Though coronavirus caseloads, deaths and hospitalizations are declining in the U.S., the nation’s top infectious disease expert is urging Americans to get vaccinated and boosted as a new variant has cases rising across Europe.
Dr. Anthony Fauci, President Joe Biden’s chief medical adviser, said the uptick in cases across the UK and Europe can be attributed to the increased transmissibility of the descendant of omicron known as BA.2; the removal of restrictions such as indoor masking, and waning immunity from vaccines and prior coronavirus infection.
“We can probably expect in this country that, given that we have those three conditions … we can expect to start to see, I would imagine in the next week or so, an increase in cases in some regions of the country, particularly those areas that are undervaccinated,” Fauci said.
Because BA.2 is more transmissible, it will eventually overtake the original omicron strain as the dominant variant in the U.S., he said.
The new strain makes up between 30 to 45% of new infections in the U.S., Fauci said, and is up to 50% in some cities.
Patrick Ashley, with DC Health, said on a call with council members Friday that BA.2 makes up 29% of new cases in D.C.
Despite its increased transmissibility, Fauci said, there’s no indication that BA.2 causes more severe disease. European officials, he said, haven’t seen an increase in hospitalizations or use of intensive care unit beds.
Still, Fauci expects cases to rise in some parts of the country where vaccination rates are low as soon as next week, because mitigation measures have been lifted. About 65.4% of the population is fully vaccinated, according to Centers for Disease Control and Prevention data, and 44.6% of fully vaccinated people have received a booster dose.
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While a prior coronavirus infection provides some protection, Fauci said, immunity from infection “wanes the same way as the immunity that’s induced by vaccines.”
Another booster shot?
The Food and Drug Administration, Fauci said, is collecting data regarding what happens to levels of protection when someone is six, seven and eight months removed from receiving a booster dose.
Moderna recently submitted an application for another booster shot for all adults. Pfizer did so for seniors.
An additional dose had previously been recommended for immunocompromised people.
Data from Israel and the U.S. reveals protection against hospitalization falls from about 91% to 78% about four to five months after the third shot, Fauci said.
The CDC and FDA will collaborate on who additional doses may be beneficial for, he said. It’s unclear whether an annual COVID-19 vaccine will be needed to boost protection as is the case with flu shots, he said.
“We do not know how long the durability of the protection is going to be,” Fauci said. “There’s always an issue — are we going to get another variant that not only eludes durability of protection, but doesn’t have any real protection to begin with? All of those factors are in play right now.”
Fauci said the possibility of another variant “that would surprise us similar to what we had with delta and then even more so with omicron” is top of mind for him. He’s also concerned by the country’s vaccination rate.
“Those two things are related, and one can help the other,” Fauci said.
Future of masking on mass transit
The Transportation Security Administration extended its requirement for masks on planes and public transportation through April 18, and Fauci said it’s too soon to know whether the agency will let it expire or extend it.
The TSA, in collaboration with the CDC, will consider factors including the national level of infection and whether there are significant regional differences.
“You evaluate what the level of viral activity is, and it’s continually being evaluated,” Fauci said. “At any time now, depending upon the level of infection, there may be a change in the guidelines of the requirements.”
Vaccines for kids
Moderna earlier this week said its planning to ask U.S. and European regulators to authorize its two small-dose shots for kids under 6, and Pfizer is testing smaller shots, a tenth of the adult dose, for kids under 5.
Fauci urged parents of young children to be patient as the FDA and CDC review data.
The agencies “will examine the data and do what they do best … to make sure that when a vaccine is approved for children within a certain age category, it will be safe and it will be effective,” Fauci said.
“I know we’d like to have the vaccines available for all age groups right now,” Fauci said. “But things are being done correctly, the data are being carefully analyzed to make sure that when a determination is made, it’s based on solid scientific data.”
Variability of risk
At this point in the pandemic, Fauci said, there’s a range of risk-taking and risk aversion. He advised people to balance how they want to live their lives and the things they think are important to do.
“There’s a tremendous range of variability of people in the risk they’re willing to take right now,” Fauci said. “Fortunately, the infections, the hospitalizations and the deaths are going down. And we are hoping that we will now gradually get to the point of approaching a degree of normality.”
Fauci said the coronavirus in the U.S. is heading from pandemic to endemic, but isn’t there yet.
“We seem to be heading toward that now; we’re getting to a low level — 27,000 new infections, [and] we now are less than 1,000 deaths per day,” Fauci said. “We’re not there yet, but we’re getting there and hopefully will continue to go in that positive direction.”
