As COVID-19 cases fall, experts are optimistic, but for how long?
COVID-19 experts, just as tired of the pandemic as everyone else, finally feel hopeful about the future.
"I am more optimistic right now than at any previous point in the last two years," said Leana Wen, an emergency physician and professor of health policy and management at George Washington University.
Cases have fallen by more than 45% from a week ago, and the pace of deaths has dropped nearly 20%, Johns Hopkins University data shows. Hospitals have nearly 24% fewer COVID-19 patients than a week earlier, according to Health and Human Services data.
As states and localities lift mask mandates and other pandemic-related restrictions, USA TODAY spoke with a half-dozen experts about whether the time is right to relax. The Centers for Disease Control and Prevention is also expected to soon loosen regulations.
Most said that time is now or coming soon. But don't throw away those N-95s.
"Generally, I'm quite optimistic, but that's not infinite," said Dr. Jeremy Luban, a virus expert at UMass Medical School and a member of the Massachusetts Consortium on Pathogen Readiness. "We don't know where we're headed. … We don't know what the virus is capable of. There have been plenty of surprises. Omicron pushed our noses in it."
The outbreak of the omicron variant of the coronavirus, although devastating in terms of infections and strain on the health care system, resulted in a lot of people getting immunity against COVID-19, at least for the time being, Wen said.
Added to the large number of people protected by vaccines and boosters, "that will keep future cases at bay at least for the short term," she said. "I believe we are in for a much better spring and summer ahead."
Most encouraging to Luban has been the success of COVID-19 vaccines, which may not prevent all infections but seem to do a terrific job at preventing severe disease and deaths. "The data from the vaccines in every context we've looked is extremely heartening."
COVID-19 has thrown out so many curve balls over the past two years, some experts are uncomfortable making predictions.
"Variants have come out of nowhere in the past and may do so again," said Dr. Jacob Lemieux, an infectious disease specialist at Massachusetts General Hospital in Boston.
Flexible safety measures
For the moment, the situation is looking good.
"If I had to put my nickel on it, I would say that the disease burden will continue to go down at least in the people who have been vaccinated and/or have been infected," said Dr. Elizabeth Halloran, a biostatistician at the Fred Hutchinson Cancer Research Center and the University of Washington, both in Seattle. "I can't really speak for the unvaccinated people."
COVID-19 "is here to stay," Halloran said, but it may soon reach an "acceptable disease burden for society."
The virus that causes COVID-19, like other coronaviruses, is likely to be seasonal, leading to more infections in the late fall and winter in the USA and perhaps more infections and more variants arising at other times in other parts of the world, Wen said.
Some people need to remain masked and potentially isolated because they have weakened immune systems and can't get full protection from vaccines, or they have children too young to be vaccinated.
Wen, who has two young children, said the decision to mask should be a personal one. Schools should lift mask requirements, she said.
She said restrictions should be dialed back when case rates are falling and dialed up again if they rise.
If officials don't adjust to improvements, they risk losing the public's trust, she said.
"I strongly believe we should let people enjoy this period of time, because we may need to hunker down in the future," Wen said.
Some remain more cautious.
Dr. Eric Topol, founder and director of the Scripps Research Translational Institute in California, said he thinks it's "a little early" to lift mask requirements and other COVID-19 restrictions.
When politicians lifted restrictions too soon, cases jumped again.
Topol said he'd be more comfortable waiting a few more weeks, until levels are as low as they were in June 2021, when about 12,000 people were diagnosed with COVID-19 every day. Over the past week, almost 80,000 people a day received a diagnosis, CDC data showed.
"I look at the numbers," said Topol, who continues to wear a mask at the grocery store and other public places. "They're not where I feel comfortable. Hopefully in a couple of weeks."
Danger of variants
The biggest wild card, Halloran and others said, are possible variants.
"We can't rule out that there may be a more severe variant coming down the road, since we've been surprised already," she said.
As long as infections occur around the world, variants can develop. Scientists said they come from people with compromised immune systems who can't fight off the COVID-19 infection – so the virus mutates inside them, sometimes for months, before being passed on to others.
Theoretically, variants can develop when the virus jumps to animals, mutates, then comes back, Topol said. Many species, including deer, dogs, cats, hamsters, mink and ferrets, can catch COVID-19 from people.
A few people have been diagnosed with delta and omicron variants simultaneously. This could lead to a dangerous mix of the two, Topol said.
Vaccine companies are developing omicron-specific vaccines, although it's not clear whether they'll be needed.
Even though omicron won't necessarily be dominant when protections wane this year, Moderna President Stephen Hoge said Thursday that the company's research suggests a COVID-19 vaccine targeting two variants may be more broadly protective against multiple others.
Most experts said they weren't too worried about BA.2, a variant of omicron that has taken over parts of the world. If the USA follows the pattern of South Africa, where BA.2 arrived early, it will not cause a huge outbreak, Lemieux said.
So many people in South Africa were infected with the original omicron that the vulnerable population is limited, though caseloads haven't fallen to pre-omicron lows, data suggests.
In the USA, BA.2 appeared in late January, according to the CDC, but accounts for less than 5% of cases. Contrast that with BA.1, the original omicron, which accounted for less than 1% of cases in early-December and 98% by mid-January.
If BA.2 has a significant impact, it's likely to be local, said William Hanage, a Harvard epidemiologist. "It's not going to turn things around, given what we see at the moment," he said.
Experts still worry, of course.
They are concerned about the death rate from omicron, which isn't as bad as delta's but is plenty high. In Boston, where the vast majority of people are vaccinated, the daily death rate was 50 people out of every 100,000 as of last week, Luban said.
More than 900,000 Americans have died from COVID-19 since the start of the pandemic, and the nation is likely to surpass 1 million deaths this spring.
Several treatments were rendered ineffective by omicron, and a monoclonal antibody, which continued to work against BA.1, may not work as well against BA.2.
An extremely effective antiviral pill, Paxlovid, made by Pfizer, is in short supply, and other treatments are hard to deliver.
To keep hospital cases at a manageable level, Topol said, more doses of Paxlovid and other easy-to-use, effective treatments are needed, as well as a vaccine that can protect against all types of coronavirus variants.
Overall, though, people should have a sense of optimism about where we are in the pandemic.
"We've been damn lucky," Topal said, citing the speed at which safe and effective vaccines and treatments were developed. "There's so much to be thankful for."
Contributed: Michael Stucka