What About BA.2?

 Covid cases, hospitalizations, and deaths are at their lowest point in Los Angeles County since July 2021 (727 new cases, 25 new deaths, and 432 current hospitalizations as of 19 March 2022). The masking mandates have pretty much been lifted except for public transit and healthcare facilities. And still.

The omicron variant BA.2 is producing surges in Europe. Asia is seeing rising cases. It has been described for several months in Africa where case counts are less precise. BA.2 is perhaps 30 to 50% more transmissible than its cousin BA.1. New York City is experiencing a rise in test positivity and cases of BA.2 in the past 10 to 14 days and is an airplane ride from Los Angeles or any other city for that matter. 

The encouraging news is that vaccinations and prior omicron BA.1 infection seems to provide protection against BA.2’s ability to produce severe disease and death. How robust this “immune wall” is and how long it will persist remain objects to study. Experts such as Drs. Fauci and Gottlieb warn of an uptick in cases but continue to stress that another wave of infection is unlikely. Time will tell if this prediction is correct.

The FDA is considering proposals from both Pfizer and Moderna for a fourth dose of vaccine (a second booster). Pfizer’s application is for those 65 and older while Moderna has a broader request for all people who have already received three doses. In the United States, 96.54 million people have received three doses of vaccine but that is less than ⅓ of our population. And the vaccine is not yet authorized for children. As an infectious disease physician and epidemiologist, I find that quite disheartening. We have had vaccines available since December of 2020 but the fractious nature of our politics has kept us from attaining the most solid protection against covid. History will record this not only as a massive public health failure but as a failure of our nation and its people.

We are nowhere near out of the woods with this virus and the work yet to be done is gargantuan. World distribution of vaccines remains abysmal, with 57.6% of the world’s people having received two doses of any vaccine (including the less effective Russian and Chinese vaccines) and 18.5% having received three doses of any vaccine. The susceptible population that will allow new variants to emerge thus remains huge. Additionally, pandemic fatigue is real and is becoming more and more widespread. The disinformation that continues to emerge regarding masks (my freedom!) and vaccines (not in my body!) is not abating.

I admit I remain skeptical of anyone who pronounces that the Covid-19 pandemic is over. Margan and I will get another booster when they are available and we continue to mask in indoor spaces around other people. We search for things to do outdoors in uncrowded situations because fresh air and lots of ventilation are best. No predictions here but my advice is to not discard your masks and don’t allow others to intimidate you when you wear them. We ought to know soon what BA.2 really means for humanity.