Consider This from NPR - Entering A Cautiously Relaxed Phase Of The Pandemic

Episode Date: February 23, 2022

As winter begins to fade, COVID-19 maps are changing colors from those ominous dark shades to a more hopeful outlook. Infections are down dramatically in the past few weeks and death and hospitalization rates are dropping too. But there's also reason for caution. NPR correspondent Rob Stein reports on a new version of the Omicron variant referred to as BA.2. It's been the dominant strain in some countries and it's showing up in the U.S. too. And NPR correspondent Michaeleen Doucleff discusses whether a fourth booster dose of vaccine may be in our future. In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

You know those coronavirus maps showing infection rates around the country, the ones that were awash in dark, scary colors for the last couple months as the Omicron wave crashed over the U.S.? Well, as winter begins to fade, those maps are changing colors. New COVID-19 infections are down more than 60% over the last few weeks. Deaths and hospitalization rates are dropping too. And if all this feels a bit familiar, well, here was CDC Director Rochelle Walensky last spring. If you are fully vaccinated, you can start doing the things that you had stopped doing

because of the pandemic. In May of 2021, Walensky announced that fully vaccinated people no longer had to mask up. We have all longed for this moment when we can get back to some sense of normalcy. At the time, that guidance surprised a lot of people, like Lina Nguyen, a professor of public health at George Washington University. The CDC seems to have gone from one extreme of over-caution to

another of basically throwing caution out the window. That was Nguyen last year, but she told NPR that this moment is different. Now, the vaccination rate overall is much higher. Children five and older have been able to be vaccinated since November. She also said that while Omicron is highly contagious, it proved to be generally milder and has already swept through the country. And I think as importantly, there is a recognition that we cannot be in a perpetual state of emergency. The CDC has already hinted that future guidance will be more measured.

Here's Rochelle Walensky again at a White House COVID briefing last week. We want to give people a break from things like mask wearing, when these metrics are better, and then have the ability to reach for them again should things worsen. You wear it when it's raining, you take it off when it stops raining. Ashish Jha, dean of the School of Public Health at Brown University, says this is the right approach. He often uses a raincoat analogy when talking about masks and other COVID precautions. And if we think of masks in that way, then yeah, during surges, we should have masks and everybody should be wearing them. And then when the surge ends, we should take off our masks. Consider this. The Omicron surge is fading away. So what comes next? A more relaxed chapter of the pandemic? Another variant? Or some combination of the two?

From NPR, I'm Ari Shapiro. It's Wednesday, February 23rd. It's Consider This from NPR. I saw a tweet the other day from the comedian Caleb Herron. It said, this time between variant surges is so precious. So yeah, everybody has learned not to get too complacent. And right now, scientists are watching a version of Omicron called BA.2. It has spread quickly in South Africa, Denmark, and other countries, although it's not clear if that'll be the case in the U.S. Here's Nathan Grubbaugh with the Yale School of Public Health. A lot of us were assuming that it was going to quickly take off in the United States, just like it was doing in Europe, and become the new dominant variant.

But that hasn't happened yet. Instead, Jeremy Lubin at the University of Massachusetts says cases of BA.2 have been steadily popping up. There are places where it's dominated pretty quickly, like Denmark. In the U.S., it's just kind of creeping up slowly. We asked NPR health correspondent Rob Stein to explain what people should be watching for. The CDC says BA.2 has now been found from coast to coast and accounts for almost 4% of all new infections nationally. And Samuel Scarpino at the Rockefeller Foundation says BA.2 appears to be doubling every seven days. And so if it doubles again to eight percent, that means that we're into the exponential growth phase and we may be staring at another wave of

COVID-19 coming in the U.S. And that's, of course, the one that we're really worried about and kind of why we're all on the edge of our seats. Especially because so many people are still unvaccinated in this country, and one of the remaining antibody treatments for COVID-19 looks like it may not work as well against BA.2. Now, some experts, like Gruba at Yale, think it's unlikely BA.2 will trigger a massive new surge because so many people have immunity from prior infections and vaccination at this point. The most likely thing that's going to happen is that it might extend our tail, meaning it might slow down the decrease in cases, but it's probably not going to lead to a new wave of cases. But Omicron is still infecting more than 100,000 people

and killing about 2,000 people every day. So even though BA.2 doesn't appear to make people sicker than the original Omicron, just slowing down the decrease will lead to a lot more suffering and death. Here's Jeremy Lubin again at the University of Massachusetts. There are going to be plenty of people getting sick and ending up on respirators and dying due to BA.2. So when it bites, it hurts.

