Top U.S. health officials warned Tuesday that a surge in COVID-19 cases driven by the highly transmissible Omicron subvariant BA.5 has arrived, but stressed that the country has the tools — such as vaccines and antiviral treatments – to prevent people from becoming seriously ill.
“We know how to manage it,” Dr. Ashish Jha, the White House’s COVID-19 response coordinator, said in a virtual press briefing. “We can prevent serious diseases. We can save lives and we can minimize the disruptions caused by COVID-19.”
According to the Centers for Disease Control and Prevention, the BA.5 subvariant now accounts for 65% of current cases of COVID-19 in the United States.
Dr. Anthony Fauci, the nation’s top infectious disease expert and President Biden’s chief medical adviser, said BA.5 “substantially evades neutralizing antibodies” induced in people who have been previously vaccinated or infected.
But Fauci said current vaccines are “still effective in preventing severe outcomes of COVID-19” such as hospitalization and death — and urged Americans to stay up to date with their COVID shots.
“The threat to you is now,” he said. “If you’re not vaccinated to the max … then you’re putting yourself at an increased risk that you can mitigate by getting vaccinated.”
The warnings Tuesday from Fauci and other top COVID officials come as the United States transitions into what experts describe as a new phase of the pandemic.
Call it the age of reinfection.
“BA.5 puts the nail in the coffin of the myth that the virus evolves into a milder form and disappears,” Dr. Eric Topol, founder of the Scripps Research Translational Institute, he wrote Tuesday in the Los Angeles Times. “We could easily see more variants—indeed a whole new family with broader immune evasion and growth advantage—in the coming months.”
At first, COVID-19 seemed like a one-and-done infection. No more. The primary culprit is BA.5, which has a bunch of mutations that make it better than any of its predecessors at dodging all the immune defenses we’ve built up over two and a half years of infection and vaccination, then infecting anyway.
BA.5 is not the first evasive variant we have come across; both Delta and earlier versions of Omicron also avoided first-generation antibodies. But BA.5 and its close cousin, BA.4, are unique because they evolved specifically to evade the huge amount of fresh immunity left by the original iteration of Omicron after it swept the world last winter – meaning that the old assumptions about a recent infection completely protecting you from rapid reinfection no longer apply.
“We know [BA.5] to be more transmissible and more immune evasive,” CDC Director Rochelle Walensky said at Tuesday’s briefing. “People with prior infection, even with BA.1 or BA.2, are probably also at risk for BA. 4 and BA.5”.
None of this will bring the United States back to square one. Despite high levels of cases, there are now fewer US COVID patients in intensive care units than there were during earlier stages of the pandemic, and the national death rate (about 300 to 400 per day) is close to all time low. Acquired immunity, multiple vaccinations and better treatment options help – a lot.
“Even in the face of BA.5, the tools we have continued to work,” Jha said on Tuesday, noting the importance of boosters for those over 50 and post-infectious treatments such as Paxlovid.
But to our immune system, the distance from BA.1 to BA.5 greatly mutated is “much bigger“That the distance between the original SARS-CoV-2 virus and previous blockbuster variants such as Alpha and Delta – which makes it more difficult to recognize and respond. According to the latest research, this could mean:
So far, the rise of BA.5 in the United States has coincided with the decline of previous versions of Omicron, leading to what appears to be a plateau in national case counts of about 100,000 per day. (Most infections go unreported, as Americans increasingly rely on rapid at-home tests rather than the PCR tests used earlier in the pandemic.) But reinfections have doubled in recent weeks in places like San Diego County, Calif., and test positivity, hospitalizations and even ICU admissions have steadily increased across the country. Experts worry that the virus’s accelerated evolution and aggressive new trajectory — toward greater transmissibility, evasiveness and possibly pathogenicity — could endanger vulnerable Americans in the coming months.
According to CDC data, 67% of the US population is considered fully vaccinated, after receiving the first two doses of the Pfizer or Moderna COVID-19 vaccines or the single dose Johnson & Johnson COVID shot. But less than half of those eligible for boosters (47%) got one, and a new booster aimed at BA.5 is not expected until October at the earliest.
“It’s very, very clear … that immunity declines, whether it’s immunity after infection or immunity after vaccination,” Fauci said Tuesday. “If you’re infected with BA.1, you don’t have good protection against it [infection with] BA.5.”
And although the US daily death toll is lower than it was earlier in the pandemic, it is still “too high,” Jha said.
“We are at a stage in the pandemic when most of the COVID-19 deaths are preventable,” he said.
“Variants will continue to emerge as the virus circulates around the world and in this country,” Fauci added. “We shouldn’t let it disrupt our lives, but we can’t deny that it’s a reality we need to deal with.”
To that end, Jha said the administration would publish two reports on “long-term covid” in early August, followed by a strategy to accelerate the development of next-generation vaccines that can protect against all variants of the coronavirus and stop the infection before it starts.
“You will be hearing more from us in the days and weeks ahead,” Jha said. “It’s something we’ve been working on very diligently.”