With pandemic surging again, will protective measures just get ignored?

The coronavirus pandemic is surging anew, with federal health officials warning that just under half of Americans live in parts of the country where transmission rates have increased sharply enough that they should return to wearing face masks in public, indoor settings.

Older Americans, officials say, should get a second booster shot if more than four months have passed since their first booster. This is an upgraded recommendation from before, when officials  described the additional shot as an option for those 50 and only encouraged it for those 65 and older.

As for those ages 5 to 11, federal regulators are recommending boosters for this group of kids if at least five months have passed since their last shot. Officials in January had recommended boosters for those ages 12 and older.

The renewed push for boosters is occurring as officials see with growing concern a spring-summer pandemic spike, with the New York Times offering this concise situation report on the worst public health crisis in a century:

“The United States is currently averaging more than 100,000 known cases per day for the first time since February. Cases are rising in nearly every state, and since many cases go uncounted in official reports, the true toll is likely even higher than these figures suggest. In New York City, where cases have doubled in the past month, officials recently declared a state of ‘high Covid alert.’ Hospitalizations, meanwhile, are increasing in all but five states and territories. Though the number of coronavirus patients hospitalized nationwide remains far below peak levels, it has increased by 29% in recent weeks, to an average of more than 23,000 per day. This week, the U.S. reached one million total coronavirus deaths, a once-unimaginable loss. The milestone comes amid declining daily rates of new deaths nationwide. Fewer than 350 fatalities are currently announced each day, a decrease of 17% in the past two weeks.”

Believing the pandemic is over

In seeking to quell the pandemic, however, the Biden Administration confronts significant obstacles. As the Axios-Ipsos poll has found (see chart above):

“Nearly one in three (31%) say that the Covid-19 pandemic is over. Large partisan differences exist, with 59% of Republicans, 27% of independents, and just 10% of Democrats saying the pandemic is over. Those that are unvaccinated are more likely to say the pandemic is over (55%) than those that are vaccinated (22%). The bulk (71%) of Americans describe the pandemic as a problem, but manageable, versus 14% that say it is a serious crisis.”

Ashish Jha, the new White House coronavirus response coordinator, told the media that he and other public health officials get it. He said that pandemic exhaustion is endemic now in the country, as the Vox news site reported:

“People are tired. People want to move on. The good news is we’re in a way better place than where we were two years ago, largely because of the capabilities that science has delivered for us. Vaccines, boosters, therapeutics, testing, masks — all of that makes an enormous difference. And we’ve got to keep using that as the virus evolves and as the virus continues to do what it’s doing.”

At the same time, though, complacency — and especially political lethargy — soon could be lethal, causing untold preventable harms and deaths, Jha and other administration officials say. As Vox reported:

“The White House has been asking Congress for billions of dollars for the next phase of the pandemic response since early March. It looked as though the money would be quickly approved, but it was pulled from a government spending bill at the last minute. Lawmakers have been trying to finalize a deal ever since. At one point, Congress cut about $5 billion in global response funding, money that would have supported vaccination efforts in other parts of the world, where rates are lagging. Jha, perhaps not by coincidence, warned … against shortsightedness in supporting the rest of the world’s fight against the coronavirus. ‘There is no “domestic-only” strategy to a global pandemic,’ Jha said. ‘We’ve now got to continue that work by making sure that we’re getting vaccines into people’s arms.’

“But Congress’s inaction also jeopardizes the pandemic response in the United States. A next generation of Covid-19 vaccines is expected to come to the market soon, but without more funding from Congress, the White House won’t be able to guarantee a shot for every person who wants one. They may have to ration the next-gen vaccine doses that they can afford, limiting access to the most vulnerable individuals, a possibility that Politico referred to as ‘unthinkable’ a year ago. The federal government is also depending on more funding in order to increase the supply of antiviral medications that can make infections less severe. Jha noted in the briefing that prescriptions for Paxlovid had increased fourfold in the last month, outpacing the increase in cases, a sign that the U.S. was finally doing a better job getting that treatment to people.”

Testing capacity across the country also soon may shrivel as funding runs out. Improved supplies of home tests have dimmed health officials’ ability to gauge the full extent of pandemic surges now, experts say. But if a pandemic funding compromise is not struck soon, it will be fact not discussion about the nation’s diminished testing capacities.

Republicans in Congress have for months now bellyached and campaigned against the administration on various health-related concerns, including an effort to control skyrocketing costs for lifesaving insulin. They have stalled pandemic money by saying the nation’s economy is awash in cash (causing inflation, they say) and contending that the White House needs only to renege on and to retake pandemic aid promised to states, counties, cities, and other local governments. This idea has gotten a blistering response from governors and others. GOP leaders also have assailed the White House for wanting to cancel pandemic-related restrictions at the border, tying up pandemic aid in the complex, freighted politics of immigration.

But obdurate GOP lawmakers — and some Democrats, too — have raised critics hackles, too, by wailing about baby formula shortages and then voting by the dozens against bills to deal with shortfalls. Or by balking at domestic terrorism legislation and refusing to denounce white supremacists and to consider weapons measures after police captured a racist gunman who fatally shot 10 black patrons at a Buffalo, N.Y., grocery. House Democrats have blasted their GOP colleagues for voting en masse against bills targeting Big Oil for gouging Americans with sky-high gas prices. Sound like a brutal midterm election is right around the corner?

