal leaders have yet to do the same for littler children, and many states do not permit it. That puts a big burden on pediatricians’ offices, where supply may not be guaranteed, and could be imperiled when skilled staff call out sick. For some children, “it might be a few months, or even a year, before they’re back in a doctor’s office,” Chomilo said. A late-June rollout also misses the end of the school year, removing the opportunity for children and parents to hear enthusiastic messaging about the shots from teachers and nurses—to the benefit of not just individual kids, but entire communities. There’s an irony to it, Martin told me: In other outbreaks, there have been calls to prioritize getting protection to the littlest kids first, “because they’re the super-spreaders, then you catch up the adults.” There will be no simple solutions to America’s kid-vaccine ennui. Financial incentives could help. School mandates, too, are an effective way to get immunization rates up, though in recent months, several states have introduced legislation to ban such measures. But the biggest and most difficult change will be cultural: repairing parents’ relationships to immunizations, and making COVID shots, perhaps even periodic ones, a little-kid routine. Every person I spoke with for this story stressed the importance of community outreach, and one-on-one conversations, starting with pediatricians, many families’ most reliable touchstone for care. It can work. Puerto Rico, which has one of the highest immunization rates in the entire country, also leads the U.S. in uptake of kids’ COVID shots—a trend that experts such as Mariola Rivera Reyes, a pediatric pulmonologist, attributes to the territory’s strong sense of community and trust in local leaders. “Almost all the parents I’ve talked to have been very enthusiastic,” said Rivera Reyes, who has taken to social media to connect with parents. “We haven’t encountered the resistance we can see in the mainland.”
from https://ift.tt/pLUZoMS Check out http://natthash.tumblr.com
0 Comments
Karen Ocwieja delivered her twin sons last June, just weeks before Delta broke across the American Northeast. For months, she and her husband sheltered the boys, who’d been born premature, limiting their exposures to friends, family, and other kids, hoping to guard them from COVID’s worst. But all four of them still ended up catching the virus this January—the boys’ first bona fide illness. Then, in May, the twins tested positive again. Born with Ocwieja’s antibodies from pregnancy and now churning out their own, they likely will never know a world without COVID. Still, Ocwieja, a virologist and pediatric infectious-disease specialist at Boston Children’s Hospital, hopes that the next time her kids encounter the bug, they’ll be far better prepared. The FDA is slated to finally authorize two vaccines for kids under 5 later this month, a milestone she has been waiting for ever since she got her first COVID shots, while carrying her sons. “It’s not going to be a free ticket to no more COVID,” she told me. But it will bring the twins one step closer to a life with fewer quarantines, more family gatherings, more playdates, more travel, and far more protection from the virus—all part of “the childhood we really want them to have.” Ocwieja knows that her excitement puts her in a minority. An April poll conducted by the Kaiser Family Foundation found that less than a fifth of parents of kids under 5 are eager to vaccinate them right away; of the rest, about half say they definitely won’t sign their children up for shots, or will do so only if required. Plenty of parents still harbor worries over the shots’ safety, fretting that the injections might be more dangerous than the disease. And many who watched their kids contract the coronavirus, sometimes repeatedly, no longer feel much urgency about tacking on immunization—especially now that American society has opened back up, and nearly all mitigation measures have been dropped, signaling that the crisis has passed. [Read: Why a three-dose vaccine for kids might actually work out] But the case for kids getting their shots as soon as possible is still strong, even two and a half years and billions of infections into SARS-CoV-2’s global sweep. Vaccination will not just protect children during the current surge but also prep them for the fall and winter, when schools resume session and another wave of cases is expected to rise. Since the pandemic began, at least 13 million American children have caught the coronavirus—a definite undercount, given the catastrophic state of testing in the United States. Of them, more than 120,000 have been hospitalized, more than 8,000 have developed a poorly understood inflammatory condition known as MIS-C, and more than 1,500 have died, nearly a third of them younger than 5. And an untold number have developed the debilitating, chronic symptoms of long COVID. “We can’t always pick out the child” who goes on