Brace Yourself for More Waves of COVID

I'm as ready as anybody to put COVID in the rearview mirror, but the latest assessment from a public health specialist I admire is truly depressing. 

a photo of a brunette women standing on the bus wearing a white surgical mask

Sorry to be a downer. I'm as ready as anybody to put COVID in the rearview mirror. But I've worried for a while that recent declines in cases and deaths have created a false sense of security about a virus that continues to mutate -- then last week saw a truly depressing assessment from a doctor whom I've followed for years and who has been consistently right about a host of public health issues. 

The assessment by Eric Topol not only says that case rates are rising again -- much faster than public metrics are showing -- but that mutations are rendering vaccines significantly less effective. Yet, at a time when precautions should be increasing again, pandemic fatigue both among public officials and among individuals means we are collectively letting our guard down. As a result, Topol sees no end in sight for the pandemic and warns that we will experience new waves of hospitalizations and deaths.

I encourage you to read his whole, depressing post, but here are what I see as his key points:

--"The United States is now in the midst of a new wave related to Omicron variants BA.2 and BA.2.12.1, with over 90,000 confirmed new cases a day and a 20% increase in hospitalizations in the past 2 weeks," Topol says. His post appeared on May 15; confirmed cases now exceed 110,000 per day. "[The surge in case numbers] belies the real toll of the current wave, since most people with symptoms are testing at home or not testing at all; there is essentially no testing for asymptomatic cases. The real number of cases is likely at least 500,000 per day, far greater than any of the U.S. prior waves except Omicron."

--He adds: "The bunk that cases are not important is preposterous. They are infections that beget more cases, they beget Long Covid, they beget sickness, hospitalizations and deaths. They are also the underpinning of new variants."

--The subvariant that is now dominant, BA.2.12.1, is quite different from earlier forms of the virus, meaning that it may circumvent the immunity that comes from contracting COVID or from vaccines.

--The percentage of COVID deaths accounted for by those who have been vaccinated has risen from 23% in September to 40% in February. "We are seeing people with 4 shots who are getting breakthrough infections," Topol writes, "even at 1-2 weeks from their most recent shot, when there should be the maximal level of neutralizing antibodies induced.... Prior to Omicron, we could, with a booster, assume there was well over 90-95% vaccine effectiveness vs. severe disease.... This level of protection has declined to approximately 80%, particularly taking into account the more rapid waning than previously seen."

--He writes: "This family of Omicron variants... indicates more rapid evolution of the virus than what we have seen previously. [Only four] of the thousands of variants since late 2019 have led to significant spikes of cases around the world.... But now multiple Omicron subvariants are outcompeting one another, predominantly because of more immune evasion."

From an insurance industry standpoint, this post may feel like same old, same old. We've been dealing with COVID for more than two years now and have sorted through many of the issues on business interruption, workers' comp, etc. But I cite the Topol piece for two reasons.

One, I hope we'll all be careful. As the saying goes, just because we're done with COVID doesn't mean COVID is done with us.

Two, I think we need to be prepared for people missing work for extended stretches because of the virus for some time to come, need to be prepared for continued consequences on healthcare and mortality, and need to be prepared to continue to wrestle with all the other insurance issues that have arisen since early 2020. I also suspect that many of the plans will to bring people back to the office will prove to be too optimistic. 

I hate to be the bearer of bad news, but I think we need to buckle in for quite a while longer.