Emergence of a Deadly Coronavirus

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The number of new coronavirus cases rose by 18% in the last week, with more than 4.1 million cases reported globally, according to the World Health Organization.

The U.N. health agency said in its latest weekly report on the pandemic that the worldwide number of deaths remained relatively similar to the week before, at about 8,500.

COVID-related deaths increased in three regions: the Middle East, Southeast Asia and the Americas.

The biggest weekly rise in new COVID-19 cases was seen in the Middle East, where they increased by 47%, according to the report released late Wednesday. Infections rose by about 32% in Europe and Southeast Asia, and by about 14% in the Americas, WHO said.

WHO Director-General Tedros Adhanom Ghebreyesus said cases were on the rise in 110 countries, mostly driven by the omicron variants BA.4 and BA.5.

“This pandemic is changing, but it’s not over,” Tedros said this week during a press briefing.

He said the ability to track COVID-19′s genetic evolution was “under threat” as countries relaxed surveillance and genetic sequencing efforts, warning that would make it more difficult to catch emerging and potentially dangerous new variants.

He called for countries to immunize their most vulnerable populations, including health workers and people over 60, saying that hundreds of millions remain unvaccinated and at risk of severe disease and death.

Tedros said that while more than 1.2 billion COVID-19 vaccines have been administered globally, the average immunization rate in poor countries is about 13%.

According to figures compiled by Oxfam and the People’s Vaccine Alliance, fewer than half of the 2.1 billion vaccines promised to poorer countries by the Group of Seven large economies have been delivered.

The fast-changing coronavirus has kicked off summer in the U.S. with lots of infections but relatively few deaths compared to its prior incarnations.

COVID-19 is still killing hundreds of Americans each day, but is not nearly as dangerous as it was last fall and winter.

“It’s going to be a good summer and we deserve this break,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle.

With more Americans shielded from severe illness through vaccination and infection, COVID-19 has transformed — for now at least — into an unpleasant, inconvenient nuisance for many.

“It feels cautiously good right now,” said Dr. Dan Kaul, an infectious diseases specialist at the University of Michigan Medical Center in Ann Arbor. “For the first time that I can remember, pretty much since it started, we don’t have any (COVID-19) patients in the ICU.”

As the nation marks July Fourth, the average number of daily deaths from COVID-19 in the United States is hovering around 360. Last year, during a similar summer lull, it was around 228 in early July. That remains the lowest threshold in U.S. daily deaths since March 2020, when the virus first began its U.S. spread.

But there were far fewer reported cases at this time last year — fewer than 20,000 a day. Now, it’s about 109,000 — and likely an undercount as home tests aren’t routinely reported.

Today, in the third year of the pandemic, it’s easy to feel confused by the mixed picture: Repeat infections are increasingly likely, and a sizeable share of those infected will face the lingering symptoms of long COVID-19.

Yet, the stark danger of death has diminished for many people.

“What we’re seeing is that people are getting less and less ill on average,” Dowdy said.

As many as 8 out of 10 people in the U.S. have been infected at least once, according to one influential model.

The death rate for COVID-19 has been a moving target, but recently has fallen to within the range of an average flu season according to data analyzed by Arizona State University health industry researcher Mara Aspinall.

Big differences separate flu from COVID-19: The behavior of the coronavirus continues to surprise health experts and it’s still unclear whether it will settle into a flu-like seasonal pattern.

In the next weeks, deaths could edge up in many states, but the U.S. as a whole is likely to see deaths decline slightly, said Nicholas Reich, who aggregates coronavirus projections for the COVID-19 Forecast Hub in collaboration with the Centers for Disease Control and Prevention.

“We’ve seen COVID hospitalizations increase to around 5,000 new admissions each day from just over 1,000 in early April. But deaths due to COVID have only increased slightly over the same time period,” said Reich, a professor of biostatistics at University of Massachusetts Amherst.

Unvaccinated people have a six times higher risk of dying from COVID-19 compared with people with at least a primary series of shots, the CDC estimated based on available data from April.

This summer, consider your own vulnerability and that of those around you, especially in large gatherings since the virus is spreading so rapidly, Dowdy said.

“There are still people who are very much at risk,” he said.

The number of new coronavirus cases across Britain has surged by more than 30% in the last week, new data showed Friday, with cases largely driven by the super infectious omicron variants.

Data released by Britain’s Office for National Statistics showed that more than 3 million people in the U.K. had COVID-19 last week, although there has not been an equivalent spike in hospitalizations. The number of COVID-19 deaths also fell slightly in the last week.

