The rapid rise of the omicron BA.5 subvariant, with its increased immune evasion abilities and a demonstrable growth advantage, has federal officials on the sidelines. In a burst of activity on Monday afternoon and early Tuesday, officials doubled pandemic measures, renewed surveillance calls and are considering extending the eligibility of second reinforcements to all adults.
At a news conference Tuesday morning, White House COVID-19 response coordinator Ashish Jha described a battle plan against BA.5, which as of today is estimated to represent the 65 percent of cases in the US. Jha highlighted efforts and tools to prevent another wave of infection, as seen with the original omicron in January. The plan includes a stronger push to vaccinate and strengthen Americans, as well as a renewed stimulus to try, treat, mask, and improve indoor ventilation.
Currently, COVID-19 cases in the United States are at a high level of about 117,000 new cases per day, but this is likely to be a significant underestimation given that many Americans are testing at home and do not report their cases. Meanwhile, hospitalizations and intensive care admissions are on the rise, up 17% and 21% over the past two weeks, respectively, according to The New York Times. Overall, the daily average of hospitalizations has more than doubled since the end of May, with the current average close to 38,000.
SARS-CoV-2 transmission levels are considered high in about 90 percent of U.S. counties, according to a red-soaked map from the Centers for Disease Control and Prevention. The agency recommends that everyone wear masks in indoor public settings in about 21 percent of counties, according to the agency’s softer metric of COVID-19 at the community level.
Announcements
Current vaccines have proven to be very effective in preventing serious illness, hospitalizations, and deaths. But so far, only 67 percent of Americans are fully vaccinated against the pandemic virus. Of those fully vaccinated, only 48 percent have received a booster. This means that only about 32 percent of Americans have had a booster, which is available to everyone ages 5 and up. In addition, people 50 years of age or older or at high risk (such as immunocompromised) are currently eligible for a second booster. But only 18.7 million people have received this second reinforcement. That’s about 28 percent of people over the age of 50 who are fully vaccinated and reinforced.
On Monday evening, The Washington Post broke the news that the Biden administration is considering expanding the eligibility of second reinforcements to include all adults. The report cited five unnamed officials with knowledge of the matter, who said Jha and top infectious disease expert Anthony Fauci support the idea of extending second reinforcements to all adults.
At Tuesday morning’s press conference, Fauci and Jha stressed that only the Food and Drug Administration and the CDC have the capacity to finally expand reinforcement eligibility. The Washington Post noted that administration officials expected to have the regulatory signature of the expansion in the next two weeks. The quick weather period could prevent a summer booster expansion from complicating the launch of next-generation boosters this fall.
It increases now and later
Currently, the administration and the FDA are planning to launch next-generation bivalent amplifiers this fall that would target both the ancestral strain and the omicron BA.4 / 5 subvariants. This release is expected to begin around October or November, or in about three to four months. In the past, reinforcement intervals have been about four to six months, Jha noted.
Announcements
Jha and CDC director Rochelle Walensky repeatedly said Tuesday that getting a booster now, or in two weeks or so, would not prevent getting a bivalent booster this fall. His thinking is simply based on the time period and interval provided for reinforcements.
“While we’ve looked at the cadence from where we needed to get momentum before, it’s been four or five months,” Walensky said. “We anticipate that it will be a similar cadence. We also want to emphasize that there are many people who are at high risk right now, and who are waiting until October / November to get their momentum, when, in fact, their risk is in the moment, it’s not a good plan, ”he added. “So we really want to say,‘ Now get your momentum. We have high expectations that the data suggest that you will be eligible for one [bivalent] boost in the fall. Of course, we will continue to evaluate this data. “
At present, there are no clinical data on the effectiveness of a second booster in healthy people under 50 years of age. It is also unclear whether a fourth dose with current vaccines, which target the ancestral strain of SARS-CoV-2, could distort immune responses to future variant-oriented promoters toward the ancestral strain. But this has not been a significant concern for people who are already entitled to a second booster. In addition, most Americans have already been exposed to variants.
As such, many experts, such as Jha and Fauci, have accepted the idea of extending access to the second reinforcement in the middle of peak BA.5. This includes virologist and vaccine expert Peter Hotez, who is dean of the National School of Tropical Medicine at Baylor College of Medicine.
“We’ve already seen the benefits in 50 years or more,” he told the Post. “Finally, what is true for older people turns out to be true for younger people; it only takes longer to reveal themselves.”