Questions and answers: COVID-19 cases, hospitalizations, vaccinations
Questions and answers: COVID-19 cases, hospitalizations, vaccinations

Questions and answers: COVID-19 cases, hospitalizations, vaccinations

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People are on the move again as the COVID-19 pandemic disappears into a more endemic phase. Ed Jones / AFP via Getty Images

That daily rate of new COVID-19 cases in the United States have stood at around 30,000 in the past month.

Admissions for COVID-19 remain around 12,000 across the country, a fraction of what they were below the height of the Omicron rise earlier this year.

That death toll for COVID-19 is still slowly declining, although it remains at more than 500 a day.

That daily vaccination rate has risen back to more than 500,000, a number that can be considered encouraging, even though it is significantly less than the more than 3 million daily vaccinations given a year ago.

Nevertheless, the future of the COVID-19 pandemic is a bit uncertain.

There are new concerns about an increase in cases in some regions of the country as new subvariants of the new coronavirus circulates and the security protocols are loosened.

There are also questions about the effectiveness of one 4th dose of the COVID-19 vaccine.

Then there is the ghost of lang COVID and how prevalent this condition will be for people who have recovered from COVID-19 but are unable to shake symptoms.

With all this in mind, we asked three infectious disease experts about their perspectives on the current status of the COVID-19 pandemic.

Dr. Monica Gandhi is Professor of Medicine at the University of California San Francisco.

Dr. William Schaffner is Professor of Infectious Diseases at Vanderbilt University in Tennessee.

Dr. Jamila Taylor is director of health care reform and senior fellow at The Century Foundation.

Here’s what they had to say.

Healthline: Do you think there will be a marked increase in COVID-19 cases and hospitalizations this summer or fall?

Gandhi: SARS-CoV-2 cannot be eliminated or eradicated for four different reasons: 1) 29 different animal species have been identified that carry the virus and they can serve as zoonotic reservoirs for humans; 2) COVID-19 symptoms may be similar to other respiratory pathogens, making it difficult to isolate only those with COVID-19; 3) The virus has a relatively long period of infection compared to a virus such as smallpox that was eradicated; 4) Our vaccines are excellent for preventing serious illness, but are increasingly non-sterilizing with the time since vaccination and with the new variants.

Therefore, I think this will become a seasonal respiratory virus and we will probably see increases in cases in the fall and winter when we see increases in other respiratory pathogens due to more time spent indoors. We have very effective vaccines and therapeutics, so we will hopefully not see a marked increase in hospitalizations with this increase in cases.

Those who are medically vulnerable (eg immunocompromised, elderly patients) should receive a fourth shot or other booster if we see cases begin to increase in the fall and should be given priority for outpatient antiviral treatment if they become infected to prevent progression to serious illness.

Schaffner: Our current dominant variant, BA.2, is highly contagious and is capable of infecting itself vaccinated, so I reckon there may well be a wave of mild infections over the summer and over the fall.

Fortunately, our current vaccines continue to provide fairly solid protection against serious illness, so hospitalizations and deaths are unlikely to increase comparably.

I’m concerned that there are still many people who are unvaccinated and even more who have not yet received a third dose (the first booster). Such individuals remain vulnerable to more serious infections and may cause local increases in hospitalizations.

Taylor: I think when we go into the summer months, and with increased travel, we will see increases in cases. We have been doing this for 3 years now. We know the patterns.

As the protocol on boosters continues to evolve, I hope more people will be vaccinated / boosted, keeping people out of the hospital due to serious illness from COVID-19.

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Vaccinations are still considered to be the best way to avoid serious COVID-19 disease. Jason Redmond / AFP via Getty Images

Healthline: If there is an increase, do you think people should be overly worried if family and friends test positive, or should they focus more on if someone becomes seriously ill?

Gandhi: Because COVID-19 cannot be eradicated, I think we need to shift our focus to prevent serious disease in both vaccinations of our population, decide who needs booster shots when we see more cases, prioritize Evusheld or prophylactic monoclonal antibodies to immunocompromised, and provide those at high risk for serious disease after being infected with oral antiviral therapies (currently, molnupiravir and Paxlovid) after testing.

If we use COVID-19 hospital admissions as our marker of COVID success now with an endemic virus (hospitals for COVID instead of COVID), people should not be worried if family, friends and others can be tested positive, as cases and hospitalizations are decoupled at high levels of immunity.

In addition, with respect to long COVID symptoms, a well-controlled study from Israel shows us that people with breakthrough infections after 1 or 2 doses of the COVID-19 vaccine report much fewer long-term COVID symptoms than the unvaccinated. In fact, those with a breakthrough infection no longer report COVID symptoms than those who were uninfected, suggesting that vaccination brings these symptoms back to baseline.

Therefore, as COVID-19 becomes endemicwe should not be worried about mild infections with SARS-CoV-2 in the future.

Schaffner: The important focus is on who you and your family and friends are. Are you in a high-risk group for serious illness? Are you / they older than 65 years, fragile, have an underlying chronic disease (heart or lung disease, diabetes), or are you / they medically overweight or immunocompromised? Are you a person who takes care of someone with these qualities?

If so, continue to be careful, pay attention to symptoms, get tested immediately if symptoms occur, and, if they are positive, contact your provider to check if you are eligible for the new antiviral drugs. , which can help ward off progression to more serious illness.

If family, friends and others test positive, it is clear evidence that they are “out and about” and no longer at a distance. You should be concerned if you are unvaccinated or incompletely vaccinated, or if you are in a high-risk group for serious illness.

Taylor: People should start to see it as something we can live with as a society. Everyone should take precautions to alleviate, keep up with vaccines and boosters, wear masks in crowded indoor spaces and practice good hygiene.

We are still in a situation where it requires all of us to keep each other safe. We’re in this together. If family, friends, and others test positive, vaccines should still prevent them from becoming seriously ill and ending up in the hospital.

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COVID-19 vaccinations have increased to more than 500,000 a day. Patrick T. Fallon / AFP via Getty Images

Healthline: What are your thoughts on a 4th COVID shot? Are they needed at this point, and if so, who should get them?

Gandhi: For 4th shots, the European equivalent of the CDC has recommended these to individuals 80 years and older at this timewith reference to the fact that they can not see evidence for the 60-79 year olds who need an extra booster at this stage of the pandemic.

I think the US FDA / CDC decision give fourth shot for those 50 and older was too early and that we should probably recommend these to the population that Pfizer asked the FDA for, which are those over 65 years and older.

A recent study in the New England Journal of Medicine did not show a benefit for the 4th dose for health professionals who were younger than 65 years of age in terms of vaccine efficacy or decreasing viral load (eg infectivity). Therefore, I do not see a broad indication that younger people get 4th COVID shot at this point.

Schaffner: The benefits of 4th COVID-shot (second booster) is focused on people older than 50 years and are in high-risk groups: those older than 65 (the older, the greater the risk), those with underlying medical conditions (heart or lung disease, diabetes, obesity), those who are immunocompromised or who are closely caring for such persons.

Taylor: A 4th shot may be necessary. In fact, we may see a similar seasonal or annual regimen as we see with other vaccinations, such as the flu shot. If that’s what it takes to keep each other safe, especially for the elderly, young and immunocompromised, we should all comply with this.

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