Dr. Shira Doron, epidemiologist at Tufts Medical Center. Photo: Tufts Medical Center

Doctors warn COVID remains a clear and present danger



Doctors warn COVID remains a clear and present danger

Dr. Shira Doron, epidemiologist at Tufts Medical Center. Photo: Tufts Medical Center

BOSTON — Although the new COVID-19 BA.5 subvariant has affected Massachusetts, local Jewish doctors are not seeing high hospitalization numbers in the area at this point.

“We have a very high rate of BA.5 in Massachusetts, but I’m not seeing an increase in hospitalization here,” said Dr. Shira Doron of the Tufts Medical Center, where she is the epidemiologist and antimicrobial steward.

“So many more people are being diagnosed with home testing, but fortunately we still see relatively low rates of hospitalization,” said Dr. Daniel Kuritzkes, the chief of the Division of Infectious Diseases at Brigham and Women’s Hospital. “There are very low rates of admission to the intensive care unit and still relatively low mortality.”

At press time, the most recent data from the state Department of Public Health covered the period from July 7 to 13. There were 7,096 new confirmed cases in that six-day span, while the number of new, confirmed deaths was 31. Overall, there were 552 patients hospitalized with COVID. Of that total, 165 were in the hospital primarily for an illness related to the coronavirus, with the remainder hospitalized for other reasons. Forty-six patients testing positive were in ICUs, with 12 patients intubated.

Kuritzkes said that at the Brigham, case numbers are in the mid-20s to mid-30s, with about two-thirds hospitalized for reasons other than COVID but testing positive for the virus. In the ICU, he said, there are two to three people at any given time who have tested positive.

“While I would prefer to see the numbers back down toward zero, which happened a few months ago, when nobody was in the ICU [with COVID], there’s just single-digit numbers of patients [there],” he said. “It just reflects the presence – the continued presence – of COVID in the community.”

Nationwide, BA.5 was the cause of nearly two of every three new COVID cases two weeks ago, CNN reported. The news channel quoted Baylor College of Medicine expert Dr. Peter Hotez, who heads the Texas university’s National School of Tropical Medicine, as calling the situation this summer “a full-on BA.5 wave” and estimating that the true new case count per day in the US is almost a million – not the reported number of 110,000.

BA.5 is “so much better adapted to spread in people than other [subvariants] might be,” Kuritzkes said. “It’s a little bit concerning right now. In Massachusetts, we seem to have really plateaued. Cases have not continued to go down.”

However, Doron noted, “There’s some misinformation floating around that each [subvariant] is more contagious than the last one.

It doesn’t mean it’s as contagious as measles – that’s not true,” she explained. “If one subvariant is more contagious than the last one, it’s because it has a growth advantage over what was circulating at the time. It doesn’t necessarily mean it’s that much more contagious. It could be more able to avoid immunity than the last [subvariant].”

In this atmosphere, Doron noted concern among the media at a July 12 White House COVID-19 Response Team press conference with Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, and fellow national COVID advisers Dr. Ashish Jha and Dr. Anthony Fauci.

The Washington Post cited telling data revealed by Walensky at the event: People aged 50 or older have a fourfold greater risk of death from COVID if they have only had one booster, as opposed to two or more; but less than a third of this age category (28 percent) have gotten a second booster.

Doron and Kuritzkes both said that many people face a difficult decision – getting a booster now versus waiting until a new, Omicron-specific vaccine is available.

Should such a vaccine emerge later this year, Doron predicted, “There will not be enough for every American to have one on Day One. Ultimately, there will be some prioritization.” She agreed with the CDC recommendation for people aged 50 or older to get a booster now, because “we don’t know what the future holds” and “there are a lot of cases out there now.”

She said that an Omicron-specific vaccine is “expected to be recommended and deployed by November,” but “there may not even be Omicron any more by then … I’m not sure an Omicron-specific vaccine is a solution,” although “[we] definitely need to continue developing new vaccines that are better than the ones we have.”

“The question right now is, do you get the booster today in July or wait a couple of months when combination vaccines become available?” Kuritzkes said. “If I’m at an age when there’s an overwhelmingly low risk of severe disease, it might make more sense to wait than get the booster now. If I’m high-risk, I would get the booster or second booster.”

“Everybody should get vaccinated and make sure they have at least one booster,” Kuritzkes said. “Elderly people, or people who have significant underlying medical conditions, should seriously consider getting that second booster. I don’t think it’s time yet to recommend it to otherwise healthy, younger people.”

Beyond getting vaccinated, the state is urging people to stay home when feeling sick and take a test for COVID-19. In addition:

Isolate if you test positive for COVID-19 and notify your close contacts they may have been exposed.

Wear a mask where advised or required and follow the guidance on selecting and wearing a mask.

Gather with others outside or increase ventilation by bringing fresh outdoor air inside when weather permits.

Keep your gatherings small and brief to help avoid “superspreader” events.

Cover your coughs and sneezes.

Practice good hand hygiene by washing hands frequently with soap and water. If soap and water are not available, use hand sanitizer.

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