By Mahlon Meyer
NORTHWEST ASIAN WEEKLY
An uptick in COVID-19 cases means we all must be careful again.
“It’s not a surge, it’s rather a swell, a gentle wave is coming,” said Peter Chin-Hong, associate dean for regional campuses at the University of California, San Francisco, who specializes in treating infectious diseases.
Already, in Washington state, COVID-19 hospitalization cases have increased over 90% over the past month, according to the Department of Health (DOH).
Still, compared with a year ago, we are still in relatively safe territory, added Chin-Hong, speaking at a webinar sponsored by Ethnic Media Services earlier this month, “It’s very clear: Covid is here to stay.”
A year ago, in Washington state, there were 519 hospitalizations on account of the disease over a 7-day period (8/12/2022-8/18/2022).
By contrast, at the beginning of July, there were 125 cases in seven days, which had risen to 238 by the beginning of this month (there is a 6-day time lag in reporting and calculating numbers).
More still to come
Still, with the opening of school coming, experts like Chin-Hong expect more cases to emerge.
Other factors for the expected surge are numerous.
People are now getting together more, as the pandemic has waned.
This is true not just in the U.S., but abroad.
Cases are going up in Ireland, the U.K., France, Brazil, New Zealand, China and elsewhere.
Pandemic fatigue has kicked in, so people are less inclined to use masks.
Heat waves, across the country and around the world, are driving people indoors where the air is not as fresh and can become crowded with viruses floating in water droplets.
At the same time, people’s immunity is waning. For many, it has been more than six months since they got a vaccine.
“As a result of all these factors, we’ll see a small rise in the summer, in advance of a bigger rise in the winter,” said Chin-Hong.
Better at knowing what to do
However, despite all this dreariness and foreboding, there is cause for good news.
As a result of changes wrought by the pandemic itself coupled with the awesome advances of modern science, “there is not as much of an uptick as there might be,” said Chin-Hong.
In the first place, overall, more people have been exposed to COVID-19 than a year ago, ratcheting up their immunity, along with the powerful immunity engendered by vaccines.
“The population is now inhospitable soil,” said Chin-Hong.
In the second, the pandemic is now no longer an unfamiliar adversary.
“We are better at knowing what to do when someone has COVID-19,” said Chin-Hong.
Science has taught us, for instance, that the earlier you treat infections, the better.
“At the beginning of the pandemic, we were reserving treatment for serious cases,” said Chin-Hong. “Now, as soon as someone is infected, we are giving Paxlovid,” an anti-viral therapeutic treatment.
One reason for this change is the recognition that at least 10% of those infected with SARS-CoV-2–the coronavirus that causes COVID-19–will have symptoms that last more than a month, and perhaps much longer, which is now called “chronic” COVID or long COVID.
The strain of the virus that is fueling the current spread is a version of the EG5 variant of Omicron.
As the virus mutates, new variants change at the site that is targeted by the immune system and vaccines—the receptor binding site.
This makes it all the more urgent for people to get vaccinated when the new vaccine is released in the fall, since it is designed to combat the new variants.
“Until the vaccine is up to date, no one is up to date,” said Chin-Hong. “Until then, we’re all hanging.”
Still, the current vaccine does provide protection against the current mutated virus.
It is all a matter of how recently you’ve been inoculated—or gotten infected.
“The more recent your immunity, the more recent your vaccine, the less likely you are to have a severe reaction,” said William Schaffner, professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine, another member of the webinar. “All the new variants are fairly close, and the vaccine works against all of them.”
Wondering whether you are up to date with COVID-19 vaccines? Visit the CDC page.
If one does become infected, we are in a better place than a year ago.
Not only do we have therapeutic agents such as Paxlovid, which stops the virus from replicating, but new therapeutics are being studied.
The phenomenon known as “Paxlovid rebound” is real—and involves one-third of all people treated with the therapeutic.
It happens because Paxlovid suppresses the replication of the virus, but it does not do so completely.
Thus, when Paxlovid is withdrawn, inflammation occurs.
“If you get a rebound, we treat it just like another infection,” said Chin-Hong.
Still, he added, there has been no authoritative study of the phenomenon.
“In any event, compared with people who don’t take Paxlovid, you’re much better off,” he said.
“Go to another drug store”
Other issues involving therapeutics like Paxlovid are the result of the federal public health emergency having ended on May 19.
Treatments for COVID-19 are, as a result, now handled through the conventional health care system.
This means an individual needs to go through the usual channels for care: contact a medical provider, check insurance coverage, and wait for an appointment.
“I am concerned about minority communities,” which are traditionally underserved, he said.
Even testing may become an equity issue, said Chin-Hong.
Now that tests are no longer subsidized by the federal government, “who’s going to pay $25 for testing at Walgreens for the sniffles?”
Vaccines, however, are still supposed to be free through the Washington State Adult Vaccine Program and Vaccines for Children Program.
“If you don’t get the right answer from one drug store, go to another,” said Chin-Hong.
When is the end?
Benjamin Neuman, another panelist, is professor of Biology and chief virologist at the global health complex at Texas A&M University.
Despite the spread and necessary preventative measures, he is optimistic.
“The moon is far away. Mars is far away. But we’ve been to both places. The end of Covid may be far away. But the biggest problem is in people’s hearts. Stop the fear,” he said.
Added Chin-Hong, “Who’d ever believe we’d rally together as a world—to come up with lots of tools to fight this?”
All three experts recommended masking in indoor public places, especially when those spots are crowded.
“I will wear a mask in public for a month and then see where we are,” said Neuman.
“You can still get chronic [long] Covid,” said Chin-Hong.
Mahlon can be reached at firstname.lastname@example.org.
Made possible in part by the Washington State Department of Health through a grant from the Centers for Disease Control and Prevention. This information does not necessarily reflect the official policies of the Washington State Department of Health or the Department of Health and Human Services.