Feature Article: 3 Practical Matters Regarding COVID-19 in May 2023
Published on in Parents PACK
Published on in Parents PACK
Today (May 11, 2023) marks the official end of the COVID-19 public health emergency. For most, the day is likely to pass without much notice, particularly as many people have not been thinking much about COVID-19 for a while now. Indeed, the weather is getting better. The school year is winding down. And, summer vacations are within reach. But, the virus that causes COVID-19 has not gone away. At the end of April, more than 88,000 cases and more than 1,000 deaths were still occurring weekly in the U.S. While these numbers are lower than during the height of the pandemic, they remind us that the virus is percolating in our neighborhoods. As such, it is useful to stay abreast of the main headlines. With that in mind, we wanted to mention three practical matters that are helpful to be aware of at this juncture.
Each week, the Centers for Disease Control and Prevention (CDC) monitors the variants that are circulating throughout the U.S. They do this by studying the genetic sequences of thousands of samples collected from a variety of labs throughout the U.S. Because of the time it takes to ship, test and evaluate samples, it takes a few weeks for these data to be posted; however, mathematical modeling is used to project the most recent weeks while the data are being processed.
With this information in hand, we can see how the virus is changing in near-real time. While omicron XBB.1.5 has been the dominant strain so far in 2023, a couple of new, related variants have started to emerge. In recent weeks, two strains have each caused around 10% of cases — XBB.1.16 and XBB.1.9.1, but they are not equally represented in different parts of the country. XBB.1.9.1 has been more prominent in the central region of the U.S., while XBB.1.16 has been more prominent in the areas around the Great Lakes and the Pacific Northwest.
As a practical matter, this means that when we are traveling and spending time around new groups of people over the summer, it is likely that these newer variants will spread.
While the CDC continues to recommend COVID-19 testing and isolation if you think you were exposed or infected, a better approach for individuals and families may be to limit your interactions with others if you are not feeling well and test if you are high risk and could benefit from taking an early antiviral treatment, like Paxlovid™. In this manner, regardless of whether you have COVID-19 or some other respiratory infection, you will decrease its spread, and if you could benefit from an antiviral medication, you can get it early enough for it to work.
Dr. Offit, VEC Director, recently wrote about testing at this point in the pandemic in his new Substack, “Beyond the Noise” (See “News & Notes” section for more information). Titled “Can We Stop Testing for COVID?” Dr. Offit’s article discussed current CDC guidelines, annual rates of other respiratory infections, and his thoughts about what recommendations make sense at this point.
As a practical matter, people most likely to benefit from early antiviral treatment should test for COVID-19 in order to get the prescription and start taking it in a timely manner. Everyone who feels ill or has symptoms of any infection should behave in ways to limit its spread, whether by limiting who they are around, masking, or other means.
Since the release of COVID-19 vaccines, the recommendations have evolved numerous times. While these changes have been frustrating to many, they were necessary.
Historically, when new vaccines were introduced, we had years of experience living with and learning about the viruses or bacteria they protected against. Even with that predetermined understanding, vaccine recommendations evolve. They change for two main reasons. First, as more doses of vaccine are administered, the prevalence of the pathogen often changes. Second, we continue to learn more about existing vaccines or new vaccines that come along. For example, after the human papillomavirus (HPV) vaccine was available for several years, the levels of HPV circulating in the community decreased, and we learned that the vaccine worked well enough in those younger than 15 years of age that only two doses were needed to protect people vaccinated when they were younger (9 to 14 years of age).
With SARS-CoV-2, the virus that causes COVID-19, we were in a situation of simultaneously learning about the virus and developing the vaccine. As such, the reasons for changes to vaccine recommendations were three-fold — learning about the virus, changing viral patterns, and gaining experience with the vaccines. Increased understanding of each of these informed and sharpened vaccine recommendations:
Over time, we have also learned that people who were both vaccinated and infected tend to have the most robust immunity. As such, even previously unvaccinated people can benefit from getting the COVID-19 vaccine, regardless of whether they were infected or not. Unvaccinated individuals remain of particular concern because they continue to be hospitalized and die from COVID-19 at higher rates than those who were vaccinated.
The most recent changes (April 2023) are meant to streamline vaccine guidance, so it is easier to understand and administer COVID-19 vaccines:
As a practical matter, vaccine recommendations change over time as we learn more. This has been particularly true of COVID-19 vaccines as we were learning about the virus and the vaccines at the same time. Most people who got one dose of bivalent mRNA vaccine are considered up to date, and those not previously vaccinated against COVID-19 can still benefit from vaccination.
In sum,
For more information about the topics in this article, check these resources:
Categories: Parents PACK May 2023, Feature Article
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