Infectious disease experts not phased by coronavirus uptick

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Infectious disease experts are optimistic about the future, saying that while COVID-19 cases may be on the rise, hospitalizations and deaths are nowhere near the levels seen in past surges.

Dr. Amesh Adalja, senior scholar at Johns Hopkins University and an infectious disease physician, said the uptick in cases is not surprising.

Adalja attributed the recent increase in cases to new variants that have emerged, coupled with the fact that “most people are back to their normal life, where there’s going to be more opportunity for the virus to spread.”

However, he said the medical community is seeing a much more manageable infection, as many people are vaccinated or have already been infected.

“It’s a different situation than prior points in the pandemic, because we’re seeing a lot of delinking of cases from hospitalizations,” said Adalja. “Hospitals are not overwhelmed at this point and it’s unlikely that they will be overwhelmed because there’s so much immunity in the population.”

Dr. Shira Doron, an infectious disease physician at Tufts Medical Center, agreed, adding that hospitalization rates tracked by the U.S. Centers for Disease Control and Prevention are misleading.

The CDC lists any person in the hospital with COVID-19 as a hospitalization, but many patients are admitted for other reasons, and test positive for the virus upon entrance, Doron said. This is because Massachusetts has a mandatory admissions testing policy.

Doron said Tufts began tracking its own hospitalization rate in January, during the height of the omicron variant surge. At that time, about 50% of patients were in the hospital for COVID-19; that number is now consistently at 32%, she said.

Since the omicron variant was first detected around Thanksgiving, it has mutated several times, with its BA.2 subvariant spawning its own mutation, BA.2.12.1, which impacted countries based on where they were at with the initial surge, Doron said.

For the United States, which had been easing out of the past surge, each subvariant caused an uptick, she said.

Going forward, Doron said the focus should be on getting two shots into the arms of those who have not been vaccinated, rather than focusing on booster shots and implementing the restrictions that were put in place earlier in the pandemic.

Mandates such as requiring everyone to wear a mask again or placing restrictions on their activities are not the solution, Doron said. These restrictions have not worked, she said, and also “sow distrust.”

Booster shots should be aimed toward older people, Doron said, rather than low-risk people. She would like to see new vaccines that prevent infection and are effective against variants.

But Dr. Todd Ellerin, director of infectious disease and chief of medicine at South Shore Hospital, had a different take on vaccine efforts.

“One of the points I want to make is: Full vaccination is no longer two shots,” said Ellerin. “Full vaccination needs to be a minimum of three shots.”

Ellerin credited vaccines and Pfizer’s new antiviral pill, Paxlovid, for reducing hospitalizations by approximately 89%.

What all three doctors agreed upon was that COVID-19 is not going away. There are always going to be infections, hospitalizations and death, particularly for those who remain unprotected. What they do foresee is a more mild infection, with Adalja speculating that it could become a fifth seasonal influenza virus.

“In general, what we’ll see is this becoming a much more manageable infection,” said Adalja.



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