Omicron variant BA.5 becomes dominant as undercounted COVID cases leave US with a blind spot, CDC says

Official COVID-19 case metrics vastly underestimate the true number of infections, leaving the United States with a critical blind spot as the most transmissible variant of the coronavirus to date takes hold.

The Omicron offshoot BA.5 became the dominant variant in the United States, according to data from the US Centers for Disease Control and Prevention last week, and the subvariant carries key mutations that help it evade antibodies generated by vaccines and previous infections , and its speed support spread.

This is accompanied by “escalating case numbers and more hospital admissions,” said Dr. Eric Topol, cardiologist and professor of molecular medicine at Scripps Research, on Monday on CNNi. “One good thing is that it doesn’t seem to be accompanied by the ICU admissions and deaths like previous variants, but that’s definitely a concern.”

But when you look at the official case numbers, it’s hard to say.

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The proportion of officially reported cases is at an “all-time low,” said Dr. Michael Mina, epidemiologist and chief science officer at telemedicine company eMed. “There’s no doubt about that.”

COVID-19 cases have been undercounted to some extent during the pandemic, in part because testing was unavailable in some locations and asymptomatic cases may have been missed. However, as people increasingly rely on rapid at-home testing — and attitudes toward the pandemic as a whole are changing — the US hasn’t found a reliable way to track transmission levels.

An estimate by the Institute for Health Metrics, a research center at the University of Washington, suggests that actual infection numbers in the first week of July were about seven times higher than reported cases — which have averaged about 107,000 per day in the past two weeks, according to Information from Johns Hopkins University.

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Before the CDC last month lifted testing for international travelers before entering the country, Mina said it was an “amazing opportunity” to monitor the state of COVID-19 in the United States among a group of mostly asymptomatic people. About 5% of travelers tested positive in May, which he says is likely leading to at least 1 million new infections per day in the broader US population – 10 times the official number.

Now that BA.5 is here, “we know there’s going to be a wave in the fall – there’s almost no doubt about that – if not sooner. So you have to be really aware that that could happen,” Mina said.

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But with so many variables at play, it doesn’t necessarily make sense to compare the current state of affairs to other points in the pandemic.

“We really don’t have a good sense of what the baseline is,” said Dr. Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials. “To say ‘Here we are at this point in 2022 compared to 2021’ – that’s not a fair comparison.”

To assess your individual risk of COVID-19 if a new variant takes hold, a personal census of cases among friends and family may be a better metric than official data, experts say.

“People ask each other, they share stories, and that’s probably not a bad source of evidence,” said Baruch Fischhoff, a professor at Carnegie Mellon University and founding chair of the US Food and Drug Association’s Risk Communication Advisory Committee.

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Our social networks have probably remained more consistent than national surveillance systems, he said, and “if more people that you hear from in your circle are getting the disease now than in the past, and the size of your circle is about the same, then there is probably a lot more diseases now than before.”

Heavy results don’t tell the whole story

At White House COVID-19 response team briefings — the last one was more than two weeks ago — CDC Director Dr. Rochelle Walensky presented case trends without pointing out these important caveats to the data.

Months ago, the CDC shifted from COVID-19 transmission tiers, which categorized risk based on case counts and test positivity rates, to COVID-19 community tiers, which rely more heavily on metrics related to hospitalizations.

During this winter’s Omicron surge, hospitalizations and deaths did not follow the same steep trendline as cases — an important change from previous waves of the pandemic.

But the fact that serious consequences are still occurring at all is reason enough to continue paying attention to the cases, experts say.

“If we’ve ever gotten into a state where people got infected but it wasn’t causing serious illness anymore — maybe it’s a new variant that’s much less severe, or it didn’t cause COVID for long — if there wasn’t really significant adverse health effects, then we wouldn’t care as much about cases,” said Jason Salemi, an epidemiologist and associate professor at the University of South Florida.

“But let me be clear, we’re not there yet.”

There is no evidence that BA.5 causes more severe disease, but studies have shown that BA.5 can evade antibodies from vaccination or previous infections – even from another omicron subvariant. Vaccines are still expected to offer protection against serious diseases, and for the fall vaccine manufacturers are developing updated booster shots containing Omicron BA.4 and BA.5 strains.

There are treatments, like the antiviral pill Paxlovid, that greatly reduce the risk of death or serious illness. And quality masks, ventilation, physical distancing, and quarantine and isolation can still help reduce the spread of any variant, including BA.5.

Currently, however, more than 5,000 people are hospitalized with COVID-19 every day, CDC data shows, and more than 300 people die every day, according to JHU data.

Focusing on these “lagging indicators” takes “significant time to start curbing people’s behavior and preventing a lot of morbidity and mortality,” Salemi said.

If 1 in 5 COVID-19 infections result in long-term COVID-19 infection and actual infections are seven times higher than reported, the number of people with long-term COVID-19 could increase by 100,000 every day.

Work around blind spots

Right now, the U.S. is in a “sustainable management phase” with continued efforts to keep things in check compared to “a much more reactive, aspiring — and aspiring — approach of the past,” Plescia said.

But the federal government recently pulled resources from testing because Congress failed to approve additional COVID funds, a move Mina says will “pretty blind the US as we move into the fall.”

Some monitoring programs are underway, such as B. Wastewater monitoring, which tracks the amount of viruses present in wastewater. But he says they’re “minimal” and “in general, they don’t really give us a good picture of what’s really happening in the United States.”

“We just floated through this big burst,” Mina said, referring to previously dominant Omicron subvariants. “But we shouldn’t let our guard down, I would say, because with BA.5, I expect it’s going to be a very different story.”

The-CNN-Wire™ & © 2022 Cable News Network, Inc., a WarnerMedia company. All rights reserved. Omicron variant BA.5 becomes dominant as undercounted COVID cases leave US with a blind spot, CDC says

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