Fauci returns with a warning: We need to be ready to impose new restrictions

If memory serves, it took all of six weeks last year for public health officials to move from urging the vaccinated to take off their masks to nudging them to put them on again.

It’s been only three weeks since the CDC updated its guidance to say that Americans who live in areas where hospitals aren’t stressed can go ahead and unmask.

Will we make it to six weeks this time before that guidance is reversed again?

Anthony Fauci has been scarce on American television lately with COVID cases falling and news outlets consumed with the war in Ukraine. But the White House is bringing him out of mothballs and dusting him off this week to remind Americans that the new CDC guidance was never meant to be permanent. The masks can come off when cases are falling — and may have to go back on when cases are rising.

And cases may be rising here again soon. Rapidly.

I wrote on Tuesday about the recent rise in viral levels in certain wastewater samples across the U.S. Nationally cases are lower right now than they’ve been in eight months as America reaps the natural-immunity benefits from a winter of infection. But across the Atlantic, countries like the Netherlands and the UK are experiencing an ominous rebound after descending from their winter peaks. In Germany, a country with a higher vaccination rate than ours, cases are at an all-time high:

That’s not supposed to happen. Omicron was the “exit wave” from the pandemic, we thought. What’s up?

Scientist Eric Topol calls it the “BA.2 triad.” There’s a new subvariant of Omicron circulating called BA.2 that seems to be even more infectious than BA.1, if you can believe it. Meanwhile, many of us are months removed from the booster shots we received over the winter and so our immunity is waning again. (Natural immunity, which varies from person to person, may be waning in some people too.) And because people are sick to death of COVID restrictions after a miserable winter, they’re letting down their guards by unmasking and socializing more as spring arrives.

Super-contagious strain + immunity falling off + fewer precautions = Fauci on your TV screen wearily mumbling about needing to be “flexible” in restoring restrictions if necessary.

Topol is particularly worried about the share of senior citizens in the U.S. who still haven’t had three shots:

Indeed, the people who need protection the most, besides those who are immunocompromised, are the 65-plus group. The US has a booster rate of 65% in this age group, whereas the UK and many European and Asian countries exceed a 90% booster rate for people 65 and over.

This is a critical issue, because there is a substantial dropdown of protection, from 90-95% with a third shot to 75-80% without a booster, versus Omicron hospitalization and death. The problem of lack of adequate vaccination in the United States is compounded by not having any plan for a fourth dose. The Israeli study of over 1 million people age 60 and over showed a 4.3 fold enhanced protection versus severe illness from Omicron compared with those receiving three shots.

Just 29 percent of the overall population has been boosted despite the fact that BA.2 is spreading in the U.S., accounting for 23.1 percent of infections last week versus 13.7 percent the week before. Communities with lower vaccination rates are obviously at higher risk of severe illness than communities with higher rates, and we know which communities those are likely to be:

[Paul] Gosar’s western Arizona district is battling for the ignominious honor of COVID-19 death king in Congress, with more than 4,000 of his constituents perishing.

He’s neck-and-neck with Rep. Daniel Webster, whose Central Florida district has logged more than 4,000 deaths, according to data tracked by Harvard University.

Both are Republicans, as are 20 others among the 30 congressional districts with the most COVID-19 deaths, according to data collected by Harvard University.

On the flip side, of the 30 House districts with the least COVID-19 deaths, 27 are held by Democrats.

Republican districts may be predisposed to higher death rates from COVID because older people, the group most likely to die from the disease, skew conservative. (Webster represents The Villages in Florida, in fact.) But lower vax rates and an aversion to precautions like masking obviously contribute too.

Which means we’re about to embark on a dispiriting new debate: With America struggling to convince people to get third doses, is it time for the FDA to recommend a fourth? The head of Pfizer said this week that the company will present data soon that makes the case for a fourth shot. Three doses provides solid protection against severe illness, he argued, but not much against infection. Yet new Israeli data suggests that a fourth dose won’t do much to prevent infection either. And the head of Moderna said he believes a fourth dose will be necessary only for older people and the immunocompromised, to give them a bit of extra security in case there’s a new wave soon. Which, per the above, there might be.

An intriguing exit quotation from WaPo: “BA.2 appears to be spreading more slowly in the United States than it has overseas, for reasons that aren’t entirely clear…”

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