to get the sickest, says Dawn Sokol, a pediatric infectious-disease specialist at Ochsner Health, in New Orleans. Many of the kids who ultimately fall ill are “running around, happy-go-lucky, no risk factors at all.” Vaccination, perhaps especially for the youngest among us, is an investment in the future. It’s true that SARS-CoV-2 hospitalizes and kills a smaller percentage of kids than adults. But that small percentage has ballooned into catastrophically large absolute numbers. Experts have also dismissed the notion of stacking childrens’ stats against adults’. The more apt comparison, rather, weighs the life unimmunized kids could be leading if they were vaccinated. The availability of immunizations has turned COVID-19, especially in its severest forms, into a vaccine-preventable disease; that alone, experts told me, makes the shots worth taking. And America’s youngest kids have few other protective or therapeutic measures available to them. Children under 2 are too young to mask; some treatments, including oral antivirals such as Paxlovid, aren’t authorized for use in kids under 12. And as more older people have gotten vaccines and kids haven’t—first because of ineligibility, and now because of lackluster uptake—COVID’s toll has bent toward the younger sectors of the population. Little kids, in recent months, have made up a growing proportion of documented SARS-CoV-2 infections, hospitalizations, and deaths in the U.S., a trend that sharpened during the peak of January’s BA.1 tsunami. During that period, the virus hospitalized five times as many kids as it did when Delta was dominant last year; children of color were disproportionately affected. Kids this young, whose bodies are still so early in development, are especially vulnerable to croup-like illnesses when viruses invade their lungs; the coronavirus also seems to increase the risk of developing chronic conditions, such as diabetes, that permanently alter a child’s way of life. And at that age, any illness is crummy, for both children and their families, who can’t just isolate their offspring and leave meals outside the bedroom door. [Read: Why kids’ COVID vaccine results don’t look like adults’] COVID shots hack away at all of those risks. In every age group green-lit for the shots, vaccination has cratered rates of hospitalization and death, even amid the rise of antibody-dodging variants such as Omicron. The injections aren’t quite as powerful at blocking infection and transmission, but they can still blunt the virus’s impact in these respects. Moderna, which is administering its under-6 vaccine as a two-dose series, spaced four weeks apart, says that its shot is about 40 to 50 percent effective at cutting down on symptomatic cases of COVID; Pfizer’s trio of doses for kids under 5—the first two separated by three weeks, the third by two more months—has clocked a very tentative efficacy of 80 percent. Those estimates aren’t as good as the ones adult trials produced at the end of 2020. Back then, though, the contents of the shots were a near-perfect match for the version of SARS-CoV-2 that was circulating at the time; the virus has birthed a menagerie of new variants and subvariants since then, making it tougher for just a duo of doses to raise as strong a shield. Efficacy estimates also don’t paint the full picture of the shots’ protective power. Vaccinated people are still less likely to catch the virus, and to pass it on; even if they end up infected, their illness tends to be gentler and resolve faster. And efficacy against severe disease in children is expected to be very, very high for both brands of shots, though neither clinical trial reported enough COVID hospitalizations to properly calculate those stats. Among adults, the shots even seem to reduce the chances that a person will develop long COVID, which may impact around 25 percent of children who contract SARS-CoV-2—and for an infant or toddler, can be especially devastating. “We want kids to live long, healthy lives,” says Nathan Chomilo, a pediatrician and health-equity advocate in Minnesota. “If they have infections now, it can have impacts for years and years. There’s so much we’re still learning about what changes happen to the body in the long term.” With their whole life ahead of them, the youngest kids among us, in some ways, have the most to lose. So it’s no surprise that some parents remain concerned about just how safe mRNA vaccines are for their infants and toddlers, especially so close to the technology’s global debut. Needles are also tough for tiny kids to take; forgoing a whole other vaccine could save busy, overstretched parents a trip or two or three. Annabelle de St. Maurice, a pediatric infectious-disease specialist at UCLA Health, who herself has a six-month-old daughter, sympathizes with some parents’ reluctance. “People feel their child is healthy and not at risk of severe disease, and they think they just don’t need the vaccine,” she told me. But she