The U.S. Is Staring Down Its First “So What?” COVID-19 Wave

BIANNA GOLODRYGA: Well, in Shanghai, China, many residents are currently starving. Facing food and medical shortages as the city combats a rise in COVID cases with one of the world’s harshest lockdowns. While city officials announce an easing of restrictions, the military is mobilizing to establish field hospitals. In contrast, our next guest believes the U.S. is staring down what it’s called, the so what, wave of the pandemic. Katherine Wu, staff writer for The Atlantic, joins Hari Sreenivasan to discuss the dangers of ignoring the latest variant.

HARI SREENIVASAN, CORRESPONDENT: Katherine Wu, thanks for joining us. Let’s start with the big picture here. We have been waiting for what is another wave, another variant. And we see reports of it in different parts of the world. Where is the United States and where is this wave now?

KATHERINE WU, STAFF WRITER, THE ATLANTIC: Yes, so things in the United States are kind of in this weird limbo period where I think a lot of people are waiting for the other shoe to drop. We are in still in kind of a low plateau. We are certainly, down from where we were in January, but we have seen those cases in, you know, roughly half of States are now starting to rise. That might be a little bit noisy in some states that haven’t seen a rise for a couple of weeks. But certainly, in the Northeast, things are looking a little rough again. We have to also square that with the idea that BA.2, this subvariant to Omicron, kind of the sister to the variant that caused that giant wave throughout December and January, is now the dominant version of this virus in the United States. And that has boded somewhat poorly for certain countries in Europe. The United Kingdom, which has often been ahead of us in terms of surges, just had another massive one. And people are wondering if we’re going to see a bit of a bump here. Can’t tell yet when that will be or how big they will be.

SREENIVASAN: So, in terms of response to this wave, it seems that our federal and local guidelines have certainly softened since the last one. Most cities in the States are easing back on their restrictions and mitigation efforts. So, is it — you know, are we setting ourself up here for a wave that might not have had to be so bad if we just were as vigilant as we were, say, a year ago?

WU: That’s definitely the worry. And, you know, I of course want to be charitable here. I know how tired people are. We have really been buckling down for the past couple of years and people do really want a reprieve. I think the big concern here is, you know, not that we are relaxing when cases go down, but that we’re not really prepared to take up action again when cases go back up. Ideally, you know, we would start masking again. We would be vigilant again as cases rise early on so that we prevent the enormous wave that could happen. But right now, CDC guidelines, in particular, have really raised the threshold at which people are told to mask up again. You know, it’s multiple times the threshold we were at before. And the focus now really seems to be on preventing severe disease, hospitalization and death. Obviously, that’s essential. But that also means that a lot of transgression, a lot of cases are going to happen before we really start taking actions again. And the big concern here is, you know, as one research group recently found, we could walk ourselves on to a path if we wait that long to mask again, that we will reach the point again where we have about 1,000 Americans dying each day.

SREENIVASAN: Wow. That’s a threshold that oddly, we have seemingly become comfortable with. I mean, that — just in any other era, if we had said there were 1,000 Americans dying a day, we would be tripping over ourselves to figure out what is causing it? How do we stop it? But, in this case, we’ve now almost reached a million people dead and 1,000 people dying a day seems normal.

WU: Yes, I mean, I certainly wish that weren’t the case. But there has been this numbness that, I think, has really set in over the past couple of years. I think part of the psychology here is we have all gotten locked into paying attention to national curves. And especially coming away from the January peak, people saw it down, down, down, down, down. And it was very easy to think, wow, things were getting better. That must mean things are great. But I think we do have to remember that, you know, even as cases come down, cases are still happening. Even on the down slope, something is keeping that curve from being at zero. And hospitalizations lag behind cases. Deaths lag behind hospitalizations. And we see the repercussions of a wave long after the wave starts to, sort of, contract. And we’re going to be dealing with, you know, things like, long COVID, this long-term consequences for a very long time. So, it is still absolutely worthwhile to be trying to keep case limits as trim as we can. And I think this is really about having preparedness. Having capacity. And reacting as early as we can when we get the signs that cases really are starting to go up again.

SREENIVASAN: Our ability to measure is pretty crucial in our ability to react. And right now, there seemed to be guidelines from the CDC and elsewhere that are decreasing what we report and how often we report it to these State and federal databases.