Persistent threat from long Covid

Long before then, Americans have plenty of reasons to take the pandemic seriously still and to consider their health and that of their loved ones in deciding whether to get vaccinated, and boosted, as well as to cover their faces again, put distance between themselves and others, and lessen their exposure to time indoors, especially in spaces not well ventilated.

New research continues to show the significant risk of coronavirus infection. Sure, it may not send patients to the hospital or kill them in the ways it did just a few months ago (credit that to vaccination, the high percentage of the population already infected, and various public health precautions and increasing treatment options).

Still, medium and long Covid is not a condition anyone wants to fool with. New research shows that three-quarters of those it afflicts did not suffer an initial illness serious enough to require hospitalization, the New York Times reported:

“Long Covid, a complex constellation of lingering or new post-infection symptoms that can last for months or longer, has become one of the most daunting legacies of the pandemic. Estimates of how many people may ultimately be affected have ranged from 10% to 30% of infected adults; a recent report from the U.S. Government Accountability Office said that between 7.7 million and 23 million people in the United States could have developed long Covid. But much remains unclear about the prevalence, causes, treatment, and consequences of the condition. The new study adds to a growing body of evidence that, while patients who have been hospitalized are at greater risk for long Covid, people with mild or moderate initial coronavirus infections — who make up the vast majority of coronavirus patients — can still experience debilitating post-Covid symptoms including breathing problems, extreme fatigue, and cognitive and memory issues.”

The independent, nonpartisan Kaiser Health News service reported disconcerting information about long Covid’s effects on older adults:

“In the largest study of its kind, published recently in the journal BMJ, researchers estimated that 32% of older adults in the U.S. who survived covid infections had symptoms of long covid up to four months after infection — more than double the 14% rate an earlier study found in adults ages 18 to 64. (Other studies suggest symptoms can last much longer, for a year or more.) The BMJ study examined more than 87,000 adults 65 and older who had covid infections in 2020, drawing on claims data from UnitedHealth Group’s Medicare Advantage plans. It included symptoms that lasted 21 days or more after an infection, a shorter period than the CDC uses in its long covid definition. The data encompasses both older adults who were hospitalized because of covid (27%) and those who were not (73%). The higher rate of post-covid symptoms in older adults is likely due to a higher incidence of chronic disease and physical vulnerability in this population — traits that have led to a greater burden of serious illness, hospitalization, and death among seniors throughout the pandemic.”

KHN added more troubling information about the condition and older adults:

“Applying the [BMJ] study’s findings to the latest data from the CDC suggests that up to 2.5 million older adults may have been affected by long Covid. For those individuals, the consequences can be devastating: the onset of disability, the inability to work, reduced ability to carry out activities of daily life, and a lower quality of life. But in many seniors, long covid is difficult to recognize. ‘The challenge is that nonspecific symptoms such as fatigue, weakness, pain, confusion, and increased frailty are things we often see in seriously ill older adults. Or people may think, “That’s just part of aging,” said Dr. Charles Thomas Alexander Semelka, a postdoctoral fellow in geriatric medicine at Wake Forest University.”

The very real re-infection threat

Those who do not want to be fatalistic or nihilistic will find further reason to safeguard themselves as much as they can against the coronavirus, because it is proving that it can reinfect people. Several times. In short spans. As the New York Times reported:

 “A virus that shows no signs of disappearing, variants that are adept at dodging the body’s defenses, and waves of infections two, maybe three times a year — this may be the future of Covid-19, some scientists now fear. The central problem is that the coronavirus has become more adept at reinfecting people. Already, those infected with the first Omicron variant are reporting second infections with the newer versions of the variant — BA.2 or BA2.12.1 in the United States, or BA.4 and BA.5 in South Africa. Those people may go on to have third or fourth infections, even within this year, researchers said in interviews … It’s difficult to quantify how frequently people are reinfected, in part because many infections are now going unreported … [based on] collected .. data in South Africa … the rate is higher with Omicron than seen with previous variants. This is not how it was supposed to be … Unlike previous variants, Omicron and its many descendants seem to have evolved to partially dodge immunity. That leaves everyone — even those who have been vaccinated multiple times — vulnerable to multiple infections.”

Protect yourself, please

We are not done with the pandemic — and the coronavirus doesn’t care how casual we wish to be about the death and debilitation it can cause. Those with heightened vulnerability to the illness — those who are older, immunocompromised, overweight, and with underlying conditions, or individuals from hard-hit communities of color — still should stay careful, including by keeping on their masks. And, yes, so-called one-way masking has protective benefits.

The savvy will want to build up not discard their supply of masks, nabbing test kits, too (free from the federal government, including a second round of them, and delivered to your door). Just in case.

The vaccines remain life changers and life savers. If you have not gotten your shots, please do so, boosters and all, pronto.

If you haven’t chatted with your doctor for a bit, you should — especially about whether your individual health would benefit from an additional dose of vaccine and when might be the time to get it. Parents should discuss potential shots for their youngest kids and boosters for the older siblings with their pediatricians. (Get the young folks caught up on their shots now if you can, too.) If you have been exposed or think you have gotten infected, please get tested — and quarantine or isolate to protect yourself and others.