Over the past two years, the U.S. has experienced Covid waves similar to those in Europe — only several weeks later.
“You’ve got to at least be prepared that we may see something similar here with some differences, because there’s always differences,” said Anthony Fauci, President Joe Biden’s chief medical officer. “We’ve got to not ignore it. We’ve got to monitor it very carefully.”
In recent days, officials from the White House Covid-19 task force and the Centers for Disease Control and Prevention have met to game out how the administration will respond if cases begin to rise drastically, according to the officials. The group has discussed the possibility of recommending communities reinstitute mask mandates indoors and how to ensure hospitals across the country are prepared for a potential spike in patients seeking care. Officials have also debated whether and when to recommend a fourth Covid-19 shot.
Pfizer on Tuesday asked the Food and Drug Administration to grant emergency use authorization for a fourth Covid-19 vaccine dose for people 65 and older amid fears of waning immunity.
The heightened concern among administration officials comes as more than $15 billion in Covid-19 funding is stalled in Congress, despite White House officials warning that they could soon run out of money to purchase life-saving drugs or provide free treatments to patients.
That shortfall, which could affect efforts both domestically and around the world, could also hamper the distribution of tests and masks just as cases begin to spike in the U.S.
“People who do get sick, to lose monoclonal antibodies, that testing plan …. there’s a long list of stuff that would really help to combat this imminent BA.2 -related wave and then the next one,” said Eric Topol, a professor of molecular medicine at Scripps Research. “Nobody wants these waves. But we have to face the music and the music isn’t pretty.”
During a call with prominent public health leaders and doctors this week, the administration warned of what could be lost if congressional funding does not come through. Several people on the call worried that recent guidance from the CDC, which said the overwhelming majority of Americans could remove their masks, detracted from the administration’s efforts to convince Congress and the public that Covid-19 remained a threat.
Those people pushed the administration officials on the call to consider changing its messaging, particularly with the spread of BA.2.
The White House did not comment for this story, and referred reporters to comments made by spokesperson Jen Psaki earlier this week about the prospect that BA.2 could continue to spread in the country, causing an increase in cases.
In anticipation, Biden officials have reached out to health leaders in Europe in recent days, inquiring about the level of spread of the subvariant and how hospitals are handling the influx of patients to glean how such a wave could impact Americans, according to two of the officials familiar with the discussions.
The administration believes the surge in the United Kingdom is attributable to a range of factors, including decreased immunity among the vaccinated, the transmissibility of Omicron and the subvariant, and the easing of public health restrictions such as indoor mask mandates, the two officials said. Many of those factors are present in the U.S.
“All of this is happening also while there is waning immunity. … Also the communities and populations [in Europe] have opened up. They relaxed many of their mitigation strategies — as have we,” CDC Director Rochelle Walensky said Thursday during a panel discussion with the Bipartisan Policy Center.
While cases are also spiking in China, its reliance on its own vaccine and zero-Covid policies means spikes there may not offer the same clues as to what might happen here. U.S. officials also have more insight into what is happening in Europe. Over the last two years, American officials have relied heavily on Europe’s data sharing and scientific analysis to help bolster the U.S. response while its communication with China is more limited.
Kristen Nordlund, a spokesperson for the CDC, said although the BA.2 subvariant has increased in the U.S. over the past several weeks, it is not the dominant variant, and the administration is not currently seeing an increase in the severity of disease in the country.
Walensky said during Thursday’s panel that she anticipates that the U.S. “will see more and more of [BA.2].”
“It may become the predominant variant in the weeks ahead,” she said.
If a Covid-19 wave similar to that currently moving through Europe were to hit the U.S. over the next few months, it is possible that the CDC would again recommend Americans wear masks indoors where community transmission levels are high, Fauci said.
“The transmissibility of this virus is really profound. The question is, how much is going to be a blip in cases? Are the cases going to translate into a significant amount of significant disease that then gets translated into hospitalizations,” Fauci said. “As the CDC said when it came out with new metrics, any change in the patterns must be met with a return to whatever appropriate mitigation is necessary. I think people have forgotten that.”