“COVID-19 has not gone away,” said Dr. Mary Ramsay, of the Health Security Agency. “It is also sensible to wear a face covering in crowded, enclosed spaces,” she said. Britain dropped nearly all its coronavirus measures, including mask-wearing and social distancing months ago and masks are rarely seen on public transport.

The latest jump in coronavirus cases comes after an earlier increase of about 40% last month, following the large street parties, concerts and festivities held to mark the platinum jubilee celebrations marking 70 years of Queen Elizabeth II’s reign.

British officials said the latest wave of COVID-19 infections were likely caused by omicron subvariants BA.4. and BA.5.

“The constant bombardment of waves we are seeing does cause clinical impact that is not to be underestimated,” said Dr. Stephen Griffin, an associate professor of medicine at the University of Leeds, explaining that any infection can lead to long COVID.

Britain’s Health Security Agency said they were seeing more outbreaks in care homes for older people and a rise in admissions to intensive care units of people over 65.

Dr. Jonathan Van-Tam, a former deputy chief medical officer for the U.K., told the BBC that COVID-19 is now “much, much, much closer to seasonal flu” than when it first emerged. Still, he said experts should be vigilant for any signs the virus was causing more severe illness.

Germany’s Robert Koch Institute also reported a similar rise in the coronavirus, with cases increasing especially among older people, children and teenagers. France has seen a jump in the COVID-19 hospitalization rate and officials recently recommended that people begin wearing masks again on public transport.

China’s virus cases continued to climb over the weekend with hundreds of infections detected in Anhui province where two counties were already in lockdown.

The country reported 385 local cases on Saturday, with mass screening resulting in more than 290 cases found in Anhui province alone. A lockdown was imposed in Lingbi county in northeastern Anhui from Friday afternoon, while the neighboring Si county conducted its sixth mass testing on Sunday.

While China seems to have brought earlier outbreaks in mega cities Shanghai and Beijing under control, its Covid-Zero goal is facing a test again in its eastern provinces. Shanghai’s neighboring Jiangsu province reported 59 cases on Saturday.

President Xi Jinping on Wednesday reaffirmed the importance of sticking with the Covid-Zero policy. He said relaxing Covid controls would risk too many lives in the world’s most populous country, and China would rather endure some temporary impact on economic development than let the virus hurt people’s safety and health.

Three asymptomatic cases were reported in Zhejiang Saturday. Yiwu airport in Zhejiang province said it is halting all flights to Beijing due to the virus. Resumption of flights will be determined at another time, according to the airport’s official WeChat account, without elaborating.

Pharmacists can prescribe the leading COVID-19 pill directly to patients under a new U.S. policy announced Wednesday that’s intended to expand use of Pfizer’s drug Paxlovid.

The Food and Drug Administration said pharmacists can begin screening patients to see if they are eligible for Paxlovid and then prescribe the medication, which has been shown to curb the worst effects of COVID-19. Previously only physicians could prescribe the antiviral drug.

The announcement comes as COVID-19 cases, hospitalizations and deaths are rising again, though they remain near their lowest levels since the coronavirus outbreak began in 2020.

Biden administration officials have expressed frustration that several hundred Americans continue to die of COVID-19 daily, despite the availability of vaccines and treatments.

Administration officials have been working for months to increase access to Paxlovid, opening thousands of sites where patients who test positive can fill a prescription for Paxlovid. The FDA change will make thousands more pharmacies eligible to quickly prescribe and dispense the pill, which must be used early to be effective.

“Since Paxlovid must be taken within five days after symptoms begin, authorizing state-licensed pharmacists to prescribe Paxlovid could expand access to timely treatment,” FDA drug center director Patrizia Cavazzoni, said in a statement.

Still, use could be limited by paperwork requirements. Patients are expected to bring their recent health records— including blood tests — and a list of their current medications so pharmacists can check for health conditions and medications that can negatively interact with Paxlovid. As an alternative, pharmacists can consult with the patient’s doctor.

Paxlovid is intended for people with COVID-19 who are more likely to become seriously ill. That includes older people and those with other health issues like heart disease, obesity, cancer or diabetes that make them more vulnerable. It isn’t recommended for patients with severe kidney or liver problems. A course of treatment is three pills twice a day for five days.

COVID-19 is not causing illness that is nearly as severe as when the first wave of omicron hit over the 2021-2022 holiday season.

But emerging subvariants of omicron continue to spread across New York – and are causing hospitalizations to sit at levels that are more than double the numbers experienced during the last two summers of the pandemic.