WU: Yes. This is a huge issue right now. And so, you know, everything I said earlier about cases looking like they’re going up and you know, cases looking like they’re flat, nationwide still. All that has to be caveated with, you know, our tests and surveillance systems being kind of on the wane right now. You know, many, many community testing sites have gone offline. People are still using home tests to some degree, but most of those are not being reported. You know, even enthusiasm for those tests seems to be going down. And we are just, sort of, losing sight on where the virus is and where the virus is moving. Testing is not just important for, you know, oh, I’m sick, I should go to the hospital, maybe, get some treatment. It’s also important for figuring out where the virus is starting to explode. And also figuring out, you know, is there a new variant popping up? We’ve had a lot of variants enter the country in the past couple of years, but our next one could be home grown. And we won’t catch it early enough unless we’re testing enough, sequencing those samples enough. And this is going to be a huge issue. You know, we cannot stop a wave that we don’t see coming.

SREENIVASAN: Right now, Congress is maybe set to approve. I always use, you know, squishy language when it comes to that. But right now, it’s about half of what the president wanted in the bill when it comes to funding COVID research, COVID distribution. Even international efforts. What does that mean when it actually comes to what the researchers get? What the State agencies get?

WU: Yes. I think there are a few things to talk about here. First of all, the fact this is basically all domestic. That is going to be a huge, huge, huge issue. I think this sort of is unfortunately in line with this very nationalistic mindset that we have adopted throughout this pandemic. But the fact that we are not devoting any of that money to helping, you know, for instance global vaccination efforts, distributing resources equitably across the world. Cases are still high extraordinarily high in many other countries. Vaccination rates are extraordinarily low. We need to fix those disparities because, you know, it is baked right there into the word. A pandemic is something that affects everyone. It’s something that moves across the entire globe and impacts everyone. The disparity is that we are going to reenforce by not helping other countries are going to come back to bite us. You know, we know that if we give the virus the opportunity to spread elsewhere, it will come here. We know that, you know, if we allow people to remain unvaccinated, we are going to have high mortality and suffering and a lingering of this virus in places that we don’t want it to be. I think the domestic focus, you know, we can sort of see why that decision was made, but it is not going to be a sustainable solution. And we absolutely need more funds to come through to help the international situation.

SREENIVASAN: One of the things that I think every American in the last two years has at least heard is the role that vaccines play in mitigating the spread of a virus. And here we are entering year three and we still only have less than two- thirds, about 66 percent of the population that has taken both shots or gotten a booster. And you know, early on, we heard about these ideas of herd immunity and what the population threshold was. Have we gotten to that or can we with 66 percent?

WU: I think we need to let the notion of herd immunity go. It has been a long time coming, but I think you know, these vaccines were certainly initially built as tools that could help us, you know, stop all transmission and by themselves end the pandemic. That is not really the case, you know. They operate incredibly well. These are extraordinary vaccines. But like most other vaccines, where they operate best is in preventing severe disease and death. And they may not have massive effects on blocking, you know, all infections on transmissions, certainly, there will be some effect of that. But, you know, even if our vaccination rates were much, much higher, we would really, really struggle to get rid of the virus or stop it from transmitting to any degree. And certainly, with the rates we have now, that is absolutely off the table. I certainly don’t think that means we give up on vaccination. I don’t think that means we give up on boosting. We absolutely need those to, again, lower transmission and certainly lower severe disease and death. But I think we need to move away from this complete elimination mindset and recognize that this is going to be about maintenance. About control. About keeping levels low so that we can live our lives in a sustainable way. You know, have some semblance of normalcy but that the virus is going to be a part of that normalcy.

SREENIVASAN: Part of the fatigue with this has also changed people’s opinions on how to mitigate. There are, now, more people who have survived a few months of low viral spread rates. Who say, you know what, there’s 80 million people in the United States who’ve already had this. There’s a bunch of other people who have the vaccine. Well, other vaccine — other viruses are going to come, let’s just let it run its course. What’s wrong with that thinking?

WU: Yes, the — interestingly the answer to this question is actually kind of a throwback back to the early days of the pandemic. You know, I certainly do want to acknowledge that a lot has changed since then. Having a relatively highly vaccinated population is going to make a huge impact. Again, lowering severe disease and death. It means, the typical case for a vaccinated individual is going to be far less likely to cause a severe outcome. And that is huge. But still, we are not vaccinated enough that we could ever, in any universe, let the virus safely run its course and not see serious repercussions. You know, think back to the early days when we were talking about flattening curve. If the virus were to, you know, run — rush out over all of us at once, that would lead, still, to a massive wave of hospitalizations. It would overwhelm the healthcare system. Even if we have a very small percentage of the cases resulting in severe cases. A small percentage of a massive number can still be a massive number. You know, we did see the effects of this with Omicron quite recently this past winter. And we don’t want to repeat that. Yes, immunity is important. Yes, immunity is sort of shifting our fates. But I don’t think we can get complacent. We know that this virus can mutate. We know it can change the game. And if we get a variant that escapes our immunity to the same degree that Omicron did, or even worse, we would really, really — I think, shoot ourselves in the foot by just saying, this is no big deal. You know, a lot of us already have immunity, whatever. The virus can always shift the playing field for us.

