Navigating the Ongoing COVID-19 Landscape: Balancing Normalcy and Caution in 2024

In recent times, a substantial portion of the U.S. population has found themselves grappling with respiratory illnesses, constituting 7% of all outpatient healthcare visits during the week ending December 30, as per data from the U.S. Centers for Disease Control and Prevention (CDC). While flu, RSV, and other routine winter viruses contribute to this surge, the highly contagious JN.1 variant of COVID-19 is playing a significant role, presenting a challenging start to the year. Epidemiologist Katelyn Jetelina, author of the Your Local Epidemiologist newsletter, asserts that Americans are witnessing a potential glimpse into their “new normal.”

Jetelina laments, “Unfortunately, signs are pointing to this [being] the level of disruption and disease we’re going to be faced with in years to come.”

The absence of active COVID-19 case tracking by the CDC complicates the assessment of the virus’s spread. Wastewater analysis, while not a perfect substitute, currently serves as a real-time signal, and its data indicate that the ongoing surge may only be surpassed by the initial Omicron wave in early 2022. Some projections suggest that over a million individuals in the U.S. could be contracting the virus daily at the peak of this surge.

Hospitalizations due to COVID-19 have seen an increase, with almost 35,000 recorded during the week ending December 30, a 20% rise from the previous week in 2023. Deaths, typically lagging behind hospitalizations, are already at around 1,000 per week in the U.S.

Despite these concerning trends, everyday activities such as working in offices, attending schools, dining in restaurants, and sitting in crowded movie theaters continue with minimal masking. Dr. Ashish Jha, dean of the Brown University School of Public Health, and former COVID-19 response coordinator for the Biden Administration, emphasizes that the changing landscape is influenced by factors such as widespread immunity, available treatments like Paxlovid, and the general population’s familiarity with mitigation measures.

Jha states, “COVID is not gone, it’s not irrelevant, but it’s not the risk it was four years ago, or even two years ago.” He advocates for a balanced approach, acknowledging the persistent risks for certain groups while asserting that vaccines and treatments should instill confidence in resuming normalcy.

Dr. Robert Wachter, chair of medicine at the University of California, San Francisco, acknowledges the challenge of adjusting to this new reality after years of heightened vigilance. Wachter advises adapting behavior based on individual risk tolerance and vulnerability to severe disease, recommending additional precautions during surges.

With precise COVID-19 data less available, Jetelina suggests aligning behavior with specific objectives. For example, individuals aiming to protect vulnerable family members may choose to avoid crowded places before visits. Dr. Peter Hotez of the Texas Children’s Hospital Center for Vaccine Development emphasizes the need for more people to receive updated vaccines targeting newer variants to enhance overall protection.

Despite vaccination efforts, Long COVID remains a challenging risk to address. Jetelina notes that staying up-to-date on vaccines reduces the risk but does not eliminate it entirely. Hannah Davis from the Patient-Led Research Collaborative for Long COVID advocates for adopting precautionary measures such as wearing quality masks, improving ventilation, and testing before gatherings.

Davis contends that the government should do more to inform the public about the persistent risks of Long COVID and reinfections. She suggests policy measures, such as ventilation requirements for public places and mask mandates on public transportation, to supplement individual efforts.

While some mask mandates have been reinstated in certain healthcare facilities and nursing homes, Jha argues against widespread mandates, asserting that with the current array of tools available, they are less crucial. Jetelina anticipates a potential relaxation of COVID-19 guidance in 2024, speculating on changes to isolation guidelines by the CDC.

Looking ahead, Wachter predicts that the threat of COVID-19 will become integrated into background risks, similar to other potential health hazards. Jha emphasizes the need to move forward rather than attempting to revert to pre-pandemic norms. He expresses hope that lessons learned during the pandemic will lead to a comprehensive approach to respiratory diseases, standardizing guidance on vaccines, masks, ventilation, and sick-leave policies for all infectious diseases, not just COVID-19.

As COVID Claims Over 300,000 American Lives, Vaccinating People Begins, Giving Hope To Millions

The first shots were given in the American mass vaccination campaign on Monday, December 14th opening a new chapter in the battle against the coronavirus pandemic, which has killed more people in the United States — over 300,000 — than in any other country and has taken a particularly devastating toll on people of color.

As per reports, the new Pfizer-BioNTech vaccine was administered in Queens, NY, which is the first known inoculation since the vaccine was authorized by the Food and Drug Administration late last week. It was a hopeful step for New York State, which the virus has scarred profoundly, leaving more than 35,000 people dead and severely weakening the economy.

“I believe this is the weapon that will end the war,” Gov. Andrew M. Cuomo said, shortly before the shot was given to Sandra Lindsay, a nurse and the director of patient services in the intensive care unit at Long Island Jewish Medical Center. State officials said the shot was the first to be given outside of a vaccine trial in the United States.

President Trump posted on Twitter: “First Vaccine Administered. Congratulations USA! Congratulations WORLD!” Shortly afterward, Mayor Bill de Blasio of New York City said at a news conference: “To me, we were watching an incredibly historic moment, and the beginning of something much better for this city and this country.”

While the first dose of the vaccine was administered in New York, people across the nation began receiving it on Monday as well. There was plenty of applause and some tears as news cameras captured the mundane rituals of an injection, underscoring the pent-up hope that this was the first step in getting past the pandemic.

“Today is the first day on the long road to go back to normal,” Mona Moghareh, a 30-year-old pharmacist, said after administering the first dose at a hospital in New Orleans.

