Across the nation there is an understandable sense of Covid-19 fatigue and a push has begun by many state and local governments to relax restrictions that were imposed including masking, isolation, social distancing, and other precautionary measures. For example, Gavin Newsom, the Governor of California, has announced that Covid-19 will be considered endemic, and there will be a series of measures put in place to manage the situation. Other states such as New York and Rhode Island have recently dropped their mask mandates and Illinois, New Jersey and Oregon will do the same in the near future. Internationally, the Prime Minister of the UK, Boris Johnson, announced that there will be a total lifting of Covid-19 restrictions there in the weeks ahead. Many have been asking: Is it too soon to drop all Covid-19 restrictions, and treat this as endemic?
After almost two years since the WHO declared a global pandemic, and a little over three months since the most recent Omicron-driven surge saw over 800,000 infections reported per day at its peak in the U.S., we are thankfully seeing downward trends in infections, deaths, and hospitalizations across the nation. In the two weeks leading up to February 22, 2022, Covid-19 cases decreased by 66%, hospitalizations were down 44%, individuals in the I.C.U.s were down 41%, and deaths down by 24%. Despite this, the United States is still experiencing high levels of Covid-19 infections. There is still a daily average of around 81,000 cases, 62,000 hospitalizations, and just over 2,000 deaths. Additionally, vaccination rates have plateaued drastically with the 7-day average trending downwards at about 425,000 doses, down 25% from the previous week, and a far cry from the high point when 2,009,864 doses were administered at the beginning of December 2021. Currently, only around 65% of eligible Americans are fully vaccinated (215 million) and 76% have received at least one dose.
Infectious disease experts have been watching the BA.2 subvariant, a significantly more contagious variant of Omicron, quickly take hold in Denmark, where it has been the dominant strain for weeks. Interestingly, Denmark lifted all Covid-19 restrictions earlier this month. In Ireland, BA.2 cases are growing at 10% per day and it is expected to become the dominant strain by the end of February. Analysts at AM LLC have been tracking reporting on the BA.2 subvariant of Omicron, and there is a growing belief among some public health experts that we must remain extremely wary and hesitant of dropping all restrictions too soon. Our analysis of over 17,000 Tweets from the past week mentioning BA.2, showed increasing concern from scientists and members of the public, and calls for it to be designated a Virus of Concern.
BA.2 is present in the US and estimated to account for about 3.9% of cases. Samuel Scarpino, the manager director of pathogen surveillance at the Rockefeller Foundation told NPR, “If it doubles again to 8%, that means we’re into the exponential growth phase and we may be staring at another wave of COVID-19 coming in the U.S,” and Dr. Jeremy Luban, a virologist at the University of Massachusetts Medical School cautioned that “there are going to be plenty of people getting sick and ending up on respirators and dying because of BA.2.” While there is much to learn about the BA.2 strain, lab studies indicate that it may cause more severe disease and might be able to overcome some of the protective measures we have in place, and escape immunity created by vaccines.
The WHO is concerned that as testing rates and surveillance efforts are scaled back around the world, this provides an opportunity for variants to gain a foothold. Maintaining monitoring, testing and case management systems is still critically important because the perceived gains in case numbers we are experiencing may not be a true reflection of the situation.
Given the recent emergence of the BA.2 subvariant, a complete lifting of protective measures might be considered unwise, especially given how many lives have been saved as a result. While it is understandable that we must learn to live with Covid and treat it as endemic, lifting restrictions quickly and without acknowledging that the risk is far from over, likely has more to do with the massive social and economic toll the pandemic has had on our communities than what the science is telling us.