US warned to prepare as Europe copes with new COVID-19 surge

(The Hill) – Rising COVID-19 cases in Europe are sparking warnings that the US could see a fresh spike this winter.

Previous jumps in the US followed a pattern with cases increasing in Europe first, which made officials nervous they could see a spike in US cases as the weather changes.

The latest data from the European Center for Disease Prevention and Control shows that the number of cases in Europe increased around the beginning of September.

The seven-day average is around 230,000 cases per day, reflecting the rates observed in late July when Europe was still grappling with the subvariant wave omicron BA.4/BA.5.

The Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus, said last week that cool temperatures were expected to see a rise in cases in Europe, but stressed that hospitalizations and deaths need not rise as much due to the viral therapeutics now available.

Confirmed coronavirus-related deaths across the European Union have remained low with a seven-day average of 280 since last week.

Cases and deaths in the US continue to fall, but falling temperatures are urging people indoors, dismal numbers of booster shots and a general disregard for pandemic containment practices are setting the stage for a winter wave similar to that across the Atlantic.

The seven-day moving average for cases in the US is about 38,000, while the seven-day moving average for deaths is about 330.

Ali Mokdad, an epidemiologist and professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington, told The Hill the contrast in the regions could be attributed to several factors, including warmer temperatures in the US and different levels of the community immunity.

“In the USA we have a higher infection rate than in many European countries, where more people have been infected here. So we have a little bit more immunity than they do, but we still have ebbing immunity,” Mokdad said.

COVID-19 cases, deaths and hospitalizations in the US are likely to increase in three to four weeks, Mokdad said, although they won’t reach the same levels as during last winter’s Omicron wave. He emphasized that this projection depends on a situation where new coronavirus variants, which are better able to escape immunity, do not gain dominance.

Researchers and virologists have consistently noted that the risk of a more infectious variant still exists as the SARS-CoV-2 virus continues to spread and mutate.

The COVID-19 Scenario Modeling Hub, a US-based data collective run by researchers and public health experts, is posting possible directions the pandemic may be taking based on multiple models.

The latest projections from the data hub show four scenarios: two in which no new variants emerge and two in which they do.

Shaun Truelove, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health and a member of the COVID-19 Scenario Modeling Hub team, said he dismisses the potential scenarios that don’t create new variants.

“We’re seeing variants, we’re seeing them pop up, and it looks like we’re going to have one of those,” Truelove said.

The BA.5 omicron subvariant, the dominant strain in the US, has begun to gain a foothold in the US, with sublineages such as BA.4.6 and BQ.1.1 increasing in distribution. In some parts of the Midwest, BA.4.6 now accounts for a fifth of COVID-19 cases.

The disparity in community immunity levels between the US and Europe, Truelove says, poses a challenge in predicting where America’s infection rates will go based on observations from overseas.

“We have a situation where people are getting infected all the time, so their immunity to that infection or vaccination goes down. And then, along with everything that’s happening, we’re also seeing the influx of these new variants that have these immune-escape properties,” he said.

Aside from COVID-19, there is other information that can be gleaned from the situation in Europe that could help predict what the US will experience in the coming months.

Health officials have warned the flu is likely to be worse than it has been in recent years due to a lack of exposure, potentially leading to a ‘twindemia’ of both viruses. Mokdad noted that amid the coronavirus surge, no surge in influenza infection has yet been observed in Europe.

“We have not seen any increase in cases in Europe at this time. … So some encouraging news for the flu, but I wouldn’t bet on it,” Mokdad said.

While cases of influenza have been increasing in the United States, only 3.3 percent of lab-tested samples are positive, according to the Centers for Disease Control and Prevention. Recent polls by the National Foundation for Infectious Diseases found that 49 percent of US adults plan to get the flu vaccine this year, just 5 percentage points lower than the percentage of adults who were vaccinated last year.

The prevalence of people getting vaccinated and practicing virus reduction methods such as masking and social distancing has largely fallen out of favour. President Biden said in September the pandemic was “over,” a move Mokdad partially cited for the slow uptake of boosters.

“President Biden said the pandemic is over, but that’s a mistake for me at a time when we’re trying to push a booster shot for a new BA.4 and BA.5 vaccine and he’s saying it’s over. So why should people go and get the vaccine?” said Mokdad. “It is very difficult for me to say that COVID-19 is over. It’s not over yet, especially now that winter is coming.”

Experts speaking to The Hill strongly encouraged people to get the updated bivalent booster ahead of the holiday season.

“The best Christmas gift you can give – whatever your celebration – that you give yourself and your family members is protection and safety. And the best way to do that is to get your booster and your flu shot,” Mokdad said.