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As the United States heads into a third pandemic winter, the first hints are emerging that another possible spike in COVID-19 infections could be on the way.
So far, no national push has yet started. The number of people infected, hospitalized and dying from COVID in the United States has been slowly declining from a fairly high level plateau.
But as the weather gets colder and people start spending more time indoors, where the virus spreads more easily, the chances of a resurgence increase.
The first clue to what might be in store is what’s happening in Europe. infections increased in many European countries, including the United Kingdom, France, and Italy.
“In the past, what happened in Europe has often been a harbinger of what is about to happen in the United States,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “So I think the key message for us in this country is this: we have to be prepared for what they are starting to see in Europe.”
Several computer models predict that COVID infections continue to decline at least until the end of the year. But the researchers point out that there are many uncertainties that could change this, for example if more infectious variants begin to spread rapidly in the United States.
In fact, scientists observe a menagerie of new omicron subvariants which have emerged recently and seem to be even better at dodging immunity.
“We look around the world and see that countries like Germany and France are seeing increases right now,” says Lauren Ancel Meyersdirector of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. “It makes me think. It adds uncertainty as to what we can expect in the weeks and months to come.”
However, it’s unclear whether the U.S. experience echoes that of Europe, says Justin Lessler, an epidemiologist at the University of North Carolina who helps manage the COVID-19 Scenario Modeling Center.
Indeed, it is not clear whether the increase in cases in Europe is linked to people’s greater susceptibility to new subvariants to which they have not yet been exposed. Also, different countries have different levels of immunity.
“If it’s mostly behavioral and climate changes, we might be able to avoid similar spikes if there’s wide uptake of the bivalent vaccine,” Lessler said. “If it’s immune evasion across multiple variants with convergent evolution, the outlook for the United States might be more concerning.”
In fact, some researchers say the United States is already beginning to see the first signs of it. For example, the levels of viruses detected in sewage are on the rise in some parts of the country, as in Pennsylvania, Connecticut, Vermont, and other parts of the Northeast. It could be a harbinger of what’s to come, although overall the virus is waning nationwide.
“It’s really too early to tell that something big is going on, but it’s something we’re watching,” says Amy Kirby, manager of the national wastewater surveillance program at the Centers for Disease Control and Prevention.
But infections and even hospitalizations have started to rise in some of the same parts of New England, as well as other northern areas, like the Pacific Northwest, according to Dr. david rubinthe director of the PolicyLab at Children’s Hospital of Philadelphia, which is tracking the pandemic.
“We are seeing the northern edge of the country starting to show evidence of increasing transmission,” Rubin said. “The winter resurgence begins.”
Assuming no radically different new variants emerge, it seems highly unlikely that this year’s surge will become as severe as the past two years in terms of serious illness and death.
“We have a lot more immunity in the population than we had last winter,” says Jennifer Nuzzowho directs the Pandemic Center at Brown University School of Public Health.
“Not only have people been vaccinated, but a lot of people have now contracted this virus. In fact, some people have contracted it multiple times. And it’s accumulating [immunity] in the population and reduce the overall risk of severe disease,” says Nuzzo.
Another crucial variable that could affect the impact of an increase in infections is the number of people who contract one of the new bivalent omicron boosters to bolster their declining immunity.
But the adoption of recalls in the United States was already slow. “Nearly 50% of people eligible for a reminder did not receive one,” says Guillaume Hanage, associate professor of epidemiology at the Harvard TH Chan School of Public Health. “It’s wild. It’s really crazy.”
And demand for new boosters has been pretty sluggish so far. Less than 8 million people received one of the new boosters since becoming available over Labor Day weekend, though over 200 million are eligible.
Given the likelihood of a flare-up, it’s essential that people are up to date on vaccines, says Nuzzo. “The most important thing we can do is take off the table that this virus can cause serious illness and death,” she says.
“There are a lot of people who could really benefit from a boost but haven’t.”