For example, COVID-19 hospitalizations in New York were below five people per 100,000 on July 1, 2020, and below 2 people per 100,000 on that date in 2021. Last Friday, the number of people hospitalized with COVID-19 was roughly at 10 per 100,000 statewide.

Two new omicron subvariants, BA.4 and BA.5, are causing concern that another infection wave could hit New York.

Infection rates in New York have been slowly ticking back up over the last couple of weeks since the end of school – which is counter to the trends seen in the last two years when outdoor gatherings increased over the summer months, decreasing the likelihood of indoor virus spread.

Dr. Jay Varma, a Weill Cornell epidemiologist who advised former New York City Mayor Bill de Blasio during the pandemic, said in a Twitter thread last week that all signs point to an impending BA.5 wave, but it's unclear to what extent the new strain will result in severe illness or death.

Albany and Rensselaer counties moved into medium COVID-19 risk at the end of last week, after being low risk in June, according to Centers for Disease Control and Prevention's data crunch of COVID-19 spread and hospital capacity. They are two of only four counties upstate that moved to a higher risk level last week, the other two being in the Southern Tier.

On Long Island, both Nassau and Suffolk counties are at high risk for COVID-19 spread, according to the CDC designation. The rest of downstate is also in medium risk, including New York City's five boroughs and Westchester County.

Many Americans don’t expect to rely on the digital services that became commonplace during the pandemic after COVID-19 subsides, according to a new poll, even as many think it's a good thing if those options remain available in the future.

Close to half or more of U.S. adults say they are not likely to attend virtual activities, receive virtual health care, have groceries delivered or use curbside pickup after the coronavirus pandemic is over, according to a poll from The Associated Press-NORC Center for Public Affairs Research. Less than 3 in 10 say they're very likely to use any of those options at least some of the time.

Still, close to half also say it would be a good thing if virtual options for health care, for community events and for activities like fitness classes or religious services continue after the pandemic.

“Rather than this either-or, I think we’re more likely to be facing a hybrid future,” said Donna Hoffman, director of the Center for the Connected Consumer at the George Washington School of Business. “People have found convenience in some of these virtual options that just makes sense, and they don’t necessarily have anything to do with like keeping you safe or the pandemic even though they came of age during the pandemic.”

Adults age 50 or older are especially likely to say they are not planning to use the virtual options asked about on the poll going forward, even though many were introduced during the pandemic to protect the at-risk population.

Despite feeling antsy about COVID-19 and infection rates in Phoenix, Tony DiGiovane, 71, said he found curbside pickup at grocery stores and restaurants to be more hassle than they’re worth.

“By the time I picked up the stuff, I needed more stuff,” he said of his grocery orders, and “something’s always missing or wrong” on takeout orders.

Karen Stewart, 63, recognizes the benefits of video calls, but she’s also found them to be limiting. That’s the case in her job organizing after school programming for kids. She also now sees some of her doctors online, one who provides virtual care almost exclusively and another who uses virtual care in between office visits.

She likes that she doesn’t have to drive, but it means a doctor or nurse can’t take her vitals or be “hands on” in her care. It was “scary,” for example, when all of her appointments in the lead-up to a surgery were online, she said.

The pandemic created an opportunity to balance in-person and virtual services to support the physical and mental health of older adults, said Alycia Bayne, a principal research scientist at NORC. That “could be particularly beneficial to older adults with different health issues, mobility limitations, people who lack transportation options, people who do not have or live near a robust social networks like family and friends to lean on,” she said.

Still, there remain limitations with technology access, broadband access and digital literacy, which Bayne said may help explain why the poll finds older adults less likely to use digital services after the pandemic.

The newest wave of COVID infections and reinfections, fueled by more transmissible subvariants of the Omicron strain including BA.4 and BA.5, continues to grow across the U.S. The extra-worrisome BA. 5 is now the most dominant variant in the country, accounting for an estimated 53.6 percent of new infections last week, according to the CDC. As countless Americans gathered over the July 4 holiday weekend, it’s entirely possible that there were more new daily infections happening in the country than at any other point in the pandemic other than the Omicron wave. As BA.5 rapidly rises to what will likely be global dominance, the U.S. isn’t the only country experiencing a surge.

Last week, the U.S. test positivity rate — which is now a more reliable indicator of case surges than official case counts — reached a seven-day average of over 15 percent for the first time since February

New York City’s test positivity rate surpassed 10 percent last week for the first time since January 22. The city also took down its color-coded COVID risk alert system last week so it could be reevaluated, city officials said.

