A new and easily transmissible COVID-19 virus subvariant is gaining traction in the U.S., according to the latest federal data, and public health experts in Maryland and elsewhere fear a fatigued and divided nation has let its guard down.
Scientists, medical professionals and researchers are racing to understand BA.5, a new subvariant of the highly contagious omicron strain that emerged last fall and quickly fanned out across the country. The rapid spread of infections caused a statewide surge in sickness that prompted hospitals to resort to emergency standards of care as patients overwhelmed the health care system.
The new strain — now accounting for about 65% of all cases reviewed by the U.S. Centers for Disease Control and Prevention’s genomic surveillance system and more than half of new cases sequenced from Maryland and neighboring states — joins a growing list of “variants of concern” monitored by the federal government. While much remains unknown about BA.5, variants of concern are generally thought to be more easily spread, more adept at evading vaccines’ protection, and less responsive to antibodies and other therapies, according to the CDC.
More than 1,000 people in Maryland have tested positive for the virus almost every day this month, according to state data, but experts say the case counts could be vastly underreported due to the prevalence of at-home tests, which aren’t automatically captured in state statistics. More than 1.1 million positive cases have been recorded in the state since officials began tracking the public health crisis in March 2020, state data shows, and more than 1,700 new cases were added to the tally Tuesday.
Health care and medical professionals said the new variant serves as a fresh reminder that the public health crisis continues to evolve and flourish, even as pre-pandemic routines resume. They said BA.5 is so far diverged from previous variants that it could cause reinfection or even more severe infections among those who have been fully vaccinated or who have recently contracted the virus.
“This is yet another change in the virus that makes it less recognizable to our bodies, and that’s created another challenge for us in that it’s shifted enough that people who have been infected with omicron [already] may be susceptible to new infections sooner,” said Dr. Gregory Schrank, an epidemiologist at the University of Maryland Medical Center in Baltimore and an assistant professor at the University of Maryland School of Medicine. “Until we see an updated, omicron-specific vaccine, we may see more common and more severe infections among the boosted and the previously infected.”
The state’s testing positivity rate now hovers around 9%, according to the latest data. National guidance from the World Health Organization cites 5% as the threshold that determines when the virus becomes widespread in communities and when more testing is needed.
At the same time, hospitalizations remain relatively low compared to previous pandemic waves: State officials reported 555 occupied hospital beds due to COVID-19 infections Tuesday, with 482 of those in the adult acute care units. In all, 14,585 Marylanders have died of COVID-19 in a little more than two years, data shows. More than 60 deaths have been recorded this month.
Federal officials are working to make second booster doses available to all adults, according to several news reports, as the national seven-day average of new cases rises to levels not seen since the spring. Such a step would require approval from both the CDC and the U.S. Food and Drug Administration.
For now, the same public health tools that became prevalent during previous waves of the virus — vaccinating and boosting, masking, hand-washing, social distancing, using ventilation and robust testing — can be applied to this moment, too, said Dr. Barry Meisenberg, chair of the department of medicine at Luminis Health Anne Arundel Medical Center.
Meisenberg said vaccines may be “substantially” less effective at neutralizing the virus, which makes using more than one tool all the more important.
Luminis Health, which operates the Anne Arundel center as well as Doctors Community Medical Center in Lanham, currently has about 36 COVID-19 patients, about twice as many from last month, Meisenberg added. He said patients at both medical centers were a mix of vaccinated, unvaccinated, and vaccinated and boosted.
“Like an umbrella on a threatening day, take the tools with you and use them when you need,” Meisenberg said. “This is the best we can offer in terms of prevention: Get your vaccine, and if you’re 50 and older, that includes two boosters.”
State health officials also encouraged the eligible population — which now includes everyone older than 6 months — to get vaccinated against COVID-19. At least one booster shot is encouraged for everyone ages 5 and older who has been vaccinated.
Chase Cook, a spokesman for the agency, said Marylanders should continue to get tested, as well. The state now runs “Test to Treat” sites, including at State Center in Baltimore, where people who test positive via rapid tests and qualify for treatments can immediately receive clinical evaluations and a prescription filled on-site.
Attitudes and behaviors toward the virus have become increasingly polarized, especially along lines of political affiliation. In Maryland, 45% of Republican voters described the COVID-19 pandemic as “not a concern” and another 36% listed it as a “minor concern,” according to a June Goucher College poll conducted in partnership with The Baltimore Banner and WYPR. Meanwhile, 56% of Democratic voters who responded to the poll listed the pandemic as a “major concern,” compared to 18% of Republicans; another 37% of Democrats reported it as a “minor concern,” while 7% said it was “not a concern.”
“Unfortunately the American public is over COVID,” said Dr. Brian Castrucci, an epidemiologist and president and CEO of the de Beaumont Foundation, a Bethesda-based public health organization. “Unless mortality goes up, it’s going to be hard to mobilize the nation; variants are going to continue to emerge and no one has the tolerance for it.”
Castrucci said the long-term effects of COVID-19 — as well as the risks associated with reinfection and severe cases — are still not known. Long COVID, or the phenomenon of having lingering symptoms after contracting the virus, also is not fully understood among the medical community, Castrucci said.
On top of that, Americans’ attention is now split among several competing priorities, Castrucci said, including midterm elections, curtailed abortion access, mass shootings and a war in Ukraine — making sustained focus on the coronavirus pandemic less realistic.
While state and local government officials may be avoiding reinstating mask mandates or business restrictions at this time, Maryland hospitals are required to take action once hospitalizations in the state reach certain thresholds. At 1,200 COVID-19 hospitalizations, all licensed acute care hospitals must reduce scheduling non-urgent surgeries that result in overnight stays; at 1,500 hospitalizations, they must implement their pandemic plans, which can involve moving staffs around and using different standards of care, according to a Maryland Department of Health directive last updated in June.
In Baltimore, where the positivity rate stands at about 8%, officials do not have specific plans to reinstate mask mandates or other virus-related restrictions, city health department spokesman Arinze Ifekauche said Tuesday. There are 146 people currently hospitalized in the city.
Ifekauche said the agency is monitoring the numbers and closely communicating with the hospitals to ensure they aren’t overwhelmed. The department encourages vaccinations, staying home when sick and masking indoors in areas where transmission levels are known to be high.
Schrank said the public’s heed of warnings now can stave off health care collapse later.
“If we wait until hospitalizations have risen higher than before applying preventative measures, at that point, it’s too late,” Schrank said. “The horse has left the barn.”
Baltimore Banner reporter Adam Willis contributed to this article.