U.S. Seeing Only a Blip in Cases Despite BA.2 Dominance

Key Points:

• In today’s Recommendations for Industry, we discuss the “blip” in U.S. COVID cases, despite the fact that BA.2 has become the dominant variant. Read more below.
• FDA Authorizes Second Booster for Older and Immunocompromised Individuals. FDA authorized a second booster dose of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for older people and certain immunocompromised individuals. A second booster dose may be administered:
  • Of Pfizer or Moderna to individuals 50 years of age and older at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine.
  • Of Pfizer to individuals 12 years of age and older with certain kinds of immunocompromise at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine. These are people who have undergone solid organ transplantation, or who are living with conditions that are considered to have an equivalent level of immunocompromise.
  • Of Moderna COVID-19 to individuals 18 years of age and older with the same certain kinds of immunocompromise at least 4 months after the first booster dose of any authorized or approved COVID-19 vaccine.
• Should you get another booster? The scientific evidence for a fourth dose is incomplete, and researchers do not agree on whether the shots are needed. Experts point out that the limited research so far supports a fourth shot only for those older than 65 or who have underlying conditions that put them at high risk.
• Twenty-one Republican state attorneys general filed a lawsuit against the Biden administration on Tuesday to block the federal mask mandate on public transportation. The lawsuit comes a few weeks after the Transportation Security Administration extended its mask requirement for airplanes and other forms of public transportation through April 18. The CDC had recommended the extension, even though it suggested in February that most Americans could stop wearing masks. In the lawsuit, the states, led by Florida, argued that the C.D.C. was overreaching its authority with the mandate and was interfering with state laws about masking.
• After rising for 2 weeks, global cases declined again, the World Health Organization (WHO) said in its latest weekly snapshot of the pandemic, but it urged caution about interpreting trends, due to reduced testing in a number of countries. Cases dropped 14% last week compared to the week before, with decreases seen across all of the WHO’s regions. However, deaths rose 45%, primarily due to changes in how some countries define COVID deaths and retrospective adjustments from others. Overall, about 10 million cases were reported, with the most cases in South Korea, Germany, Vietnam, France, and Italy.
• WHO officials also unveiled a third version of a strategy for fighting the pandemic, which spells out three scenarios for how the situation might unfold this year.  The WHO Director-General said the most likely scenario is that SARS-CoV-2 continues to evolve but severity declines as populations build up immunity due to vaccination and infection.
• The White House has launched a ‘one-stop’ website for COVID-19 needs. Covid.gov is a new one-stop shop for finding COVID-19 vaccines, masks, tests, and treatments by county on an easy-to-use website.

Food Safety & Public Health

• Avian flu has struck flocks in five more states—Massachusetts, North Carolina, North Dakota, Ohio, and Wyoming—expanding outbreak activity westward and to nearly half of US states. The USDA/APHIS announcement lifts the number of affected states to 23, leading to the loss of about 16 million birds. Events have included both backyard flocks and commercial operations, mainly in the Midwest and East.

Recommendations for Industry

U.S. Seeing Only a Blip in Cases Despite BA.2 Dominance

With the BA.2 variant of Omicron creating some case surges in the UK and Europe, there has been some expectation that the U.S. may see a surge as well – since the U.S. has tended to follow the trends of the UK about a month after. However, CDC data is showing BA.2 to already be the dominant variant across much of the U.S. – reaching figures of nearly 75% in the Northeast, but we’ve seen more of a “blip” than a surge.

This is good news, in that BA.2 has become dominant without a significant surge in numbers, so we are optimistic that the impact in the U.S. will be lower than that of the UK/Europe, as we would expect to already be seeing a rise with the extent of BA.2.

While TAG’s weekly matrix (data shown below) does not specifically track variants, we are seeing trends that follow those of the CDC, with a gradual, predictable upward drift of cases in some states, others plateauing, and only one (Alaska) showing significantly high rates.

We will continue following the trends in our matrix and the news, expecting that the next two weeks will provide a solid picture of whether the U.S. will face a surge or simply continue with a blip.

Risk Matrix:

Things are looking much better; however, there are some slight indications that cases may be going up in some states. Alaska is the only state which has a TPR <10% and case rate >25 cases/100K (TPR: 7% with a case rate of 29 cases/100K).

