Epidemiology
Case counts remain relatively flat in the US, although there may be indications of the beginning of a slight downward trend. Only 13 states are showing an increasing 7-day trend
- NYC has shown a steady decrease in cases since July 11.
- California remains at a medium-to-high community level, although rates are slowly dropping.
Globally, cases appear to have peaked around July 22 and slowing decreasing
- Cases in Europe have dropped by over 1/3rd since peaking around July 22
- Korea and Japan are still at high levels of transmission and continuing to increase.
Hospitalizations
- In the US, new hospitalizations are decreasing, although the census of people hospitalized continues to increase in many areas: Fewer people need hospitalization, but those who do are tending to stay longer.
Deaths
- Increased deaths have been noted worldwide. Deaths are a trailing indicator, and many of these deaths result from infections 4 to 6 weeks ago.
Variants
- A new omicron variant, BA 4.6, is being tracked in the US, where it makes up about 10% of cases in Iowa, Kansas, Missouri, and Nebraska. So far, it does not appear to be significantly different from the BA4/BA5 duopoly of the last 6 weeks, but it is worth watching. No data yet on any changes in resistance to immunity.
Testing
With BA5, antigen test sensitivity may have increased slightly. Antigen tests are still the first line, but if negative and with symptoms, do not assume 1 or even 2 days of negative rule out COVID. Either get a molecular test or wait for the end of symptoms.
Treatments
- Paxlovid and the monoclonal antibody treatment, Bebtelovimab, remain effective treatments for COVID. Generally, Paxlovid is the first line and Bebtelovimab is used if there are contraindications to Paxlovid.
- The FDA recently authorized Baricitinib for the treatment of hospitalized patients with COVID. This is an approved drug, usually used in treating rheumatoid arthritis, which inhibits the action of an enzyme called Janus Kinase. There are potential serious side effects in the way it modulates the immune system, but it becomes another tool in the arsenal.
Prevention
Vaccines
- Pfizer noted that they have already manufactured 150M doses of a BA5 COVID vaccine and authorization is on track in the US for early September. European authorities are targeting late September.
- Moderna has consistently said that they will have a BA5 vaccine ready this fall, but they have not been more specific.
