US at Covid pandemic crossroads as omicron subvariants emerge

Dr. Anthony Fauci, White House Chief Medical Advisor and Director of NIAID, answers questions from Sen. Rand Paul (R-KY) at a Senate Health, Education, Labor and Pensions Committee hearing on Capitol Hill on January 11, 2022 in Washington, DC

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The White House’s chief medical adviser, Dr. Anthony Fauci said Thursday that the United States is at a crossroads in the Covid-19 pandemic as new omicron subvariants emerge across the country.

Fauci said in a radio interview Thursday that the pandemic has clearly slowed since last winter, but the death toll, which averages more than 2,600 a week, remains far too high. At the same time, the new omicron variants knock out key tools used to protect the most vulnerable.

“We’re really at a point that could be a crossroads here. As we go into the cooler months, we’re starting to see the emergence of sublineage variants of omicron,” Fauci said on “Conversations on Health Care” radio. show.

Natural infection from the BA.5 subvariant or vaccination with the new boosters should provide protection against these subvariants in healthy people, Fauci said. But U.S. health officials are concerned that the subvariants will fundamentally knock out antibody treatments like Evusheld that play a key role in protecting people with severely compromised immune systems, he said.

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Of greatest concern are the Omicron subvariants BQ.1 and BQ.1.1. They are resistant to Evusheld and are increasing in the US every week. BQ.1 and BQ.1.1 represent 27% of infections combined, while omicron BA.5 has dropped to 50%, according to the Centers for Disease Control and Prevention.

Fauci said the United States needs to dramatically reduce the number of Covid deaths, which currently stand at about 400 a day, before the country can declare the pandemic over.

“We’re still in the middle of this — it’s not over,” Fauci said. “Four hundred deaths a day is not an acceptable level. We want to get it much lower than that.”

Fauci said hospitals could face a “negative trifecta” this winter from new Covid variants as well as resurgent influenza and respiratory syncytial virus. The United States should expect a more severe flu season based on what scientists observed in Australia, he said. And there is already a significant increase in RSV cases in the United States, he added.

“It will be very confusing and may even stress the hospital system, especially for the pediatric population,” Fauci said.

Although RSV looks like a mild cold to most people, the virus can be dangerous to infants and newborns. Between 58,000 and 80,000 children under the age of 5 are hospitalized with it each year, according to the CDC.

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The severity of influenza varies from season to season depending on the effectiveness of the vaccine and the circulating strain. The most severe season in the past decade was in 2017, when the virus killed 52,000 people and hospitalized more than 700,000, according to the CDC. In the mildest pre-pandemic season, influenza killed 23,000 people and hospitalized 280,000.

There is no vaccine yet for RSV, although Pfizer has a candidate that was 81% effective in preventing severe disease in newborn infants. New boosters for omicron as well as flu blasts are widely available.

Fauci said everyone who is eligible should get their Covid boosters and flu shot. People who face a high risk of respiratory viruses should consider wearing a mask indoors in public, Fauci said. Those who have people in their homes who are vulnerable should do the same, he said.

People should also consider taking rapid Covid tests before going to social gatherings indoors where vulnerable individuals will be present, Fauci said.

“It’s a very good way to make sure you don’t spread infections, so using tests, wearing masks where appropriate and getting vaccinated,” he said.

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