The Covid virus has a Darwinian quality. As variations emerge, they compete with each other to become dominant. The most contagious variants tend to win the competition because they can spread faster. It is the survival of the fittest.
That’s why the virus has become more contagious over time. Today, the most contagious form of Covid – subtype BA.5 – is spreading globally. “It doesn’t seem like we can control it,” Dr. Charles Chiu of the University of California, San Francisco, told The Times.
In the US, cases has increased recentlyas well as the number of patients hospitalized for Covid (although some of them were hospitalized for other reasons and happened to test positive for the virus while in the hospital):
At the same time, I know that many readers are not sure how much attention they will pay to Covid. Most Americans are immunized, and the vaccine provides excellent protection against serious illness in most cases. In a recent Times poll,Less than 1% of Americans describe Covid as the country’s most important problem.
Dr Ashish Jha, President Biden’s Covid coordinator, told me: “I’m really glad to see that the pandemic isn’t the most important thing. “It means we are making progress. The last thing I want as a Covid response coordinator is for us to go back to a time when Covid dominated our lives in terrifying ways.”
Today’s newsletter provides a guide to thinking about BA.5, including steps the United States can take to minimize its damage.
Powerful tools…
During a pandemic, people often pair two different concepts: spread and severity. The first concerns how easily the virus spreads. The second concerns how prone the average person is to get infected.
Both problems. A more contagious variant infects more people, increasing numbers the person is seriously ill even if percentage of infected people seriously ill people remain the same. On the other hand, a more severe variant increases the incidence of cases leading to a bad outcome.
But the two concepts are different. If the prospect of getting Covid hasn’t dominated your life in recent months – because you’re boosted and not in the high-risk category – a new variant doesn’t need to cause major changes to behavior. your vi unless it’s more serious.
So far, evidence suggests that BA.5 does not cause more severe disease than other Omicron variants, as Chiu and other experts have said. Instead, the percentage of Covid cases that lead to a bad outcome is declining.
Consider these comparisons: covid cases increase faster than hospitalizations (again, including many people with Mild Covid requires hospitalization for other reasons). In turn, the number of hospitalizations increased faster than the number of Covid patients in the ICU, and the number of Covid deaths barely increased.
One reason is the steady formation of natural immunity, as more and more people contract the virus. Another factor is the availability of drugs such as Evusheld (to help protect immunocompromised people from infection) and Paxlovid (to reduce severity in infected people). “We have the ability to protect ourselves,” said Dr. Joseph Kanter, Louisiana’s chief medical officer, speak.
Paxlovid is not perfect. Many people find that it leaves an unpleasant taste and recovery case – in which people get sick again after taking the drug – is quite common. But those rebounds tend to be mild. As Jha said: “When you have people with Paxlovid, they don’t have to go to the hospital. We know it’s working. “
What about long Covid? It is still something of a mystery, and many experts hope that scientific research can eventually clarify what it is and how many people suffer from it. The vaccine seems to reduce the risk of long-term symptoms, and those symptoms seem to go away within a few months in a very high percentage of cases, says Jha.
However, if even 2% of infections lead to long-term problems, that number would represent millions of people around the world, which is why more research is important. Until then, long-term Covid will resemble many other everyday risks: Some people will largely ignore it, while others will try to minimize the risk (e.g. by wearing a mask during the day). home). Both approaches seem reasonable.
… Not always used
The United States, like many other countries, already has most of the tools needed to combat BA.5. Unfortunately, many people don’t use those tools.
Only about half of American adults received a booster shot. Even less received a second boost. (Anyone age 50 or older is currently eligible to get a shot, and the Biden administration appears likely to expand eligibility soon.) Jha offers this general rule: If you haven’t been vaccinated. vaccine – of any kind – in 2022, consider getting one. .
For their part, many doctors are still unaware of the evidence that Paxlovid and Evusheld made a difference. This slow adoption is typical for new drugs, but it is costly in the case of Covid.
The hardest decisions are probably for those who are up-to-date on vaccinations and are willing to take Paxlovid if they get sick, but are still at risk because they have underlying injuries, such as old age, heart problems or being treated for cancer . In these cases, an increase in BA.5 could cause you to wear more masks, skip certain indoor events, or postpone travel. In the long run, it’s a reminder that medical research to find more effective vaccines and treatments continues to have the potential to save lives.
An increase in BA.5 is unlikely to lead to big new Covid rules, like mask regulations, even in the most formerly liberal cities that were the fastest to adopt them. “You can’t always be like a crying wolf,” said Dr. Allison Arwady, Chicago health commissioner, told The Times. Most Americans are understandably tired of such duties. It’s not even clear How well did the mission work?.
But Covid is still killing alarmingly high number of Americans. The start of BA.5 could offer a reminder that there is a middle ground between allowing Covid to rule everyday life and pretending that the pandemic is over. “We shouldn’t let it disrupt our lives,” said Dr. Anthony Fauci, the top federal infectious disease official. “But we can’t deny that it’s a reality that we need to deal with.”
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