Fauci sees reduced Covid threat this winter

Federal health officials expressed optimism on Tuesday that the country is better prepared to deal with a surge in Covid-19 infections this winter compared to a year earlier, and they renewed their calls for Americans to receive an updated booster shot ahead of the holidays.

While the trajectory of the virus remains uncertain, Dr. Anthony S. Fauci, President Biden’s chief medical adviser, said the administration hopes the combination of infections and vaccinations has created “enough community protection that we weren’t going to see a rehearsal”. from what we saw last year around this time,” when a brand new variant, Omicron, appeared seemingly out of the blue.

As families gather for Thanksgiving, the coronavirus appears to be less of a threat to most Americans than a year ago, when Omicron began spreading the infection at an alarming rate. At the time, Mr Biden banned travel from eight African countries and warned Americans not to panic, and then sent military medical workers to hospitals authorities feared would be overrun with patients .

Now, Dr. Ashish K. Jha, the White House’s Covid-19 response coordinator, said he’s confident the holiday season will come as long as Americans continue to get vaccinated and strengthened. “Nothing I’ve seen in the subvariants makes me believe we can’t get out of this effectively, especially if people step in and get vaccinated,” he told a briefing. to the White House.

This could be an important caveat. Weary of two years of repeated vaccination campaigns, Americans have been reluctant to embrace the updated booster shots the administration rolled out in September. So far, only 35 million people have received one of the revised shots from Moderna and Pfizer-BioNTech. The administration purchased enough doses for nearly five times as many people.

On average, about 300 Americans a day still die from Covid-19, even though federal health officials say nearly all Covid deaths are now preventable through vaccination and treatment. Other respiratory illnesses, including influenza and respiratory syncytial virus, or RSV, are also reappearing after two years of low levels of infection.

And where the coronavirus is headed remains a mystery. Federal officials observed a new subvariant of Omicron called XBB with some trepidation. The new subvariant accounts for only a tiny percentage of cases in the United States so far, but it is showing up in traveler testing at major international airports across the country and has taken hold in India and Singapore.

Dr Fauci said XBB seemed exceptionally nimble at evading antibodies created by previous infection or vaccination and which form the body’s first line of defense against the virus. But vaccine experts have long said that other parts of the immune system can step in to ward off serious illness if antibodies fail to block the virus.

And Dr Fauci said he and others were encouraged by data showing that countries like Singapore, where XBB has led to increased infections, have not reported a commensurate increase in hospitalizations.

Dr Fauci, who has become a household name during the pandemic and is retiring from government service at the end of the year, made what was most likely his last appearance in the White House briefing room and took advantage the opportunity to urge Americans to get the updated booster shots.

“My message and my last message – perhaps the last message I give you from this podium – is that please, for your own safety, for that of your family, get your Covid-19 vaccine updated. day as soon as you are eligible,” Dr. Fauci said.

The administration is ramping up efforts for new boosters over the next six weeks. He announced spending $475 million to expand vaccination efforts at community health centers and other locations, and officials hope to reach more Americans by running ads during the World Cup. The government has also warned care homes must offer the updated plans to residents or face enforcement action from regulators.

The push comes as the Centers for Disease Control and Prevention delivered what some experts described as encouraging news about the effectiveness of new vaccines.

A major new study published by the agency showed that updated injections boosted protection against symptomatic illness in adults by 28 to 56 percent, depending on the person’s age and the time since the previous injection. The researchers studied people who received a dose of the revised boosters between two months and more than eight months after their last vaccine dose, and they found greater benefits in those who waited longer.

“Is it a home run? No, but it’s a good baseline success,” said Dr. Peter Marks, the lead vaccine regulator at the Food and Drug Administration who lobbied for the development of the new boosters.

The study, the first published that looked at the real effectiveness of new vaccines, looked at 360,000 adults who reported symptoms of Covid-19 between mid-September and mid-November. Its importance is limited by the fact that the Omicron subvariant that accounted for the highest number of infections during this period, BA.5, has declined and now accounts for only a quarter of cases in the United States. .

“Real-world variants have already evolved,” said Pei-Yong Shi, a virologist at the University of Texas Medical Branch who has conducted laboratory studies of the updated boosters both independently and in collaboration with Pfizer-BioNTech.

Dr Shi also said it was difficult to measure the effectiveness of the updated boosters because many people now had some immunity from previous infections, including people who had never been vaccinated or boosted. This can make estimates of the effectiveness of updated plans artificially low, he said.

Dr. Roby Bhattacharyya, an infectious disease physician at Massachusetts General Hospital, said the CDC study showed the revised reminders were “clearly worth getting.”

Some other experts were more skeptical, saying the new vaccines seemed to offer only moderate protection against symptomatic illnesses and that while such protection would help in the short term, it was unclear how long it would last.

John P. Moore, a virologist at Weill Cornell Medicine, said researchers hadn’t shown whether the updated boosters worked any better than the original boosters they replaced — a swap that cost the federal government dearly. . “I personally doubt there was much difference, if any, but we may never know,” he said.

While Americans moving indoors over the winter and a succession of holiday gatherings are expected to drive up cases, federal officials aren’t the only ones showing cautious optimism. Dr Bhattacharyya said he did not expect the virus to cause as much suffering and death this winter as it did a year ago because “we are a more immune population”.

Another study released by the CDC on Tuesday highlighted the effectiveness of Paxlovid, an antiviral drug recommended for adults with mild to moderate symptoms of Covid-19 who have a higher risk of severe disease.

Adults diagnosed with Covid who were prescribed Paxlovid had a 51% lower rate of hospitalization within 30 days of their diagnosis than those who were not prescribed the drug, the study found. The researchers compared nearly 200,000 adults who received Paxlovid within five days of their diagnosis with more than 500,000 people who did not receive it for a five-month period ending in August.

The study found that only 28% of people eligible for Paxlovid had been prescribed it. The researchers said the drug should be offered to all eligible people, especially the elderly and people with multiple underlying health conditions. The study did not address how often Covid symptoms rebounded after people had completed the five-day treatment, a question that some providers say has them wondering if the treatment is long enough.

Kody Kinsley, North Carolina’s top health official, said he hopes the new study will inspire some doctors and patients to use the drug. He said about two-thirds of adults in his condition were at high risk of serious illness from the coronavirus, but for reasons that were unclear, doctors were hesitant to prescribe Paxlovid for them.

“It’s been an ongoing issue and something we’ve talked about,” he said, adding, “What we hear from people is, ‘I talk to my doctor and my doctor says, ‘Hey Well, your symptoms are mild, so hold on. And I don’t know if you need it.

In fact, he said, the decision to take Paxlovid should depend on a patient’s vulnerability to a severe case of Covid-19, not the severity of the symptoms.

Zolan Kanno-Youngs and Noah Weiland contributed report.

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