Virus Expert Just Issued This "Cautionary" Warning

Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, explains what to expect next with the COVID-19 pandemic on an episode of The Osterholm Update. "I can tell you that this pandemic is not over and trying to declare it as such would be a huge mistake," Dr Osterholm says. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

"On a worldwide basis COVID cases and deaths continue their downward descent, which has been a fairly consistent pattern we've seen throughout the past several months," says Dr. Osterholm. "As a reminder, during the original Omicron surge in January, reported weekly cases surpassed 23 million and weekly deaths reached 77,000. Compare that to last week's numbers, where cases stood at around 3.1 million, not 23 million, and deaths were below 10,000, not 77,000. And you can see where the past four months have taken us. 

"Now for all of you who will challenge these numbers saying they are incomplete, that they surely don't represent all the cases that have occurred, all the deaths that have occurred, I agree wholeheartedly," says Dr. Osterholm. "But I think that the trend data does tell us a real story. For context, consider the following: As of this Tuesday, the global death toll for last week, according to the world health organization's dashboard, stands at around 8,000 now due to slight legs in reporting. And the fact that it's somewhat early in the week, there's a chance that this toll could be slightly higher. By the time you actually listen to this podcast, nonetheless, a weekly death toll of around 8,000 or even 9,000 would be the lowest we've seen since the start of the pandemic."

"I'm also aware of just how quickly this virus could wipe away any progress that's been made to date," says Dr. Osterholm. "So despite the overall pattern of declines, I think it's important to keep monitoring those outliers that are seeing increases, or facing notable challenges from the virus, since they might best provide insight on where we stand moving forward. Never forget we are still in an incredible tug-of-war between our human immune system and the evolutionary pressures of this virus. And between the two, we are still not quite sure one day's equilibrium might actually exist."

"A growing body of data suggesting that BA.4 and BA.5 can readily evade protection against infection, particularly among unvaccinated individuals previously infected by BA.1, indicates that growth of these sublineages could prompt notable case increase into a number of different countries," says Dr. Osterholm. "Again, I come back to that issue of the battle between our human immune system and the virus and its ability to evolve. We don't know where this ultimately will take us. In fact, there's some evidence of that playing out in countries like Portugal and Switzerland, and we're seeing these sublineages grow in places like the UK and the US as well. So as always, we'll have to see what actually happens in the days ahead. Ideally, any waves we could see won't be followed by a significant amount of hospitalizations or deaths, as has so far been the case with South Africa, but it just goes to show how quickly this virus can adapt and overcome the protection against infection."

"There's no way for us to know exactly what's happening on the ground in Ukraine still," says Dr. Osterholm. "There's no doubt that this virus is having an impact there. And that impact has likely been exacerbated by the war, which for obvious reasons has become the top priority for the country. So in addition to the countless tragedies and atrocities that we're seeing as a result of this war, many Ukrainian residents are also living in settings where the resources and tools used against COVID are unavailable or inaccessible. For example, it's difficult to obtain appropriate medical care when buildings are destroyed or qualified health personnel aren't around, even getting diagnosed can be a challenge."

"BA.2.12.1 continues to be a dominant strain making up 62% of new cases. These variants are certainly something to keep an eye on in the coming weeks and months. I'm convinced particularly what we've seen in Europe, that we will see BA.4 and BA.5 becoming the dominant subvariants within the next several weeks."

"Novavax has some potential logistical advantages over other COVID vaccines in that it does not require the super cold temperatures like the mRNA vaccines and can be kept in a much more typical refrigerator-like environment. There are some potential advantages for people that have been hesitant to receive the newer mRNA vaccines: Protein-based vaccines have been widely used since the 1970s. It's possible that the added option of the Novavax vaccine will help convince some people to be vaccinated that have been holding out so far."

"The primary issue raised is around myocarditis and pericarditis, something we've talked about with the mRNA vaccines. The clinical trials showed five cases of myocarditis in participants within 20 days of immunization, which is only slightly higher than that seen in the placebo group. The company did know that they will continue to monitor the issues of myocarditis and pericarditis after receiving an emergency youth authorization approval. Just like the mRNA vaccines, the data show that there is still a higher chance that someone would have a severe cardiac event as a result of COVID infection than from receiving any of these vaccines."

"So with this situation there really are two main concerns. First, it's not that people with rebound infection may experience serious disease, but rather they could unknowingly transmit the virus to others in their rebound period. It's recommended that if someone develops symptoms or has a positive test after a course of treatment with Paxlovid, that they begin the isolation protocol all over again, to keep them from infecting others. This is a very important point, and this is really the second issue at concern. If I'm someone at low risk of experiencing serious illness, and I take Paxlovid, and rather than recover within the seven to 10 days, I have a rebound, might then that mean I would be in isolation for an additional seven to 10 days, making my course anywhere from 12 to 15 days of isolation, as opposed to what we currently do. At this point, there is currently no evidence that additional treatment is needed with Paxlovid, or other therapies and cases where COVID 19 rebound is suspected."

"Not surprisingly monkeypox cases have now continued to increase in the last few weeks. As of Tuesday, there have been over 1088 cases reported from 29 countries, most of them in Europe.  This is likely an undercount, as some countries have already identified cases that have not had any close contact with other known cases, meaning there is something going on undetected in terms of transmission occurring in these various areas. Last Friday, the CDC released a report in the morbidity mortality report with details regarding the first 17 monkeypox cases identified in the us. Of these 17 cases, 16 occurred in men who've had sex with men. This is similar as to what's being reported out of Europe, where most but not all cases are occurring in men who've had sex with men, which I will talk about more in a moment. 14 of the 17 US cases also reported recent international travel prior to the onset of their symptoms."

"Many of these symptoms are consistent with what we would expect to see with monkeypox. All but one of the men had a rash across their body. Many reported fatigue, chills, swollen, lymph nodes, all common for monkeypox. The one unusual aspect of their symptoms is that for 18 of these 17 men, their rash started in the anal genital area, and then spread to the rest of the body. This is not consistent with past monkeypox cases where the rash most often started in the patient's face. As I said before, a vast majority of reported cases have been in men who have had sex with men. Contact tracing has revealed that cases are largely occurring within extended sexual networks. It is possible that due to the higher prevalence of HIV in this group, that they may be more likely to seek sexual healthcare, which could lead to a higher proportion of cases in this group being reported. Though the disease may have a low mortality rate, again, with this particular strain of the virus, we need to be clear about the fact that this is something that people do not want to be infected with and should make an effort to avoid."

Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.