And Lubin says it's impossible to rule out the possibility of another surge driven by BA.2. It may be that the virus has to get to somewhere like 5, 7 percent, and then all of a sudden, once it has a foothold like that, it will take off. That's a particular concern as mask mandates and other restrictions are being lifted around the country, and people are really laying down their guard. Here's Samuel Scarpino again at the Rockefeller Foundation. There is this lurking threat of BA.2, and we need to make sure this isn't going to be a problem before we roll back all the mandates, before we tell everybody that it's safe. Because, Scarpino says, the nation has been blindsided before,

so everyone is continuing to keep a close eye on BA.2. NPR health correspondent Rob Stein. As Rob mentioned, lots of people in the U.S. have immunity from prior infections and vaccination. And that's one reason public health officials are willing to loosen restrictions, even as new threats loom. So how long does immunity last after people get vaccinated? If you got a booster shot more than a few months ago, should you think about a fourth shot? NPR's Ayesha Roscoe spoke with global health correspondent Michaelene Ducliffe about that. So I understand that several countries are already starting to roll out fourth doses, including Sweden and Chile. Do people here in the U.S. need a fourth dose?

Yeah, so right now the data suggests that for the general population, people don't need a fourth dose, and here's why. Last week, a study came out of Israel looking specifically at what a fourth dose does. How much does it help? It's a preliminary study, and it's pretty small. It included only about 700 people. But it found that quite clearly that a fourth shot of either Pfizer or Moderna doesn't add much protection against infection beyond the third dose. Specifically, it increased protection by only about 10 to 30 percent. And that protection will likely wane over time.

So 10 to 30 percent increase. Why would the fourth shot not boost protection like the third shot did? Why isn't it the more the better? Yeah, I was talking to Jenna Guthmiller about this. She's an immunologist at the University of Chicago. She says, you know, this vaccine really isn't designed to stop Omicron, stop Omicron infections. It's designed to stop the original variants of the virus that circulated two years ago and are very different than Omicron. We know that this virus is way more likely to cause an infection just

because it's more infectious, right? And so what used to work for something like, you know, the Alpha variant and even to a certain degree with the Delta variant is perhaps not the same thing that's going to be necessary for Omicron. In other words, no matter how many shots you throw at it, four, five, six, it's just not going to stop infections. Okay, well, for people who may be looking for a little hope, the fourth dose isn't going to stop infections, but what about preventing severe disease and hospitalizations? Like, would a fourth shot at least help with that? Yeah, so first off, three doses for healthy people under age 65 or so are still doing a good job of preventing what you said, severe disease and

death. But a recent study from the Centers for Disease Control and Prevention shows that this protection may wane just a little bit over time. We're talking about a decline after four months from about 90% to 80%. Okay, so a drop in protection of about 10%, that doesn't sound like a huge amount, but for some people, could that be a problem? Yeah, you know, that right there is really the key. So for people who are at high risk of severe disease to start off with, losing even a small fraction of protection could be a problem. These are people who are over age 65 or who have health problems like heart disease or obesity, which put them at higher risk, or people with compromised immune systems. Akiko Iwasaki is an immunologist at Yale University. She says these people will likely benefit from an additional dose. Their immune response is not as robust as a healthy young person. And that is probably the first target group that would require such a

booster. But she says when that booster will be needed isn't known right now and depends on just how quickly this immunity is waning in this group. Hopefully we'll have data on that in the next month or so. Okay, so I hear you, but some people may be wondering, is there any harm in getting a fourth shot? You know, that's a really good there any harm in getting a fourth shot? You know, that's a really good question and probably not for the fourth shot, but some immunologists say there could be harm in getting many shots in a short period of time. This is all speculative, but in the lab, sometimes researchers do see negative effects with other vaccines. Parts of the immune system can kind of start slowing down a bit. And one immunologist told me that you could actually make your immune response worse with too many shots.

NPR Global Health Correspondent Michaelene Ducliffe. And we heard additional reporting in this episode from NPR White House Correspondent Tamara Keith. You're listening to Consider This from NPR. I'm Ari Shapiro.