Valley News – COVID-19 in Vermont: BA.5 variant last on parade
It’s been about a year since the Delta variant arrived in Vermont, reversing what had been a nearly COVID-free summer.
Delta caused an increase in cases and hospitalizations, propelling what Health Commissioner Mark Levine considered a new phase of the pandemic – only for Omicron to arrive in December, causing cases to skyrocket.
Just as Omicron was declining and Vermont was beginning to ease restrictions, BA.2 arrived, and then its close cousin BA.2.12.1. Now, on the heels of that strain’s recovery, Vermont’s COVID-19 levels remain “low” by most indicators — but another strain is on the horizon.
The strain has become dominant in the United States, forming 77% of new cases, according to the United States Centers for Disease Control and Prevention. Although it is difficult to estimate the rate for Vermont, the CDC reports that BA.5 is also the dominant strain in New England.
Experts say BA.5 is about as severe as Omicron and about as transmissible. But they fear BA.5 appears to be good at evading people’s immunity to the virus, meaning reinfections are likely.
“It’s like the population is seeing a completely new virus in some ways,” said Denis Nash, a professor of epidemiology at the City University of New York.
The strain also comes at a time when Vermont has reduced its efforts to fight the disease, said Anne Sosin, health equity researcher at Dartmouth College. Businesses, summer camps and social gatherings have largely returned to normal. Testing, vaccination and treatment are only available through medical providers, rather than state-run sites. The state Department of Health is tracking less data regarding the status of the pandemic than it did for the first two years of the pandemic.
“Our concern with this surge is that BA.5, due to behavioral changes, will find Vermonters most at risk,” Sosin said. While many people have resumed their normal activities, “their exposures in their communities have increased”.
Levine is less worried. The head of the health department said that although BA.5 may cause an increase in infections, it seems unlikely that it will overwhelm hospital resources or cause an increase in deaths.
“If you are (vaccinated and) boosted, you are still very, very strongly protected against serious consequences,” he told VTDigger. “So while we can’t promise you that you won’t get infected at all, or even that you won’t have a symptomatic infection that you feel kind of ugly, we can tell you that the promise of the vaccine is still that you won’t get a serious result if you’ve been boosted appropriately.
He said the number of new hospital admissions for COVID-19 would have to change “drastically” for Vermont to change its policies.
“If more people get sick, there will be more hospitalizations and more serious consequences, but that does not mean that they will be (on) such a scale or an order of magnitude that you will have to change the policy significantly” , did he declare. said.
Sosin said while the hospital system may not be over capacity due to this strain, it — and almost every aspect of Vermonter life — is still vulnerable to the economic and social impacts of COVID.
“The push comes at an incredibly precarious time,” she said. Vermont is navigating both economic and health crises, she said, and many of its primary care providers and community service agencies have been overstretched over the past two and a half years.
The latest strain is already causing disruption in schooling, childcare, work, essential services and other essential industries such as airlines, Sosin said. But Vermonters may not have the resources to adhere to COVID policies, such as getting tested as soon as possible.
“The cost of living has gone up so much, and so many people are really struggling to meet their basic needs,” she said. “COVID dysfunction is certainly exacerbating this, but it’s not the only concern that’s getting our attention.”
Experts also pointed to particular concerns for those at high risk, who may want to take extra precautions at a time when most Vermonters are going about their daily lives. Nash said “the news isn’t good” if you’re trying to avoid COVID infection for your own safety.
“It can be really, really difficult unless you stay confined,” he said.
There are some tools that the health department recommends for high-risk people to protect themselves, such as staying on top of recalls, wearing high-quality masks, and calling their doctor as soon as they test positive to get antiviral treatment.
But Sosin warned that now may be the time for those at high risk to increase their precautions as much as possible. She recommended taking advantage of outdoor activities when they are an option.
The health department’s latest COVID case data does not indicate a BA.5 surge. The state is reporting about 80 cases a day, little changed from the previous week.
But case data doesn’t tell the whole story. In fact, Sosin thinks we’re already in a “phantom flare,” where people are getting sick but aren’t included in state data, which relies on PCR tests — which have declined in popularity and availability. and whose results are a day or more behind the time of the test.
This is not a new concern. State officials, including Levine, have warned of growing inaccuracy in case data since the Omicron push, and the health department has been working to establish new measures, such as surveillance syndromic – which involves looking at population-level health data – or sewage testing.
Still, it’s a problem that continues to worry experts like Nash, who said “we kind of have to wait” until hospitalizations and deaths have increased to say we’re in a wave.
“It’s really problematic because it might be too late to have avoided a lot of hospitalizations and deaths if you wait that long,” he said.
Nash conducted research during BA.2 that tested a random sample of New York’s population. He found that the prevalence of the virus was much higher than officially reported and was particularly high among people with underlying medical conditions who were at risk of developing serious complications from the disease.
Ted Cohen, an infectious disease epidemiologist at Yale University, is working on a project that would estimate the true prevalence of COVID across the country using the limited hospitalization data available.
“Trying to figure out where we’re relying on just the case records is basically a nightmare,” he said.
Nash said the Omicron subvariants caused a “parade of surges” that collide closely, making it difficult to distinguish between the different strains and understand their different effects on the population.
It’s hard to say whether or not BA.5 will lead to an increase in hospitalizations, Sosin said. The number of hospitalizations for COVID rose from 10 to 31 last week, but remains below the high BA.2 level of more than 60 in mid-May.
“We fly in the BA.5 surge blindly to make both individual and political decisions,” she said.