The BA.5 omicron subvariant is pushing up coronavirus cases and hospitalizations yet again in Michigan and across the U.S.
“I do believe that we are now in another surge,” said Dr. Dennis Cunningham, medical director of infection control and prevention at Detroit-based Henry Ford Health. “This one is being primarily driven by the BA.5 omicron, although BA.4 is also very similar and causing some of the cases as well.”
The BA.5 subvariant now accounts for an estimated 65% of new cases in the U.S., said Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention. COVID-19 hospitalizations nationally have doubled since early May, she said.
Known cases of the virus in Michigan have risen nearly 34% in the last three weeks — from a daily average of 1,780 new cases in the week ending June 21 to 2,383 new daily cases reported in the week ending July 12, according to state data.
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And the percentage of positive coronavirus tests rose to 19.6% statewide Monday, the Michigan Department of Health and Human Services reported.
Hospital admissions of people with COVID-19 are up 13% over the last seven days in Macomb, Oakland and Wayne counties, Cunningham said.
“We are not at the levels of previous surges,” he said. “I think we are early on in this. … We’re not slammed too bad, but I do expect it’s going to start looking like other surges soon.”
Dr. Natasha Bagdasarian, the state’s chief medical officer, didn’t go so far as to say the Michigan has entered another coronavirus surge just yet.
Judging only by the U.S. Centers for Disease Control and Prevention’s COVID-19 Community Levels map, she said Michigan appears to be a relatively low-risk state for coronavirus transmission.
“We are still looking fairly good with most of our regions in green,” Bagdasarian told the Free Press on Tuesday. “Now do I think we will we’ll stay that way? Probably not. We have to be prepared for cases to go up. We know that BA.4 and BA.5 are spreading throughout the country and in our in our region as well.”
State health leaders, she said, are monitoring the situation closely, taking into account several metrics, including data derived from wastewater, the percentage of positive coronavirus tests, newly identified cases, hospitalizations and what appear to be geographic differences in coronavirus transmission.
“One of the things that we saw last summer was states in the South … had an uptick in cases before we did. It could have something to do with really hot states in the South, (where) people sort of move indoors into air-conditioned spaces in the summer,” Bagdasarian said.
“Whereas in places like Michigan, this is our fantastic weather and a lot of folks are moving outdoors for their socializing. So our uptick of cases came a little bit later last year. We started seeing an uptick right around the time that schools reopened. So I think there are a few different factors that have to be accounted for.”
Still, she acknowledged, it’s difficult to get a precise picture of how much the BA.5 subvariant is spreading in the state because genetic sequencing can take a week or longer to complete.
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“Our sequencing data is always lagging a little bit. It’s never real-time data,” Bagdasarian said.
What’s clear, however, is that Michiganders ought to be prepared for a surge that might not be fully apparent for a few more weeks.
“We have the tools to be able to overcome another surge,” she said of vaccines, monoclonal antibodies, at-home tests and COVID-19 treatments. “It’s just a question of whether Michigan residents want to make use of them. I certainly hope that that we’re not so fatigued by the pandemic that we overlook or disregard these really amazing tools that we didn’t have two years ago.”
Why is BA.5 a concern?
More details are emerging about the BA.5 subvariant, but it’s still unclear whether it causes more severe disease than previous strains of the virus, Walensky said Tuesday.
“But we do know it to be more transmissible and more immune-evading,” she said. That means it can infect people who’ve recently had the virus. Some new research suggests it’s possible for a person to be reinfected as soon as four weeks after a previous infection with another variant of the virus.
It’s also more likely to cause breakthrough infections in people who are vaccinated. That’s why COVID-19 vaccine boosters are so important now for people who are eligible, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the president’s medical adviser.
“If you’ve been infected or vaccinated and your time comes for a boost, that’s when you should go and get the boost,” he said.
The COVID-19 vaccines have offered protection against severe illness and death from other omicron subvariants, Walensky said, “and likely also for BA.4 and 5.”
But few Americans who are eligible for booster shots have taken them.
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About 55% of Michiganders who are eligible for a first booster dose have gotten one, CDC data shows. And just 28.2% of Michigan residents ages 50 and older who are eligible for a second booster have gotten one.
“My message right now is very simple. It’s essential that these Americans … get their second booster shot right away,” Walensky said.
In addition to being able to re-infect people and evade vaccine protection, the BA.5 subvariant also is significantly more transmissible than previous strains of the virus.
“Over the last several months, we’ve seen each successive variant have a bit of a transmission advantage over the prior one,” Fauci said. “And right now we’re with BA.4/5, and we don’t know what the future will hold as we might get even more subvariants.”
Vaccines, he said, are the key to living life as normally as possible and to preventing new variants from emerging.
“We should not let it disrupt our lives,” he said, “but we cannot deny that it is a reality that we need to deal with. … The good news is that we have the tools to do this. We need to keep the levels of virus to the lowest possible level and that is our best defense. If a virus is not very robustly replicating and spreading, it gives it less of a chance of a mutation, which gives it less of a chance of the evolving of another variant.”
Should I wait to get a boost until there’s a vaccine that targets omicron?
No, said Dr. Asish Jha, White House Coronavirus Response coordinator.
“The data on this is very clear is if you’re over 50 that extra booster dramatically lowers your risk of getting into the hospital, going to the ICU (intensive-care unit) and dying,” Jha said. “And there are very few things we do in medicine that have the kind of benefit that we see from that extra shot.
“Let me be clear: If you get vaccinated today, you’re not going to be ineligible to get the variant-specific vaccine as we get into the later part of fall and winter. So this is not a trade off. We’ve got plenty. This is a great way to protect yourself.”
Henry Ford’s Cunningham agreed: “Get that second booster dose now,” he said. “With the universal vaccine, once the clinical trials are done, it still has to be analyzed. I don’t see that coming down anytime in the next couple of months.
“I think we’re going to be on this rollercoaster for a while.”
I’m not eligible for a booster. How can I protect myself?
“I think it’s time to break out the masks when we’re in crowded or public settings,” Cunningham said. “We’re at the point you need to seriously consider wearing masks, especially if you are vulnerable or you have risk factors for more severe COVID disease or if you live with someone who has more risk factors.”
Choose outdoor gatherings and events over those held indoors, he said.
“When you’re outdoors, I feel a whole lot safer. There’s more air movement, people tend to not be quite so close together,” Cunningham said.
But if you’re going to a big concert where people are close together, even if it’s outside, it probably makes sense to wear a mask,” he said.
Bagdasarian suggested stocking up on at-home rapid antigen tests.
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“It’s really important to test if you are symptomatic, if you think you may have been exposed, or if you’re going to be gathering with people who are especially vulnerable, who may be immunocompromised, etc.” she said. “So keeping the supply of over-the-counter tests at home is really important.”
If you do contract the virus, she said it’s important to find out whether you’re eligible for treatments such as monoclonal antibody therapy or Paxlovid, the COVID-19 antiviral pill Paxlovid.
Could authorization of a second booster dose be coming soon for those under age 50?
Jha said Tuesday that conversations “have been going on for a while” about how federal authorities can better protect Americans from the virus. However, he said, those decisions are made by the U.S. Food and Drug Administration and the CDC.
“I know that the FDA is considering this, looking at it,” he said. “And I know CDC scientists are thinking about this and looking at the data as well. The decision is is purely up to them.”
Contact Kristen Shamus: firstname.lastname@example.org. Follow her on Twitter @kristenshamus.