The vaccinations started after the F.D.A.’s emergency authorization of the Pfizer-BioNTech vaccine on Friday night. On Sunday, trucks and cargo planes packed with the first of nearly three million doses of coronavirus vaccine had fanned out across the country, as hospitals in all 50 states rushed to set up injection sites and their anxious workers tracked each shipment hour by hour. But the rollout is less centralized in the United States than in other countries that are racing to distribute it.

According to Gen. Gustave F. Perna, the chief operating officer of the federal effort to develop a vaccine, 145 sites were set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday. There appeared to be few logistical problems, though Puerto Rico received half the number of doses it expected, and had to scramble to adjust its distribution plan. The remaining doses are expected to arrive Tuesday and Wednesday.

A majority of the first injections given on Monday went to high-risk health care workers. In many cases, this first, limited delivery would not supply nearly enough doses to inoculate all of the doctors, nurses, security guards, receptionists and other workers who risk being exposed to the virus every day. Because the vaccines can cause side effects including fevers and aches, hospitals say they will stagger vaccination schedules among workers.

Residents of nursing homes, who have suffered a disproportionate share of Covid-19 deaths, are also being prioritized and are expected to begin receiving vaccinations next week. But the vast majority of Americans will not be eligible for the vaccine until the spring or later.

In an interview with MSNBC on Monday, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, laid out a timeline for a return to normalcy that stretched well into 2021. He stressed that until then, social distancing and masks will remain crucial in the fight to stop the spread of the virus.

“A vaccine right now is not a substitute for the normal standard public health measures,” he said, adding, “Only when you get the level of infection in society so low that it’s no longer a public health threat, can you then think about the possibility of pulling back on public health measures.”

He predicted that the average person with no underlying conditions would get the vaccine by the end of March or beginning of April. If the campaign is efficient and effective in convincing people to get the vaccine, most people could be vaccinated by late spring or early summer, he said.

“I believe we can get there by then so that by the time we get into the fall, we can start approaching some degree of relief, where the level of infection will be so low in society we can start essentially approaching some form of normality,” he said.

Until then, he stressed, the standard public health measures — distancing, masks, avoiding indoor gatherings — remain necessary.


Moderna Seeking US, European Regulators To Approve Covid-19 Vaccination

Moderna Inc, which has reported its Covid-19 vaccine is 94 per cent effective, on Monday announced it is filing with US and European regulators for emergency use authorization. Moderna follows barely a week after Pfizer and its German partner BioNTech filed for US regulatory approval. By the end of 2020, Moderna expects to have approximately 20 million doses of its mRNA-1273 vaccine available in the U.S and is “on track to manufacture 500 million to 1 billion doses globally in 2021.

Moderna created its shots in collaboration with the U.S. National Institutes of Health and got a final batch of results over the weekend which show the vaccine is more than 94% effective. Moderna’s efficacy results are based on 196 Covid-19 cases in its huge U.S. study with more than 30,000 participants. Of the 196 cases, 185 were in participants who received the dummy shot and 11 who got the vaccine. Severe cases and one death were reported in participants who got the dummy shot.

Moderna expects to present its data to the US Food and Drug Administration on December 17. First up will be Pfizer and BioNTech, on December 10. Both Pfizer and Moderna are two-shot vaccines.

The US government’s vaccine management chief has said all systems are ready to deliver the vaccines to priority groups within 24 to 48 hours of FDA approval.  Government Model Suggests U.S. COVID-19 Cases Could Be Approaching 100 Million

The actual number of coronavirus infections in the U.S. reached nearly 53 million at the end of September and could be approaching 100 million now, according to a model developed by government researchers.

The model, created by scientists at the Centers for Disease Control and Prevention, calculated that the true number of infections is about eight times the reported number, which includes only the cases confirmed by a laboratory test.

Preliminary estimates using the model found that by the end of September, 52.9 million people had been infected, while the number of laboratory-confirmed infections was just 6.9 million, the team reported in the Nov. 25 issue of the journal Clinical Infectious Diseases.

“This indicates that approximately 84% of the U.S. population has not yet been infected and thus most of the country remains at risk,” the authors wrote.

Since then, the CDC’s tally of confirmed infections has increased to 12.5 million. So if the model’s ratio still holds, the estimated total would now be greater than 95 million, leaving about 71% of the population uninfected. The model attempts to account for the fact that most cases of COVID-19 are mild or asymptomatic and go unreported.

Scientists used studies looking for people who have antibodies to the coronavirus in their blood – an indication that they were infected at some time — to estimate how many infections went undetected. Some of these antibody studies have suggested that only about one in 10 coronavirus infections is reported.

The goal in creating the model was to “better quantify the impact of the COVID-19 pandemic on the healthcare system and society,” the authors wrote. The model also estimated that official counts do not include more than a third of the people hospitalized with COVID-19.

NPR (11/26, Hamilton) reported “the actual number of coronavirus infections in the U.S. reached nearly 53 million at the end of September and could be approaching 100 million now, according to a model developed by” Centers for Disease Control and Prevention researchers. The model “calculated that the true number of infections is about 8 times the reported number, which includes only the cases confirmed by a laboratory test.” NPR added, “Preliminary estimates using the model found that by the end of September, 52.9 million people had been infected, while the number of laboratory-confirmed infections was just 6.9 million, the team reported in…Clinical Infectious Diseases.”