On May 5, 2023, the WHO declared an end to the public health emergency caused by the Covid-19 pandemic, but the virus is still circulating. And it will not stop doing so in the near future. As such, increases in infections such as those being witnessed in Spain and other parts of the world in recent months were to be expected. The recording of statistics is no longer as exhaustive as it was during the first two years of the global pandemic and, since the summer of 2022, following the seventh wave, the peaks and troughs in transmission have ceased to be recorded. The latest spike, which started at the end of June, has already surpassed the incidence rate of last December when there was another upward tick, but there are no indications that it is more severe than previous ones.
How do we know that cases are increasing?
As of March 2022, cases in the general population in Spain are no longer measured and follow-up was restricted to those aged over 60. And since July 2023, when the government ended the health emergency (two months later than the WHO), it stopped publishing reports on all detected cases to focus on the same method that has been used for influenza for many years, which is based on an estimate made with data supplied by health centers and hospitals. The most recent one shows an incidence of 137.3 cases per 100,000 inhabitants, slightly above the peak of last December. The highest rates have been observed in children aged under four and adults over 64.
In the U.S., Covid-19 hospitalizations have been rising since late summer although — thanks to lasting immunity from prior vaccinations and infections — not nearly as much as this time last year. Johns Hopkins University, one of the global benchmarks for Covid-19 statistics, stopped publishing date in March 2023 but the most recent WHO report, dated August 10, states: “Globally, nearly 1.5 million new Covid-19 cases and over 2,500 deaths were reported in the last 28 days (10 July to 6 August 2023), an increase of 80% and a decrease of 57%, respectively, compared to the previous 28 days.”
What is known about the new variants?
The predominant variants in Europe continue to be those of the XBB family, according to the European Centre for Disease Prevention and Control. The virus mutations that thrive do so because they are more transmissible than previous strains, but none of the new ones have been shown to be more severe than their predecessors. The mixture of natural and vaccine-generated immunity among the population means that it is now normal to pass on the infection with mild symptoms, or none at all. EG.5, known as Eris, also from the XBB family and a sub-lineage of Omicron, has been declared a variant of interest by the WHO and BA.2.86, known as Pirola, which was first detected in Denmark in July and has now spread to the UK and U.S., among other countries, has been declared a variant under surveillance. As stated by the Pan American Health Organization in August, neither of these strains have been proven to generate more severe symptoms or to be more resistant to vaccines than any of their predecessors.
What’s the latest advice in case of infection?
Covid-19 restrictions have been lifted across the world and there are currently few restrictions on global travel. Visitors to the U.S. no longer require a negative Covid-19 test or proof of vaccination. In the EU, most restrictions for non-essential travel were removed in March 2022, and it is no longer mandatory to isolate oneself when infected. The recommended course of action is now the same as for any other respiratory infection: see a doctor if symptoms worsen and, if necessary, have him or her sign the patient off work. Experts, however, recommend teleworking as far as possible in the event of a positive result, as well as wearing a mask to reduce the risk to others. This is especially critical when dealing with vulnerable people: the elderly (especially those over 80) or those with underlying issues that make them more susceptible to serious illness. These population groups should also be more careful when interacting with each other now that cases are on the rise, because they are the ones at real risk of being admitted to hospital for covid.
How and when will the new vaccination campaign be carried out?
A new vaccination campaign is scheduled for October. The European Medicines Agency has already approved the Pfizer drug, adapted to the variants of the XBB family, and this is expected to be the most widely used, provided that the doses arrive in due time. In the U.S., The Food and Drug Administration (FDA) has approved updated Covid-19 vaccines, with the latest shots from Moderna and Pfizer and its partner BioNTech to be made available to most Americans even if they’ve never had a coronavirus vaccination. A Centers for Disease Control advisory panel is set to issue recommendations Tuesday on who most needs the updated shots. Vaccinations could begin later this week, and both the Covid-19 and flu shot can be given at the same visit.
What is expected this fall-winter?
Covid-19 has not displayed clear seasonal patterns since the pandemic began in early 2020. As of 2021 there have been peaks in the summer, but they have also been frequent in the autumn-winter season and there have also been spikes in the spring. Being a relatively new virus that is being fought with a massive global campaign of injected vaccines, it does not have such clear cycles as others viruses such as the flu, which is much more regular and almost always at its most virulent in the coldest part of the winter. No one has a clear answer as to how the virus will behave in the coming months, in terms of its spread or its severity. Much will depend on the virus’ mutations and on the response of the vulnerable population to the vaccination campaign.
“Vaccination remains critical to public health and continued protection against serious consequences of covid-19, including hospitalization and death,” FDA vaccine chief Dr. Peter Marks said in a statement. “We very much encourage those who are eligible to consider getting vaccinated.”
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