plans to sign her kid up for her shots “as soon as possible.” The mRNA vaccine technology has been in tightly monitored development for decades, and since its public debut in 2020, has proved exceptionally safe in adults, teens, and older kids. The same attributes that make the shots ultrasafe in those populations should hold extra true in the youngest children. The pediatric vaccine pipeline is designed to prioritize safety above almost all else; it’s part of why the data from both Moderna and Pfizer took some time to generate. To minimize the risks of side effects, Pfizer’s under-5 doses are just three micrograms of mRNA, a tenth of adult doses, and Moderna’s under-6 doses are 25 micrograms of mRNA, a quarter of the adult dose. Both companies have reported that the infants and toddlers in their trials tolerated the vaccines very well. And no kids in either company’s studies developed the rare condition of myocarditis, or heart inflammation, that’s been spotted among some older kids who have received the mRNA vaccines. (COVID, notably, can cause myocarditis too--more commonly, and usually more severely, than what’s been linked to the shots.) [Read: Why are we microdosing vaccines for kids?] Any medical intervention, including a vaccine, will come with risks that some parents may take comfort in avoiding. But “not getting a vaccination is not zero-risk, either,” Chomilo said. Forgoing a shot while SARS-CoV-2 is still ricocheting about means accepting a higher chance of sickness, which could be severe, lasting, or even lethal; it means accepting the higher chance that the virus could use a child as a conduit, and spread rapidly to someone else. Chomilo, for one, feels confident about the risk-benefit math. Earlier this year, he hurried to get his son vaccinated as soon as he aged into eligibility. “After he turned 5, we were in the very next day to get him his shot,” he told me. “It was something that we had no hesitation about.” In many ways, the rollout of this last round of shots might feel ill-timed, with few rewards waiting on the other side. Fresh off Omicron’s winter and spring surges, many kids have recently been infected and may now be at least partially buffered from a viral encore. Add to that “the view that maybe the pandemic is over, and we don’t need these vaccines quite as much,” de St. Maurice told me, and plenty of parents are primed to wait and see what comes next before jumping to vaccinate their kids. Summer’s right around the corner, and families are eager to move forward, past COVID, into the sunny, post-pandemic season that last year seemed to promise but never delivered. Masks and other mitigation measures, too, have been phased out of schools and other public venues, vanishing some of the most visible markers of the coronavirus’s crisis-level threat. If normalcy is the watchword, it doesn’t square with an urgent call for little kids to sprint toward an inoculation line. But there’s still an urgent argument to be made for near-term vaccination. Infections tend to leave behind rather scattershot protection, especially if their symptoms weren’t all that severe; the defenses laid down by the original Omicron subvariant, BA.1, also don’t seem to guard particularly well against some of its wilier siblings, including BA.2.12.1, which has become the dominant strain in the U.S. When vaccines are added on top of infection, though, protection skyrockets, both broadening and deepening, in order to help the body better recognize, then thwart, a whole bevy of SARS-CoV-2 morphs. “Anything you can do to help more, why not do it?” Ocwieja, the Boston pediatric infectious-disease specialist, told me. Her two sons, who have each caught the coronavirus twice, clearly weren’t protected enough from their first viral encounter to stave off a second, just a few months later. Trials in older kids also haven’t raised any safety concerns about inoculating children who have survived the virus. COVID, after all, will be a recurring danger for most of us, especially as the virus continues to spread with abandon, and new subvariants keep branching off. The wave of cases currently gripping the U.S. could yet get worse; a spike of even greater magnitude or speed could follow. Sokol, the New Orleans pediatric infectious-disease specialist, also points out that summer’s no time to let down our guard. In the South, especially, warm weather can pose its own perils, as people flock indoors unmasked to beat the heat. Families are also gearing up for travel, which will bring them into contact with new people, and potentially offer the virus new networks in which to spread. Vaccinating kids now, de St. Maurice told me, will steel them against what is inevitably on the horizon. Waiting for things to get worse is “too late,” she said. “You can’t predict when the next surge is, and the body needs time to mount an immune response.” Pfizer’s three-dose series, for instance, takes three months to complete—just in time