The CDC estimates that the level of community transmission remains high in more than 87 percent of U.S. counties, and remains substantial or higher in more than 95 percent of counties.

The good news? While U.S. COVID hospitalizations have been trending up since mid-April, they are nowhere near the levels reached in the Omicron wave, and the rates of new reported COVID deaths and COVID patients in intensive-care units are thus far only slightly ticking up and remain near pandemic lows. The vaccines are still doing an excellent job of preventing severe illness in most instances (and are finally now available for small children), and doctors have never had more tools to combat those severe illnesses when they do occur.

The bad news? Against these new subvariants, vaccines and prior infection are proving less and less effective at preventing infections and reinfections. They also appear to be at least somewhat less effective at preventing hospitalizations as the coronavirus evolves — particularly among the many un- and under-boosted seniors. A big wave of cases will be at best disruptive, will increase the risk of a lot more people developing long COVID, and will give SARS-CoV-2 many more opportunities to evolve. The impact of multiple COVID reinfections, which many Americans already have or soon will experience, remains unclear.

BA.5 and BA.4 continue to outcompete the other Omicron subvariants across the U.S. and BA.5 has quickly become the most dominant variant in the U.S. As of the week ending July 2, the CDC’s NowCast model estimates that BA.5 accounted for 53.6 percent of new infections nationwide, up from under 10 percent a month ago. BA.4 and BA.5 together comprised more than 70 percent of U.S. cases, and the previously dominant BA.2.12.1 continues to fade, after peaking at an estimated 63 percent of cases five weeks ago.

Health experts in the US and abroad have found that the coronavirus variant currently responsible for most infections in the US, Omicron BA.5, can quickly reinfect people who have protection against the virus.

People who have been vaccinated, received antibody treatments, or developed natural immunity from contracting the virus were previously thought to have a lower risk of getting COVID-19, at least in the months following exposure.

But Andrew Robertson, the chief health officer of Western Australia, told News.com.au that he's seeing people get reinfected with the coronavirus in a matter of weeks.

"What we are seeing is an increasing number of people who have been infected with BA.2 and then becoming infected after four weeks," he said. "So maybe six to eight weeks they are developing a second infection, and that's almost certainly either BA.4 or BA.5."

Reinfections with BA.5 and BA.4 are typically less severe compared with early COVID-19 infections, Dr. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told Insider. As the virus has evolved to have some resistance to antibodies, immune systems are learning to respond to it without making the body go haywire, he said.

A recent study out of Columbia University that has not been peer-reviewed found that the recent BA.4 and BA.5 subvariants were at least four times as resistant to protection against the virus compared with previous variants in the Omicron lineage.

Researchers led by Dr. David Ho, the director of the Aaron Diamond AIDS Research Center, took antibodies from people who received at least three doses of an mRNA vaccine or got two shots and were then infected with Omicron. In a lab study, researchers watched to see how these antibodies performed against Omicron subvariants.

Peter Chin-Hong, a University of California, San Francisco, infectious-disease expert, told the Los Angeles Times that BA.4 and BA.5's "superpower is reinfection."

Meanwhile, Dr. Eric Topol, the director of the Scripps Research Translational Institute in La Jolla, S an Diego, called BA.5 "the worst version of the virus that we've seen" in a recent blog post because of its ability to evade immunity and increased transmissibility.

Now we are having a wave which is suggestive that it is not only more transmissible, but transmissible outdoors.

America has decided the pandemic is over. The coronavirus has other ideas.

The size of that wave is unclear because most people are testing at home or not testing at all. The Centers for Disease Control and Prevention in the past week has reported a little more than 100,000 new cases a day on average. But infectious-disease experts know that wildly underestimates the true number, which may be as many as a million, said Eric Topol, a professor at Scripps Research who closely tracks pandemic trends.

Antibodies from vaccines and previous coronavirus infections offer limited protection against BA.5, leading Topol to call it “the worst version of the virus that we’ve seen.”

Other experts point out that, despite being hit by multiple rounds of ever-more-contagious omicron subvariants, the country has not yet seen a dramatic spike in hospitalizations. About 38,000 people were hospitalized nationally with covid as of Friday, according to data compiled by The Washington Post. That figure has been steadily rising since early March, but remains far below the record 162,000 patients hospitalized with covid in mid-January. The average daily death toll on Friday stood at 329 and has not changed significantly over the past two months.

There is widespread agreement among infectious-disease experts that this remains a dangerous virus that causes illnesses of unpredictable severity — and they say the country is not doing enough to limit transmission.

