What Californians should do now to prepare for a possible spring Omicron BA.2 surge
Quick Take
From tracking early signals to getting boosters and knowing about new drug options, here’s what should Californians be doing now to prepare for a possible spring surge of infections by the Omicron BA.2 subvariant.
Is California doing enough to prepare for a potential increase in cases of the Omicron subvariant BA.2 this spring?
California has made great strides in improving access to vaccinations and testing, but officials say there’s plenty of room for improvement, and that doing so is essential, given concerning trends elsewhere in the country, especially in the Northeast.
Early signals
The Omicron subvariant BA.2 — about 30% to 60% more transmissible than the currently dominant Omicron subvariant — is being detected more frequently, according to the U.S. Centers for Disease Control and Prevention. And, even though the weekly count of new coronavirus cases nationally has been declining or flat, there are some hints that they could be starting to rise in New York City.
In California, sewage treatment sites serving six counties are reporting at least a doubling of detected coronavirus samples in wastewater over the last 15 days. The sites serve Santa Cruz, Monterey, San Benito, San Diego, Contra Costa and Fresno counties, according to the CDC’s wastewater tracker as of Tuesday morning.
“The increasing presence of the highly transmissible BA.2 subvariant in many regions of this country reminds us that we need to remain vigilant and prepared for the possibility of more cases in the near future,” L.A. County Public Health Director Barbara Ferrer said in a statement last week.
“And while discouraging to face this possibility, the best way to blunt another surge in cases from increasing hospitalizations and deaths is to increase vaccination and booster coverage,” Ferrer said. “Waiting until we start seeing increases in cases is not optimal, since once there are more people testing positive, there is already more community transmission.”
Booster shots
Officials have been concerned about lackluster rates of booster shots, which help further protect vaccinated people — especially older people and those with underlying health concerns — from severe illness, hospitalization and death.
It’s important to get a booster shot, experts say.
According to data published by the CDC in February, when Omicron was dominant, vaccine effectiveness against hospitalization was 71% during the first two months after people completed their primary two-dose vaccination series of the Pfizer-BioNTech or Moderna shots. But that fell to 54% five months after the second dose. A booster shot brought vaccine effectiveness against hospitalization to 91% in the first two months following the injection, and was at 78% four months after that shot.
During a time Omicron was dominant, vaccine effectiveness against death or needing a mechanical ventilator to breathe was 79% for people who received two vaccination doses, and 94% among those who received a third shot, according to data published this month by the CDC.
It’s uncertain whether an increase in coronavirus cases fueled by BA.2 could result in merely a ripple or the kind of rapid surge that would strain hospital systems. Experts have suggested reasons for why a BA.2 wave in the U.S. could end up being either mild or quite worrisome.
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Masking up even as rules ease
The unsettled outlook is a big reason why California health officials still strongly recommend universal wearing of masks in indoor public settings.
There are a number of reasons why some health officials express some concern about preparing for the next surge.
A drug option
In Los Angeles County, more needs to be done to improve access to anti-COVID drugs, like Paxlovid pills that are intended for newly diagnosed coronavirus-positive patients at higher risk for severe COVID-19, Ferrer said last week. Drugs like Paxlovid must be given within a certain number of days after symptoms begin, or from the day of a positive coronavirus test, and they work best if given early.
As of Tuesday, there were 17 sites around Santa Cruz County that had COVID therapeutics available, per the U.S. Department of Health & Human Services.
Some officials have expressed concern that anti-COVID drugs are sitting unused because the populace doesn’t know about them.
In remarks to the California Medical Assn. on March 8, State Epidemiologist Dr. Erica Pan suggested that lack of familiarity with the potentially lifesaving anti-COVID medications are a reason the drugs are being “turned away at the local level.”
Pan told doctors that we “need to kind of increase awareness — that if you have patients that are testing positive, that are risk for hospitalization, they really should seek treatment.”
California health authorities have continued to say that COVID-19 still remains a more potent public health threat than the flu, and that it’s important that people get their shots — especially seniors who haven’t received their booster and children age 5 to 11 who have been vaccinated at lackluster rates.
The low vaccination rates among young children are a concern. There were 66 COVID-related deaths among children 5 to 11 in the year that ended Oct. 2, according to CDC data, making COVID-19 equivalent to the eighth-leading cause of death in that age group when compared to data of deaths from 2019.
According to the CDC, since the start of the pandemic, 167 COVID-19 deaths have been reported nationally in children 5 to 11.
Racial disparities
Officials are also concerned about racial and ethnic disparities in vaccinations. In L.A. County, 55% of Black and 57% of Latino residents are considered fully vaccinated, compared to 73% of white and 82% of Asian American residents.
“A lot of people talk about: Are we at an endemic phase yet?” Pan said. Bringing the pandemic to an endemic state means that COVID-19 is no longer affecting hospitals significantly and is no longer generally disruptive to daily life.
But we’re not there, Pan said. In California since October, there have been more than 10 pediatric COVID-19 deaths, already greater than the total number of pediatric deaths from the flu in the 2016-17 flu season, according to data she shared.
In addition, the total weekly number of deaths from all causes in California still remains above pre-pandemic highs, with COVID-19 still a major factor.
This past winter, California recorded nearly 8,000 deaths from all causes during its worst week, with COVID-19 blamed for nearly 25% of them.
Over the past five years, this number was only exceeded by the previous winter’s COVID-19 surge. During that winter’s worst week, 12,000 deaths from all causes were recorded, with 45% of them blamed on COVID-19.
Both peaks were worse than at any point during the three years preceding the pandemic. The previous high number of weekly deaths from all causes was about 7,000 in the winter of 2017-18, with flu causing fewer than 5% of fatalities, even though there was a very bad flu season under way at that time, Pan said.
“So this means we are not at a stage where this [COVID-19 pandemic] is, you know, endemic or normalized yet,” Pan said. “We are not at a place yet where this is just like the flu.”
Testing
Ferrer encouraged people to get tested if they have symptoms of COVID-19, have been in close contact with someone who has tested positive, before and after travel, and prior to indoor visits at nursing homes.
She also encouraged people to take rapid tests just before or after events and gatherings, especially for people who are either at higher risk for COVID-19, live with someone at higher risk, or are meeting with someone at higher risk. Find more information on testing at Lookout’s COVID dashboard.
This story originally appeared in Los Angeles Times.