SREENIVASAN: We seem to have collectively started to put the onus back on to the individual versus us as a collective taking different types of measures and responsibilities. By that, I mean that there is an emphasis on return to work, return to office, get the economy going again, et cetera. Where that is part of our return to normalcy, I understand that, but at the same time, how successful can we be when every single person is responsible for knowing their status? Where they’ve been? Whether they’re infecting other people versus as a society if we do it together?

WU: Right. I really appreciate how you phrased that. I think that is exactly the problem that we have been dealing with in the past two years. I — I’m not sure that America ever really had a collectivist approach to this pandemic. Which is unfortunate, because the problem is at heart, a collective problem. I think — unlike a lot of the other diseases or problems that trouble Americans, this is something that is infectious. It spreads from person to person, which means the actions that I take don’t just affect me, they affect the people around me. My neighbors. My family. My friends. And those problems compound. I think what I’m seeing, certainly now in the guidance in the messages from the administration, has repeatedly been, you know, for many months now, your health is in your own hands. Your decision, you know, to boost. To mask up. Even when cases get to a level at which the CDC recommends masking, it is a recommendation. It still remains to some degree, personal choice. And below those levels, there’s language about, you know, if you feel like it, it’s a matter of personal preference. You know, mask if you feel like it, that’s cool. But also, if you don’t or whatever. It’s — it — I think it just reenforces this idea that people are making their own decisions and out for themselves. Where this really becomes a problem and when you consider that in those situations, there are people among us who are far more vulnerable than others who have far less access to resources, tests, treatments, vaccines, booster shots, which is getting even more difficult as funding continues to dry up. These individuals are going to be asked to, sort of, bear the burden of early caseloads before they get to those sky-high levels, you know, that will be unfortunately the burden that is thrust on them if we don’t come together and decide we need to protect these people. We need to make sure that, you know, long COVID does not balloon even further out of control. We need to make sure we are not imperiling the people who can least afford it.

SREENIVASAN: Let’s talk about long COVID. I mean, often the conversation focuses on the infection that you or I could get and the small flu-like symptoms, et cetera, et cetera. But the people that you’ve spoken to, not just the sufferers of long COVID, but also the researchers, what are they concerned about when it comes to the scale of the population that might have it? And what sorts of impact this could have on our overall healthcare system going forward?

WU: Right. This is such an important issue and unfortunately, it’s so difficult to talk about because there are so many open questions still about long COVID. You know, certainly I’ll start with what we are certain about. You know, this is definitely something real. This is definitely impacting millions of people. And, you know, current estimates are still being worked out, but it’s thought that 10 to 30 percent of all infections from SARS-COVID to BA.2, this coronavirus, could result in long-term symptoms that persist for weeks, months. For some people, they are years into suffering these symptoms. And this does not mean, oh, I feel like I have a cold for two years. This can affect you know, all the organ systems that we can think of. People are struggling to return to work. Their lives have been permanently altered by this incredible constellation of symptoms. You know, we know this is not unique to COVID, but the fact that COVID has torn through our society to such a degree over the past two years means that so many people are dealing with this. It has become a crisis. And I think because this is chronic, people really need to wrap their minds around the idea that it’s not something that, you know, goes up and comes down. You know, we’re sort of ascending this hill. Cases are accumulating and accumulating and that means we will be dealing, potentially, with many millions or hundreds of thousands of these cases. Not just throughout the rest of the pandemic but for years after potentially.

SREENIVASAN: How do researchers need to begin tackling this? Because if they don’t know what is causing some of these underlying organ system failures and how that’s connected to this specific virus, people who are suffering from this right now, there’s not a pill they can take.

WU: Right. Well, fortunately, there is a lot of research that is going into this. You know, and the government as allocated funds. They’re recruiting for, you know, a national study at this point. So, many are going on in different parts of the country. And that is heartening. But this is not something that invites a lightning-fast solution. And I think that’s another reason people need to stay invested in this idea that the pandemic is still happening. That COVID is not going away. That we will need to keep thinking about this whether we like it or not, for quite some time to come.

SREENIVASAN: Katherine Wu of “The Atlantic”, thanks so much for joining us.

WU: Thank you for having me.