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CNN
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Two weeks after the United Kingdom dropped its last remaining Covid-19 mitigation measure – requiring people who test positive for the virus to self-isolate for five days – the country is seeing cases and hospitalizations rise once again.
Last week, Covid-19 cases in the UK rose by 48% compared to the previous week. Hospitalizations increased by 17% over the same period.
The country’s daily case rate – about 55,000 a day – is still less than a third of Omicron’s peak, but cases are rising as fast as they were falling just two weeks ago, when the country lifted pandemic-related restrictions.
Daily cases are also increasing in more than half of the European Union countries. They jumped 48% in the Netherlands and 20% in Germany in the past week, according to data from Johns Hopkins University. But daily cases in Germany have yet to fall below pre-Omicron levels, and the Netherlands has not seen as many cases drop as the UK.
The situation in Europe draws the attention of public health officials for two reasons: first, the UK offers a preview of what might play out in the United States, and second, something unusual seems to be happening. In previous waves, the spike in Covid hospitalizations lagged behind the jump in cases by about 10 days to two weeks. Now, in the UK, with the number of cases and hospitalizations increasing, it seems experts are stumped.
“So we’re obviously very interested in what’s going on with that,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN.
Fauci said he had spoken to his UK counterparts, and they attributed the increase to a combination of three factors. In order of contribution, Fauci said, these are:
- BA.2 variant, which is more transmissible than the original Omicron
- As society opens up, people are mingling more indoors without masks
- Reduced immunity from vaccination or previous infection
In a technical briefing on Friday, the UK Health Security Agency said that BA.2 has an 80% higher relative growth rate than the original Omicron strain, although it does not appear to be more likely to cause hospitalization.
Given that BA.2 does not appear to cause more severe disease – at least not in the highly vaccinated British population – it is not clear why hospitalizations are increasing.
“The hospitalization issue is a little bit more puzzling, because even though hospitalizations are increasing, it’s very clear that their ICU bed utilization is not increasing,” Fauci said. “So is the number of hospitalizations a true reflection of the number of Covid cases, or is it difficult to discern between people who come to hospital with or because of Covid?”
The UK, like the UK, has lifted most mitigation measures as Covid-19 infections have fallen. Two weeks ago, the US Centers for Disease Control and Prevention changed how it measures the impact of Covid-19 in communities. The new metric — which depends on hospitalizations and hospital capacity in addition to cases — eliminated masking recommendations for most parts of the country. States and schools have followed suit by lifting indoor masking requirements.
Read: Your top Covid questions, answers
“Without a doubt, opening up society and getting people indoors is clearly something that’s contributing, as well as overall declining immunity, which means we really need to keep our heads up and keep an eye on the patterns here,” Fauci said. “So that’s why we’re looking at this very carefully.”
“It’s like a weather warning,” Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN. Right now, the sky is sunny and bright, and we hope it stays that way. But we could have bad weather by evening, and we don’t know.”
BA.2 continues to grow in the US. Last week, the CDC estimated that it was causing about 12% of new Covid-19 cases here.
Meanwhile, BA.2 now accounts for more than 50% of cases in the UK and several other European countries.
“The tipping point seems about 50% correct,” said Kerry Althoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. As far as its severity is concerned, “that’s when we really start to flex that kind of power in the population.”
Althoff said that while the UK can provide a glimpse of the future, there are key differences that will affect how BA.2 plays out in the United States.
In the UK, 86% of eligible people receive the full vaccine, and 67% receive a boost, compared with 69% eligible vaccinations and 50% boosts in the US.
“What we’ll see happening in the UK will probably be a better story than what we should expect here,” Althoff said.
In the Netherlands, it took BA.2 about a month to overtake BA.1, she noted. If the same timeline occurs in the US, it would mean that the variant is dying out just as immunity generated by winter Omicron infection is waning.
“I’m worried about that,” Althoff said. “But we were in a similar situation last spring, where we were really hoping things were going to settle down, and we got a little summer, and then we got surrounded by the Delta.”
It’s important for people to understand that they may be able to take off their masks for a few weeks, but may need to go back to wearing them regularly if cases increase, Elthoff said.
“We may see another wave of illness in our hospitals,” she said.
Althoff will also be keeping a close eye on wastewater data over the next few weeks.
“Wastewater monitoring is an amazing breakthrough in how we can monitor SARS-CoV-2 and what it’s doing in the population without requiring any input from people,” she said. “Monitoring wastewater is an important tool to understand where the virus is going and whether it is increasing in terms of infection.”
Protection against the next variant should start with vaccination.
“We absolutely have to continue to find people who are unvaccinated and get them vaccinated,” Althof said.
Fauci agreed that vaccination rates could be better across all age groups but said current numbers are particularly bad for children. Data collected by the CDC shows that about 28% of children aged 5 to 11 years are fully vaccinated, while 58% of children aged 12 to 17 years have received two doses of the Covid-19 vaccine.
Even though the youngest children, under the age of 5, cannot yet be vaccinated, recent studies have shown that young children are less likely to catch Covid-19 when they are surrounded by vaccinated older children and adults.
“So the way you protect them is to have children, to the extent possible, with people who are vaccinated and encouraged so that you have a veil of protection around them,” Fauci said.
It will also be important to continue to be flexible.
“The important thing in this large experiment where we’re leaving all the masking and restrictions is that we have to be diligent in terms of monitoring and testing it and possibly being prepared to reverse a lot of these restrictions,” Deborah Fuller said. Fuller said. , a microbiologist at the University of Washington.
“We cannot let our guard down, because when people say ‘we are lifting restrictions’ the message is that the epidemic is over. And it’s not,” she said.
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