for the start of the fall school year, if parents start now. “And there’s no guarantee the next variant will be as kind to kids,” Chomilo said. Every immunized body simply becomes more inhospitable to the virus, and gives it one less place to safely land. Vaccinated kids will pose less risk to vulnerable members of their communities, including immunocompromised or older people and infants under 6 months, and will help loosen the virus’s grip on the country. The virus’s impacts on kids, after all, haven’t just been direct: Countless children have, for two and a half years, had to endure a steady drumbeat of school closures, exposures, and the heartache of sick caregivers and friends--many of whom have died. But the push to vaccinate America’s youngest kids will still be an uphill fight—especially in parts of the country where the discourse about shots remains fraught. In Louisiana, where Sokol practices, just 39 percent of kids 12 to 17 years old, and 12 percent of kids 5 to 11 years old, have opted for their first two Pfizer shots. Many of the people in her community have been swayed by misinformation about the vaccines—that they’ll negatively affect kids’ fertility, or that they contain microchips, or that they’re still experimental and not to be trusted. “I don’t think it’s going to be an easy battle,” she told me. She and other experts pointed out that there isn’t just one thing staying parents’ hands over the COVID vaccines; the sluggish uptake is a multifaceted problem that will demand solutions just as diverse as strategies to vaccinate adults, if not more so. Hopefully, Sokol said, further devastation—more loss, more death, more disease, colliding further with little kids’ lives—won’t be necessary to persuade parents to protect their youngest. As children grow into adults, their vulnerabilities will increase; delays in protecting them could also ramp up the risks of exposures, whose effects may be impossible to erase. But Sokol and others have little choice but to play the long game. “Maybe a year from now,” she told me, “we’ll have made some steps forward.” from https://ift.tt/pM0Naq2 Check out http://natthash.tumblr.com In mid-March, I began to notice a theme within my social circle in New York, where I live: COVID—it finally got me! At that point, I didn’t think much of it. Only a few of my friends seemed to be affected, and case counts were still pretty low, all things considered. By April, images of rapid tests bearing the dreaded double bars were popping up all over my Instagram feed. Because cases had been rising slowly but steadily, I dismissed the trend to the back of my mind. Its presence nagged quietly throughout May, when I attended a party at a crowded hotel and hurled myself into a raging mosh pit. As I emerged, sweating, cases were still creeping upward. Only last week, more than two months later, did cases finally stop rising in New York—but they’ve plateaued more than they’ve fallen back to Earth. If you simply look at the case counts, this surge is not even in the same stratosphere as the peak of Omicron during the winter, but our current numbers are certainly a massive undercount now that rapid tests are everywhere. The same sort of drawn-out wave has unfolded across the Northeast in recent months, and frankly, it’s a little weird: The biggest waves that have struck the region have been tsunamis of infections that come and go, as opposed to the rising tide we’re seeing now. Other parts of the country currently seem poised to follow the Northeast. In the past two weeks, cases have noticeably increased in states such as Arizona, South Carolina, and West Virginia; California’s daily average case count has risen 36 percent. In April, I called the coronavirus’s latest turn an “invisible wave.” Now I’m starting to think of it as the “When will it end?” wave. [Read: Is America in the middle of an invisible wave?] Consider New York City, which by this point has been the epicenter of several waves, including the one we’re dealing with now. When Omicron arrived last fall, cases jumped very quickly as the new, more transmissible variant broke through existing immune defenses and infected lots of people, who spread the virus like wildfire. A combination of factors quickly extinguished the flame: People got boosted, the public-health messaging changed and some people changed their behaviors, and eventually so many had gotten sick that the virus had fewer people to infect. That’s not what seems to be happening now. For one thing, the shape of the curve feels different: From December 2021 to mid-February 2022—about two and a half months—Omicron erected a skyscraper on the charts. Since March, the current wave has drawn just the rising half of what looks to be a modest hill—and, again, the true shape is much taller. Broadly, the same trends have played out elsewhere, too. Now it’s June, and fresh images of rapid-test results are still circulating within my social circle. Why has this wave