Coronavirus surge this fall could infect 100 million people, administration warns

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Experts have agreed that a major surge this fall and winter is possible given dwindling immunity to vaccines and infections, easing restrictions and rising variants.

The Biden administration warns that the United States could see 100 million coronavirus infections and a potentially large wave of deaths this fall and winter, driven by new omicron subvariants that have shown a remarkable ability to escape to immunity.

The projection, made Friday by a senior administration official at a briefing as the nation nears a million COVID death toll, is part of a broader push to bolster the nation’s readiness and persuading lawmakers to appropriate billions of dollars to buy a new tranche of vaccines, tests and therapeutics.

Forecasting 100 million potential infections during a cold snap later this year and early next year, the official did not present any new data or make a formal projection. Instead, he described the fall and winter wave as a scenario based on a range of external models of the pandemic. These projections assume that omicron and its subvariants will continue to dominate community spread, and that there will not be a radically different strain of the virus, the official said, acknowledging that the course of the pandemic could be altered by many factors.

Several experts have agreed that a major surge this fall and winter is possible given dwindling immunity to vaccines and infections, easing restrictions and the rise of variants better able to evade immune protections. .

Many have warned that a return to more relaxed behaviors, from going without a mask to attending crowded social gatherings indoors, will lead to more infections. The national seven-day average of new infections more than doubled, from 29,312 on March 30 to nearly 71,000 on Friday, just over five weeks later.

“What they’re saying sounds reasonable — it’s on the pessimistic side of what we projected in modeling the COVID-19 scenario,” said Justin Lessler, an epidemiologist at the University of Washington’s Gillings School of Global Public Health. North Carolina. “It’s always hard to predict the future when it comes to COVID, but I think we’re at a point now where it’s even harder than normal. Because there’s so much sensitivity, in terms of from long-term trends, to things we don’t exactly understand about the virus and about [human] behavior,” Lessler said.

Another modeller, epidemiologist Ali Mokdad of the University of Washington’s Institute for Health Metrics and Evaluation, said in an email on Friday that a winter surge is likely. His organization, which has made long-term forecasts despite the many uncertainties, has just produced a new forecast which shows a slight increase in cases until the end of May, then a decrease until the arrival of winter.

The administration official said the latest forecast was being shared with lawmakers on Capitol Hill as the White House seeks to reinvigorate stalled negotiations on allocating additional funds for the coronavirus response. While the White House had asked for $22.5 billion, top Senate lawmakers struck a bipartisan deal for $10 billion in COVID relief last month. But a dispute over the administration’s decision to ease pandemic restrictions at the U.S. border has upended the swift passage of the deal, which has languished for weeks.

White House officials have said they fear a significant portion of the national supply of antivirals and tests may be depleted due to an expected rise in cases in the South this summer. Without these tools, they say the country would not be prepared for a fall and winter surge, and deaths and hospitalizations could rise dramatically.

If Congress remains at a standstill, the official said, the administration would likely withdraw money that has been set aside for more tests and therapies to buy more vaccines — decisions that will leave the country more vulnerable than ever. it shouldn’t be.

The projected summer surge in the South, which would reflect similar increases in 2020 and 2021, is of particular concern due to lower vaccination and booster rates in the region. While deaths in the northeast have remained stable amid a sharp rise in cases there in recent weeks, the south remains more vulnerable as fewer people have been vaccinated, the official said.

This forecast is taken up by outside experts. “For some reason we are seeing seasonality in these spikes. We see a very high rate of cases in the South during the summer months, perhaps because so many people are indoors because it is so hot there, ”said Mercedes Carnethon, epidemiologist at Northwestern University Feinberg School of Medicine.

Part of the administration’s challenge in responding to the pandemic is that the virus continues to mutate in ways that have sometimes surprised scientists. Omicron, in particular, appeared in southern Africa with astonishing speed in November with a set of mutations and came from a different part of the virus family tree than the delta variant it replaced. The origin of the omicron remains unknown.

Omicron has since created many sub-variants that are even more transmissible than the original strain. The BA.2 omicron subvariant continues to account for the majority of new infections in the United States, but the BA.2.12.1 subvariant is rapidly gaining traction and may soon become the most common strain. Meanwhile, two other highly transmissible variants, BA.4 and BA.5, have fueled a recent spike in infections in South Africa.

“Predicting new variants that will spread – that’s a total guess,” said Jeffrey Shaman, an epidemiologist at Columbia University. “Predicting that they will succeed is also a guess.”

Another big unknown that could affect the size and severity of another wave is whether there will be more effective vaccines available in the fall. Pfizer and Moderna are both working on new boosters that combine different versions of the coronavirus to protect against variants, but it’s unclear whether they will be more effective than existing vaccines. Administration officials said they hope to be able to distribute such reminders in the fall, especially to the elderly and those most at risk of serious infection and death.

Natalie Dean, a biostatistician at Emory University, said the longer the period of time between coronavirus waves, the greater the number of people who will be vulnerable to infection due to waning immunity.

“It just puts vulnerable people back at risk,” Dean said. “It seems likely that there will continue to be these ups and downs.”

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