119: Is COVID-19 in Retreat?

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Tuesday, February 15th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

Is COVID-19 in retreat? The case numbers have many thinking maybe so. It would be a welcome development in this pandemic, now in it's third calendar year. Dr. Ashish Jha is dean of the Brown University School of Public Health. He addresses the question in today's morning conversation.

By almost every measure, the COVID-19 variants appear in retreat. Is that how you see it?

DR. ASHISH JHA:

I do. I see right now that Omicron surge that we just went through as a nation on its tail end—still, infections are still high, but coming down very, very nicely. And my expectation is in the upcoming weeks and hopefully months, we'll really see very low infection rates as this surge really gets into the rearview mirror.

JOHNSON:

Many states are rolling back mask mandates. We've been here before. Is there any reason to think this light at the end of the tunnel will be short-lived?

JHA:

Well, it's a good question. And you know, there's a sense somehow people have that there was, because we ended the mask mandates last May, that caused the Delta surge over the summer. I don't think there's any real reason to believe that Delta was going to come and take off as it did.

I'm pretty hopeful that we're going to be able to get through the spring and into the summer without having to think about masks. Would not be surprised if we see a surge of infections in the South this summer as we have each of the last two. At that point, it'll be important to wear masks when there's a surge happening, and I wouldn't be surprised if we get a surge of infections in the fall and winter—in fact, I expect in the northern half of the country—and again, that may be a good time to put the mask back on.

So, I don't think we're done with masks forever, but I'm hoping that we're going to get a reprieve from having to wear a mask for at least some period of time.

JOHNSON:

What's your latest thinking as it relates to herd immunity? A lot of people have caught COVID, a lot of people are vaccinated. Where do we stand with that idea?

JHA:

Yeah, so, I think we've all had to do a mental kind of update on what we think about what we mean by herd immunity. At this point in the United States, I'm guessing 90, 93% of Americans have some immunity against this virus, either from a prior infection or from vaccines. And yet, we saw Omicron's surge kind of rip across the nation with impunity.

And so, that means is I think the idea that we're going to have herd immunity, and that's going to wipe the virus out or kind of suppress it for a long time, is wishful thinking because you have waning immunity, you have a highly contagious virus that can break through immunity. at least in terms of causing infection. And so, I don't see herd immunity as a strategy.

I do think building up as much population immunity is possible to protect people from getting sick is important, but I wouldn't spend too much time worrying about a herd immunity threshold for this virus.

JOHNSON:

Dr. Fauci recently said the e word; what's your take on the chance we could get to endemic status sometime soon?

JHA:

So, people mean different things by endemic. I mean, one notion is endemic, just the virus becomes in the background and not a big deal. My expectation is that the virus is not only going to be around for a long time, but it will continue to pose challenges for a while. I expect spring and summer to be reasonably good—again, we may see a surge in the South.

We'll see surges in the future, that doesn't feel very endemic—I mean, it doesn't feel very endemic to say it might be surges. Also, I have every reason to believe we're going to see more variants. So, I don't use the word endemic 'cause I think people sort of think that that's somehow the end of everything and things will be fine. I'm confident we're going to face more challenges with this virus.

But that said, I do think we're entering a new phase where we can manage the virus much more effectively than we could in the past; and our ability to not have things shut down, lots of people die, that's much, much better. So, if that's what people mean by endemic—the work of learning how to manage the virus—sure. If it means the virus is going to go away or not cause problems, that I wish were true, but I don't think it's gonna necessarily be true.

JOHNSON:

If we do get a break as a nation from COVID, what ought public health professionals do during that low?

JHA:

So, I think couple of things, three things.

I would argue one is clearly communicate to the American people that we may have to face challenges so that if there is another surge or another variant, people are not taken by surprise—I certainly wouldn't be surprised.

Second is use this time to worry less about predicting what's going to happen and more for preparing for what's going to happen. So, let's assume there are going to be surges and more variants. Let's build up our supply of testing and masks and therapeutics. Let's keep investing in better vaccines and getting people who are not getting vaccinated, vaccinated. Use this lull not to take a break, but to actually get us ready for the next thing.

And then the last point is, of course in the last two years, all of our public health efforts have gone towards the virus—and of course, rightly so. Maybe we can use this reprieve to start looking at other issues: mental health, substance use, things that have not gotten the attention that they deserve. We need to start focusing on that as well.

JOHNSON:

And they've gotten worse during the pandemic.

JHA:

They've gotten worse, and our ability to focus on them has gotten more limited and they've gotten worse. So, it needs to get attention sooner rather than later.

JOHNSON:

Whatever happens, you're hopeful that we will get a little reprieve.

JHA:

I'm pretty hopeful we're going to get a reprieve. Now, I'll tell you at the end of the day, it's what the virus gets to decide. So, I'm hopeful we're not going to see another variant anytime super soon, but who can predict that for sure. But I think by all means, yeah, we should assume that we're gonna have a pretty nice rest of the winter, spring, most places the summer should be pretty good. Let's keep our fingers crossed and see how it plays out.

JOHNSON:

Organizers have a new conference on dementia caregiving planned for June in Minneapolis and want public health professionals to know more about the subject. That's why they've set the first ever national event for people working in all levels of public health.

Dr. Joe Gaugler directs the BOLD Public Health Center of Excellence on Dementia Caregiving at the University of Minnesota.

DR. JOSEPH GAUGLER:

When we consider the long-term care system in the United States, particularly for people with dementia, the core of it is really this vast unpaid network of caregivers—by and large family members; that in and of itself, because of its prevalence and our heavy reliance on family caregivers, makes it a public health priority.

JOHNSON:

The conference is set for June 14th and 15th. It'll be online and in-person. Get more information and register using the link in the show notes.

Finally today, ASTHO has a new website with a redesigned user experience. The site is more intuitive, featuring an updated look and all the great information you've come to expect from the organization's online portal. Rediscover it for yourself by visiting the site at astho.org.

That'll do it for today's newscast.

Be sure to join us again tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.