Talk of turning the corner on COVID-19 premature, experts say

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MERIDEN — William Frias lost his sister to COVID-19 Thursday night and on Friday morning was taking nothing for granted.

“I have to do it,” Frias said Friday about vaccinations and mask wearing. “Viruses have been around for a long time. It’s not going away just because we want it to.”

The Meriden native, who is vaccinated and boosted, was leaving a train at Meriden Station from New York, where he travels three or four times a week. His sister was unvaccinated.

“She didn’t want to get it,” he said about the vaccine. “It’s been hard for her family.”

Frias intends to continue wearing a mask even if mandatory restrictions on public transit are lifted.

“It’s irresponsible” not to, he said.

Mask-wearing, vaccines, boosters and regular testing are key to making COVID-19 an endemic illness like the cold and flu, health experts said. But despite a slowing rate of COVID-19 infections and hospitalizations statewide, experts said that talk of turning the corner is premature. 

“It’s still too early to determine that,” said Dr. Ulysses Wu, chief epidemiologist & system director at Hartford HealthCare. “It has to move away from being widespread in all countries. I don’t know when, but eventually.” 

World governments, including the U.S., can do more to move things in the right direction, said Dr. Peter Hotez. A global vaccination effort, including developing and manufacturing vaccines that utilize a variety of technologies, is critical to keeping variants at bay and overcoming hesitancy. 

Hotez told reporters, during a virtual media conference Thursday, that it’s time to take a look at the durability of the current mRNA vaccines now used to combat the pandemic. Hotez is dean of the National School of Tropical Medicine and co-director of the Texas Children’s Center for Vaccine Development. 

“The omicron wave does seem to be subsiding. We have to see if it goes down as quickly as it accelerated,” Hotez said. “I’m careful not to be too overly optimistic. Sometimes it’s going down then goes up. The question is will it subside”

What’s next?

The delta variant was an epidemic among the unvaccinated, health experts said. Their core messaging was about the importance of vaccinations and boosters, but the breakthrough infections with the omicron variant as vaccination effectiveness waned told a different story. Still, data indicated that vaccinated patients who caught the virus were less likely to require hospitalization, ICU and ventilation treatment. 

“What’s next is what happens after that,” Hotez said. “Too many colleagues are engaged in too much happy talk that omicron will create immunity and end the pandemic. I’m of the opinion that’s not going to happen.”

Two hours after Hotez made his comments, the Yale School of Public Health released a study of 2.5 million people which found that before the emergence of the delta variant in Israel, vaccination reduced the risk of being infected by 89% and lowered the risk that people with breakthrough infections would transmit the virus to other household members by 23%.

After the emergence of the delta variant, however, vaccination no longer reduced the infectiousness of breakthrough cases and provided slightly less protection against infection, the scientists found. Instead, people who had received their second dose of vaccine more than three months ago were only 40% less likely to be infected compared to an unvaccinated person and may have actually been more likely to transmit the delta variant to other household members.

“Our analysis suggests that while vaccines provide good protection against coronavirus infection, this protection wanes over time,” said Virginia Pitzer, an associate professor at Yale School of Public Health and the study’s senior author. “Moreover, vaccinated people who got infected with the delta variant were just as infectious as unvaccinated cases. This emphasizes the need for booster doses and for people who are infected to isolate regardless of whether or not they are vaccinated.”

The transmission study did not review hospitalizations or serious illness, the impact of boosters, and was conducted prior to the omicron variant. 

This doesn’t necessarily mean the vaccines failed. They do the things they were designed to do — protect against serious illness, hospitalization, and death — and taken as a three-dose series, reduce the duration of infection. But almost 40 million people remain unvaccinated in the U.S.; globally, only 58 percent of the world’s population has been able to receive even a single shot. 

This population provides an endless opportunity for the virus to survive and any mutation around the corner could bring us back to square one. This is why health leaders, such as the World Health Organization, likely won’t classify COVID-19 as endemic should omicron subside.

Shift to endemic

Wallingford Public Health Director Stephen Civitelli explained how health officials classify disease.

Epidemic is a disease that affects a large number of people within a community, population, or region.

Pandemic refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.

Endemic refers to the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.

An outbreak is a greater-than-anticipated increase in the number of endemic cases. It can also be a single case in a new area. If it’s not quickly controlled, an outbreak can become an epidemic.

“The discussion currently had by public health and medical professionals as to when the shift will begin from a classification of a pandemic to endemic will be based on various factors,” Civitelli said in an email. “The amount of a particular disease that is usually present in a community is referred to as the baseline or endemic level of the disease.”

Evaluating the data trends surrounding the latest omicron surge will allow public health officials to determine what phase the state/country are in as well as how to best approach combating COVID-19 moving forward. At this time both pharmaceutical (vaccines/boosters) and non-pharmaceutical interventions (masking/testing) are the best line of defense against COVID-19, Civitelli and other health experts said.  

COVID-19 treatments need to be administered early in the infection stage and are not considered a substitute for vaccination. Two monoclonal antibody treatments were found to be ineffective in treating omicron. 

Steady practice

The evolving science and introduction of new variants and vaccine durability have done little to boost confidence in vaccines that have tested safe and effective. 

But the anti-vaccination movement, which has grown in the U.S. throughout the pandemic, is also diminishing the chances of slowing the spread of the virus. 

“Rates of vaccination in our community continue to rise weekly — albeit very slowly,” said Lea Crown, director of health and human services for the city of Meriden. “The issue public health is facing is that we are also in an ‘infodemic’ of health misinformation, in which many people have had trouble figuring out what to believe, which sources to trust, and how to keep up with changing knowledge and guidance. We ask residents to stay the course; we know that it is frustrating, in our fourth calendar year of COVID, to still be dealing with this pandemic.” 

Masking should remain a steady practice when people are indoors among those whose vaccine status is unknown. Testing should become routine to ensure asymptomatic positive cases isolate to prevent spread, health experts said. 

Evolving science

Hotez and others blame extreme right-wing commentators for sowing doubt about the vaccines, which has slowed global vaccine efforts that could prevent variants such as omicron from forming in hosts. Hotez advocates for a vaccine task force that will study and make available a variety of technologies in vaccine development that could overcome hesitancy. 

Hotez, a Connecticut native, is among those who developed a low-cost COVID-19 vaccine at Texas Children’s Hospital and Baylor College of Medicine. Unlike the mRNA vaccines produced by Pfizer-BioNTech and Moderna and the modified adenovirus technology shot developed by Johnson & Johnson, Hotez’s vaccine CORBEVAX is a recombinant protein vaccine. The technology has existed since the 1970s and was used to develop a vaccine against hepatitis B. Other forms of recombinant protein vaccines using protein from insect cells have been used to fight ebola, SARS, MERS, influenza, and Zika. CORBEVAX involves loading the genetic code for the viral protein into yeast cells.  

“It's made through microbial fermentation of yeast,” Hotez said Thursday. 

Last month, Corbevax was authorized for emergency use in India, and technology to develop more is available in dozens of countries. Although the drug is not authorized for use in the United States, Hotez has received numerous requests from those who are hesitant about getting an mRNA vaccine. 

“The US is vulnerable to the next wave,” Hotez said. “Delta rose out of unvaccination, omicron out of west Africa. Mother Nature is going to continue to hurl variants of concern. We have to recognize we still have variants. The only way to get around this is to vaccinate the global population.”

mgodin@record-journal.com203-317-2255Twitter: @Cconnbiz


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