5 Questions for COVID Experts How Worried Should We Be?

5 Questions for COVID Experts How Worried Should We Be?

COVID-19: What Can We Expect in the Coming Months?

As summer comes to a close, the concern around COVID-19 hospitalizations is on the rise. The unpredictable nature of SARS-CoV-2, the virus behind COVID, makes it difficult to predict transmission rates, hospitalizations, and mortality rates accurately. To gain some insight into the current situation and what the future might hold, HealthyGrown consulted experts in the field. They shared their thoughts on the potential end-of-summer COVID wave, the possibility of mask mandates returning, the impact of testing and vaccination costs, the efficacy of vaccines against circulating variants, and the implications of the BA.2.86 variant.

Understanding the Potential End-of-Summer COVID Wave

When it comes to the expected end-of-summer COVID wave, opinions among the experts vary. Eric Topol, MD, founder and director of the Scripps Research Translational Institute, is cautiously optimistic, suggesting that the wave might not be substantial and could be more like a “wavelet.” On the other hand, Thomas Gut, DO, associate chair of medicine at Staten Island University Hospital/Northwell Health, stresses the difficulty in predicting the severity of COVID waves due to the constantly evolving nature of the virus. Gut acknowledges that while some mutations favor easier transmission and milder illness, others have proven to be more dangerous and deadly than previous strains.

Robert Atmar, MD, professor of infectious diseases at Baylor College of Medicine, highlights the existing substantial surge in infection burden, especially in Houston. However, despite the increase in infections, there hasn’t been a significant rise in hospitalizations for COVID-19. Stuart Campbell Ray, MD, a professor of medicine at Johns Hopkins University School of Medicine, observes that while infections are on the rise, the proportional increase in hospitalizations from severe cases is lower than in the past. This suggests that immunity gained through vaccination and prior infections may be providing some level of protection against severe illness.

The Potential Return of Mask Mandates

The discussion around the return of mask mandates stirs differing opinions among the experts. Eric Topol expresses skepticism regarding the effectiveness of mandated mask usage. However, he suggests that if a descendant of the BA.2.86 variant, which has shown increased transmissibility, gains traction, we might see a voluntary increase in mask usage.

Thomas Gut believes that mask mandates are unlikely to return unless a more deadly strain emerges. The relative mildness of the Omicron strains, compared to previous variants, reduces the urgency for public masking.

Robert Atmar predicts a low probability of mask mandates returning due to potential public resistance. However, he emphasizes the importance of using masks as an additional measure of protection, especially when combined with booster vaccinations. Stuart Campbell Ray recognizes that some individuals will choose to wear masks during surges, especially in situations such as commuting, where masks do not interfere with daily activities.

The Impact of Testing and Vaccination Costs

With the cessation of free testing and vaccination, the usage and accessibility of these resources might be affected. Eric Topol believes that the charge for testing will further decrease its already low uptake. Thomas Gut expects a reduction in testing, particularly for patients with milder or asymptomatic disease.

Robert Atmar raises concerns about decreased vaccine uptake if additional costs or administrative barriers are involved. To ensure vaccine acceptance, proper education about the potential benefits is crucial. Stuart Campbell Ray highlights the existing disparities in healthcare access and the potential exacerbation of these disparities without public support for prevention and testing. He emphasizes the importance of finding ways to ensure equal access to those who need tests and vaccinations.

Efficacy of Vaccines Against Circulating Variants

The effectiveness of vaccines against current circulating variants is a topic of interest. According to Eric Topol, upcoming XBB.1.5 boosters, set to be available on September 14th, should offer protection against the EG.5.1 and FL.1.5.1 variants. Thomas Gut expects newly developed monovalent XBB-based vaccines to provide good protection against current circulating COVID variants and the emerging Eris variant.

Robert Atmar explains that while the vaccines induce immune responses against the presently circulating strains, their effectiveness might be higher in preventing severe illness rather than infection or mild illness. Stuart Campbell Ray affirms that the updated vaccine design, including the XBB.1.5 spike antigen, closely matches the dominant variant, ensuring protection with lower risks compared to natural infection.

The BA.2.86 Variant and Potential Concerns

The BA.2.86 variant raises questions about its potential impact. Eric Topol suggests that the scenario could change if new functional mutations are added to it. Thomas Gut highlights that people who have been exposed to more recent mutations of the COVID virus tend to have more protection against newer strains. Therefore, those who have not had recent infections or boosters may be at higher risk for infection from XBB- or BA.2-based strains.

Robert Atmar mentions that BA.2.86 is currently under monitoring, and its prevalence and associated characteristics require further investigation. Stuart Campbell Ray acknowledges that while the variant is still rare, it has been detected in various locations. The concern lies in how effectively it can bypass acquired immunity. T cells, which target more stable parts of the virus, are expected to remain protective, while antibodies from B cells may face challenges in recognizing BA.2.86.

Overall, insights from these experts provide valuable perspectives on the potential trajectory of COVID-19 in the coming months. While uncertainties persist, combining vaccination, mask usage, and regular testing can help mitigate the risks and ensure the health and well-being of individuals and society as a whole.