Covid rises in US amid muted warnings and murky data

CHICAGO — Covid-19 is sweeping the United States again in what experts consider the most transmissible variant of the pandemic to date.

But something is different this time: public health authorities are holding back.

In Chicago, where the county’s Covid alert level was raised to “high” last week, the city’s top doctor said there was no reason for residents to let the virus control their lives. . The Louisiana state health director likened a further rise in Covid cases there to a downpour – “a surge within a surge” – but called the situation concerning but not alarming.

And King County, Wash., Public Health Officer Dr. Jeffrey Duchin said Thursday that officials are discussing reissuing a mask mandate but would prefer that the public mask up voluntarily. “We’re not going to be able to have an endless series of mandates forcing people to do this, that, and the other,” he said.

The latest surge, driven by a spike in BA.5 subvariant cases there since May, has pushed infections up in at least 40 states, particularly in the Great Plains, West and South. Hospitalizations have increased 20% in the past two weeks, leaving more than 40,000 people in US hospitals with the coronavirus on average per day.

More than two years into the pandemic, however, public health officials are issuing only muted warnings amid a picture they hope has been altered by vaccines, treatments and growing immunity. Deaths are rising, but only modestly so far in this new wave. And state and local public health officials say they must also now heed a reality that is evident on the streets of Seattle in New York: Most Americans are encountering a new wave of Covid with a rise in collective shoulders, dodging masks, joining the crowds indoors and moving following the endless barrage of virus warnings of the past months.

“I’m convinced you can’t just cry wolf all the time,” said Dr. Allison Arwady, the commissioner of the Chicago Health Department, who said she would wait to see if hospitals get strained before to consider another citywide mask mandate. . “I want to save mask requirements or update vaccine requirements if there is a significant change.”

The lack of data complicates the country’s understanding of this BA.5 wave. Not since the early months of the pandemic has there been so little accurate information about the number of actual infections in the United States. As public testing sites have closed and home testing — if people test at all — has become common, publicly reported data has become sparse and spotty.

Yet, experts say, the outlines of a new wave are undeniable.

“You don’t have to count every drop of rain to know it’s raining,” said Louisiana public health officer and chief medical officer Dr. Joseph Kanter. “And it’s pouring rain right now.”

In this state, the health department is analyzing a wide range of data to track the spread of the virus, including the number of cases, samples from a growing network of sewage testing sites, the rate of test positivity and hospitalization measures.

The BA.5 subvariant, which was first detected in South Africa in January and has spread to a number of European countries, was responsible for 1% of cases in the United States in mid- May but now accounts for at least two-thirds of new cases. in the country.

Anita Kurian, deputy director of the San Antonio Department of Health, said cases have been rising in the area for six straight weeks. But some measures, like the low death toll so far, suggest the country is entering a newer, less deadly phase of the pandemic where vaccines and treatments have dramatically improved chances of survival, she said. declared.

“We’re nowhere near where we were with previous surges,” she said.

So far, the number of hospitalizations and deaths from the current wave pales in comparison to previous peaks. At the peak of Omicron’s surge in early 2022, nearly 159,000 people were hospitalized every day.

Experts warn that it is difficult to predict the coming months, especially given the high transmissibility of BA.5. The warnings from national health leaders have slowly increased in intensity in recent weeks.

Yet even as federal health officials have reiterated calls for people to test for Covid before attending large indoor gatherings or visiting particularly vulnerable and immunocompromised people, they are striking a delicate balance, telling Americans that even s ‘they don’t need to turn their lives upside down, they need to be careful of the Covid threat.

“We shouldn’t let it disrupt our lives,” Dr. Anthony S. Fauci, President Biden’s chief medical adviser on the virus, said at a White House press conference in which he added that many new variants may continue to emerge. “But we can’t deny it’s a reality we have to face.”

As health officials in many places avoided issuing new virus restrictions during the latest wave, California stood out as an exception. There, public health authorities issued stern warnings and moved toward reimposing restrictions.

The warnings were spurred by worrying data, experts said. Walgreens said more than half of the Covid tests administered at its California stores have come back with positive results. Sewage surveys in the Bay Area suggest this increase may be the largest yet.

And the number of weekly deaths in Los Angeles County from the coronavirus has doubled from about 50 a month ago to 100 last week. Deaths are still below levels from the Omicron winter surge, when more than 400 people died each week in the county.

Los Angeles officials said they plan to reinstate a countywide indoor mask mandate as early as the end of this month. Barbara Ferrer, the county’s director of public health, said even a slight increase in masking would help slow transmission of the virus.

“I’m like everyone else: I hate wearing this mask. But more than that, I hate the idea that I might accidentally pass it on to someone else,” Ms. Ferrer said. “That’s my biggest fear – that we are so eager to end this virus that we become complacent.”

Charles Chiu, an infectious disease specialist and virologist at the University of California, San Francisco, says data from patients suggests that BA.5 does not cause more severe disease in patients than other Omicron variants. But he says he is concerned that the variant is so contagious and so able to evade the protections of vaccination and previous infection that it could be unstoppable.

“It seems like we can’t control it,” he said.

Dr Chiu said he was sensitive to the plight of government officials seeking to mitigate the spread of the virus. They face a public chafing at the renewed guidelines, even in parts of the country where people were previously most willing to follow. In places where Covid mitigation measures are mandatory, such as on New York’s subways, compliance with masking rules is increasingly patchy.

“Public health workers have an impossible job here,” Dr Chiu said.

In New York, rates of positive tests, cases and hospitalizations are all rising. But health officials resisted reissuing mask mandates, and many residents said they weren’t worried, relying on vaccines, immunity from previous infections and antivirals to protect against serious illnesses. The city no longer has a contact tracing system in place or requires proof of vaccination to enter restaurants.

In Louisiana, officials have seen hospitalizations of people with Covid rise in the state, but they say those numbers are still far lower than previous surges when more than 2,000 residents were hospitalized at times.

“I feel a lot more empowered that we have the ability to protect ourselves,” Dr. Kanter said.

At the height of the Delta wave in Louisiana in 2021, about 20% of hospitalized Covid patients were on ventilators, according to Dr. Kanter, public health officer and medical director. This figure dropped to 10% during Omicron’s initial ramp-up and is now below 5%.

For those most at risk of serious illness from Covid, the feeling that public health warnings have diminished was little comforting and in fact made them more worried than ever about getting infected.

Neyda Bonilla, 48, of Mission, Texas, was diagnosed in April with breast cancer. With the rise in cases in South Texas, she now fears an infection while undergoing chemotherapy could spell disaster for her health.

She received all the shots and boosters available to her, she said, and now wears a surgical mask in public and rarely leaves the house except to work as an administrator at an ambulance company.

“I hope people will open their eyes,” she said. “We should never have taken off our masks. It is not finished.

Yet even in some cities whose residents have taken Covid precautions throughout the pandemic, the latest surge has not caused widespread alarm.

In Berkeley, Calif., Jeff Shepler, the general manager of Spanish Table, a boutique specializing in the sale of wines and Iberian dishes, said he travels to Giants games across the bay from San Francisco, and that he had recently attended a Pearl Jam concert at the Oakland Coliseum. and do not hesitate to shake hands.

“It was exhausting for me to wear a mask all day, every day,” he said. “I am at the point in my life where I have the vaccine and I had Covid. I think I’m pretty safe.

Julie Bosmann reported from Chicago, Thomas Fuller from San Francisco, and Edgar Sandoval from San Antonio. The report was provided by Soumya Karlamangla, Eliza Fawcett, Sarah Cahalanand Holly Secon.

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