felt so different? The major reason, public-health experts told me, is that Americans, on the whole, are more protected against COVID now than they were during previous times when infections have soared. Omicron was a completely new variant when it first hit during the winter, and it swept through a large chunk of the country. “We built a lot of immunity due to so many people getting sick,” Marisa Eisenberg, an epidemiologist at the University of Michigan, told me. So far, that immunity seems to dampen the spread of the two new forms of Omicron that are behind the current, stretched-out wave of cases. “It’s imperfect, but it’s at least some protection,” Joe Gerald, a public-health professor at the University of Arizona, told me. “As we take people out of the susceptible pool, basically the math works against a large and fast outbreak, so it would tend to slow transmission and make the size of the wave smaller.” Another major factor at play is the onset of warmer weather, especially in colder parts of the country. School’s nearly out, if it isn’t already, and though people are getting together and traveling more, they’re likely doing so outdoors. In other words, even if people are getting infected with new Omicron strains, they’re not able to spread it as efficiently. “These aren’t ideal transmission conditions for this usually winter virus,” Gerald said. Seasonality may also be one reason that cases first rose in the Northeast, given that the “When will it end?” wave began when it was relatively cooler and people were inclined to gather indoors. [Read: COVID sure looks seasonal now] The UCLA epidemiologist Tim Brewer said he’s confident that COVID is settling into similar seasonal patterns as illnesses such as the flu and the cold. We’ve seen smaller waves before outside of the winter months, he pointed out. “What’s going on right now is very similar to what happened if you look back at 2020, around June through July. It had this gradual rise in cases and then things kind of leveled off for a while. Hopefully [soon] they’ll level off.” That being said, what we’re seeing now is not identical to earlier stages of the pandemic: Reported cases are much, much higher now versus in summer 2020, and that’s before you account for all the missed infections right now. Also the onset of the summer 2020 wave was not as maddeningly slow as this one has been. Meanwhile, reported cases are continuing to climb in other regions, namely the South and Southwest. That raises the uncomfortable, frustrating possibility that we’ll be stuck in this wave for quite some time. But then again, even that is hard to know right now, especially as our view of basic pandemic numbers is so murky. “What makes it difficult to understand how a new wave might play out is that we’re still struggling to understand what the size of our susceptible population is, how many people have truly been infected, and how quickly immunity wanes from both vaccination and prior infection,” Gerald said. Eventually, as we learn more about this virus, we might get better at predicting its next turn. But for now, “there’s also going to be weirdo surges that happen whenever they happen,” Eisenberg added. There’s no sugarcoating it: The “When will it end?” wave is frustrating. We’re entering our third pandemic summer, and yet again cases are high enough that activities such as indoor dining and weddings can come with a real fear of getting sick. But that pattern of slow and steady spread has benefits as well. It’s exactly what we need to prevent our health-care system from getting overwhelmed—with all the side effects of delayed procedures and hospital burnout that comes along with that. Some 25,000 Americans are currently hospitalized with COVID, compared with more than 150,000 at the height of Omicron. There’s a reason “flatten the curve” became an early pandemic slogan—by drawing out infections, we’re helping to ensure that hospitals have space for us when we need it, whether that’s for COVID or any other reason. But we shouldn’t get too comfortable. This winter could be bad once again—the Biden administration predicts that we’ll see 100 million new cases during the fall and winter, and a new variant could still worsen that outlook. Such a dire situation is not inevitable, though. If anything, the “When will it end?” wave is a reminder that dramatic, all-consuming surges are not necessarily our destiny. Slowing this virus down, whether that’s through vaccinations or ventilation upgrades—or, in this case, the fortunate coincidence of immunity and weather—can go a long way. “The more we interfere with the ability of this virus to replicate and transmit, the fewer the cases will be, and the less we interfere with its ability to replicate and transmit, the more cases there will be,” Brewer said. “It’s just as simple as that.” from https://ift.tt/50LMIHF Check out http://natthash.tumblr.com |
Authorhttp://natthash.tumblr.com Archives
April 2023
Categories |