• Wed. Oct 5th, 2022

A Message from The Center for Closing the Health Gap

By Clyde E. Henderson, MD

Cincinnati Medical Association

We are continuing to see hopeful news regarding the Omicron variant of this COVID-19 virus.  Cases are down by at least 50% in every state, except four, over the last two weeks.  Even though the American case count is down by 80% since the mid-January peak, we are still experiencing in excess of 100,000 new US cases per day.  Hospitalizations and intensive care unit bed occupancy are down 30% in the last two weeks. Unfortunately two of our neighboring states, WV and KY along with AL, are experiencing the highest number of recent hospitalizations. Predictably their vaccination rates lag behind the national average. Although percentage wise the Omicron variant death rate is lower than previous variants, the absolute number of Americans succumbing to this virus remains a staggering 2,300 per day. This number represents a downward trend of 10% over the last two weeks.

With the falling cases, hospitalizations, and death rates have come the ever increasing cries for the elimination of mask mandates.  As of today, February 19, 2022 Hawaii became the only state that has not at least announced the lifting of the indoor mask mandate. New Mexico lifted its mandates effective immediately and Washington State lifted its mandates effective March 21. All of the state government officials are out in front of the CDC which has declared that it will update its recommendations “within the coming weeks”. We have reason to look ahead as the Institute for Health Metrics and Evaluation (Seattle) states that 73% of Americans have some immunity to the Omicron variant either because of vaccinations (especially boosters),or from having been exposed. The caution is that the latter is more of a waning immunity. Those individuals should clearly get vaccinated. Current CDC guidelines recommend vaccination as soon as an infected person is out of quarantine. It should also be noted that the CDC has changed its guidelines and now recommends that those individuals who received monoclonal antibodies for treatment of COVID-19 no longer wait to be vaccinated. Studies have shown that proper immunity is inferred when they are vaccinated immediately after quarantine. The previously recommended sixty day wait is no longer necessary.

Another cautionary tale regarding the potential hazard of lifting mask mandates can be found in the Denmark experience. That country was one of the first to lift its mask mandate and this was followed by sharp increases in cases, hospitalizations and deaths. In early February the deaths had surged to 67% of their highest peak. It is noteworthy that Denmark’s lifting of its masks mandates became synonymous with the “end of the pandemic”.  A more appropriate reading of the situation is that the country has decided that it is willing to tolerate whatever happens as mitigation measures have been relaxed or removed. This is apparently where we are in the USA as well. The good news remains that if you are vaccinated and particularly boosted, you are well protected against the currently known variants of COVID-19. Vaccinated Americans have decided that they no longer should be denied the benefits of a return toward normalcy at the sake of those who have decided that they will not get vaccinated.

The bad, yet predictable, news is that the unvaccinated will still continue to fuel the persistence of the influence that COVID-19 has on all of our lives. Specifically we are seeing the emergence of yet another variant. This one is labeled BA.2 and is a sub variant of the Omicron. It can spread faster. Its virulence (potential to cause disease) is not yet clear.  It has only 20 different mutations from its Omicron parent and therefore is not given its own Greek letter designation. It has also been termed the “stealth Omicron” because it doesn’t have a mutation which allows it to be clearly identified as being distinguishable from its parent BA.1 (Omicron) variant. Currently the boosted vaccine remain effective at preventing even the “stealth Omicron” from causing severe disease, hospitalization, or death.  This sub-variant has been identified in sixty-nine countries and multiple states in the US.

This virus, its variants, and sub-variants know not geographic boundaries or politics. Neither our frustration nor fatigue will decide when the pandemic is over. COVID-19 will!!