In Case You Missed It:

• In Tuesday’s Recommendations for Industry, we discussed the flattening of global COVID cases. Read more here.
• Asian COVID hot spots show signs of improvement. The pace of COVID-19 spread appears to be slowing in some of Asia’s recent hot spots, including Hong Kong, where the number of daily cases has been declining since about the second week of March, with cases now at their lowest level in a month. In Vietnam, cases are showing signs of decline, with the 7-day average for daily cases down 27% compared to the week before. South Korea’s daily cases today dropped below 400,000 for the second day in a row. 
• The WHO says the BA.2 subvariant of Omicron is driving most cases around the world. The World Health Organization reported that the Omicron subvariant, BA.2 is now the dominant version of Omicron around the world. Globally, BA.2 made up about 86% of cases reported to the WHO between Feb. 16 and March 17. The previously dominant subvariants, BA.1 and BA.1.1, together represented about 13 percent of the cases.
• Shanghai’s lockdown. China’s largest outbreak since the beginning of the pandemic is now gripping Shanghai, its largest city and a global financial center. The city of 26 million reported more than 2,600 COVID infections yesterday, from just a handful in early March, with hospitals and medical staff already stretched thin. The government is introducing a two-stage lockdown and plans to test all 26 million residents in the coming weeks.
• Africa’s Low Vaccination Rates Should Concern Everyone/S. Africa easing COVID restrictions. Only about 15 percent of the population in Africa has been fully vaccinated. Because of this, the trajectory of the pandemic on the continent remains unpredictable and uncertain. With low vaccination rates, we run the risk of being hit by new variants that may severely impact the effectiveness of vaccines globally and limit people’s lives once again. On the other hand, South Africa, the country in Africa worst affected by coronavirus, has eased COVID restrictions for vaccinated travellers, dropping mandatory negative results for inbound fully vaccinated travellers, a move expected to boost tourism.
• The Pandemic Revolutionized Disease Surveillance. Now What? As the pandemic enters its third year, funding for COVID data collection is drying up. The article discusses a number of UK-funded COVID surveys will be greatly reduced or discontinued. Researchers warn that relaxing restrictions and surveillance at the same time could be unwise since these surveys act as early warning systems for new variants or mysterious bumps in cases. With stripped-back restrictions, data is all we’ve got. There also remains a threat of future waves because there’s the threat of new variants.
• Cruise ship with fully vaccinated passengers/crew has COVID outbreak. The Ruby Princess returned to San Francisco from a 15-day Panama Canal cruise with some passengers and crew members infected with COVID-19. All guests and crew on the ship were fully vaccinated, and those infected were either asymptomatic or showed mild symptoms. The total number of infections resulting from the cruise was not released. The ship’s medical team ordered everyone who tested positive to isolate.

Influenza, Infectious Disease, and Food Safety:

• There are continuing reports of rising flu cases in parts of the world, attributed to relaxation of COVID precautions.
• Tuberculosis
  • March 24 was world tuberculosis day, so it is a good time to remind all of the need to focus on recognizing and following latent TB cases and those among pregnant women and children to ensure treatment is effective.
  • In India – As the home to a quarter of the world’s TB infections, an estimated half-million people died of TB in 2020 – one-third of the global toll.
    • It now faces an uphill battle to meet its goal of ending the spread of TB by 2025, after the pandemic reversed years of progress
    • Increased mask-wearing was one silver lining, but more funding is now needed for TB vaccines and support to combat malnutrition, a major trigger for the disease
  • In the U.S. Reported tuberculosis (TB) diagnoses in the United States fell 20% in 2020 and remained 13% lower in 2021 than TB diagnoses made prior to the COVID-19 pandemic
    • Mask use and distancing measures—aimed at preventing COVID spread—likely limited TB transmission, and TB infections were likely missed as healthcare visits dropped during the first months of the pandemic.
• Three states report more avian flu outbreaks in poultry. Iowa, New York, and South Dakota reported more highly pathogenic avian influenza (HPAI) outbreaks in poultry, most of them involving commercial flocks. The spread of the Eurasian H5N1 strain has affected poultry in 17 states and led to the loss of at least 13.6 million birds, and the Philippines has reported its first outbreak in poultry involving the highly pathogenic H5N8 strain.