Restrictions and mandates are long gone. Air travel is nearly back to pre-pandemic levels. Political leaders aren’t talking about the virus — it’s virtually a nonissue on the campaign trail. Most people are done with masking, social distancing and the pandemic generally. They’re taking their chances with the virus.

“It’s the Wild West out there,” said Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis. “There are no public health measures at all. We’re in a very peculiar spot, where the risk is vivid and it’s out there, but we’ve let our guard down and we’ve chosen, deliberately, to expose ourselves and make ourselves more vulnerable.”

Angela Rasmussen, a virologist at the University of Saskatchewan, would like to see more money for testing and vaccine development, as well as stronger messaging from the Biden administration and top health officials. She was dismayed recently on a trip to Southern California, where she saw few people wearing masks in the airport. “This is what happens when you don’t have politicians and leaders taking a strong stand on this,” she said.

The CDC said it has urged people to monitor community transmission, “stay up to date on vaccines, and take appropriate precautions to protect themselves and others.”

Nearly one-third of the U.S. population lives in counties rated as having “high” transmission levels by the CDC. Cases are rising especially in the South and West.

Many people now see the pandemic as part of the fabric of modern life rather than an urgent health emergency. Some of that is simply a widespread recalibration of risk. This is not the spring of 2020 anymore. Few people remain immunologically naive to the virus. They may still get infected, but the immune system — primed by vaccines or previous bouts with the virus — generally has deeper layers of defense that prevent severe disease.

But the death rate from covid-19 is still much higher than the mortality from influenza or other contagious diseases.

“It feels as though everyone has given up,” said Mercedes Carnethon, an epidemiologist at the Northwestern University Feinberg School of Medicine.

Many experts concerned about ongoing transmission have also pushed back against online fearmongering and apocalyptic warnings about the virus; people are not routinely getting infected every two or three weeks, Rasmussen said.

Population-level immunity is one reason the virus remains in mutational overdrive. The risk of reinfections has increased because newly emergent subvariants are better able to evade the front-line defense of the immune system, and there is essentially no effort at the community level to limit transmission.

Al-Aly, who is also chief of research and development at Veterans Affairs St. Louis Health Care System, has scoured VA’s vast database to see what happened to the nearly 39,000 patients infected with the coronavirus for a second or third time. What he found was sobering. In a paper posted online last month, but not yet peer-reviewed or published in a journal, Al-Aly and his co-authors reported that people with multiple infections have a higher cumulative risk of a severe illness or death.

It’s not that the later illnesses are worse than, or even as bad as, earlier cases. But any coronavirus infection carries risk, and the risk of a really bad outcome — a heart attack, for example — builds cumulatively, like a plaque, as infections multiply.

“Reinfection adds risk,” he said. “You’re rolling the dice again. You’re playing Russian roulette.”

Vaccination remains an important, if still underused, weapon against the virus — even if it’s not that effective at stopping new infections.

“I worry that by the time we have a vaccine for BA.5 we’ll have a BA.6 or a BA.7. This virus keeps outsmarting us,” Al-Aly said.

“We are in a very difficult position with regard to the choice of vaccine for the fall because we’re dealing with a notoriously moving target,” Anthony S. Fauci, President Biden’s top adviser for the pandemic, told The Post in June, a few days before he, too, announced that he was sick with the virus.

Already there’s another omicron subvariant that has caught the attention of virologists: BA.2.75. First seen last month in India, it has been identified in a smattering of other countries, including the United States. But it’s too soon to know whether it will overtake BA.5 as the dominant variant.

There is no evidence that the new forms of the virus result in different symptoms or severity of disease. Omicron and its many offshoots — including BA.5 — typically replicate higher in the respiratory tract than earlier forms of the virus. That is one theory for why omicron has seemed less likely to cause severe illness.

It’s also unclear if these new variants will alter the risk of a person contracting the long-duration symptoms generally known as “long covid.” The percentage of people with severely debilitating symptoms is probably between 1 and 5 percent — amounting to millions of people in this country, according to Harlan Krumholz, a Yale University professor of medicine.

His colleague, Akiko Iwasaki, a professor of immunology and expert on long covid, said in an email that she believes the world is not sufficiently vigilant about the disease anymore. She is often the only person masking in a crowd, she said.

“I understand the pandemic fatigue, but the virus is not done with us,” she said. “I fear that the current human behavior is leading to more people getting infected and acquiring long covid. I fear that this situation can lead to a large number of people with disability and chronic health problems in the future.”

The precocious nature of the virus has made infectious-disease experts wary of predicting the next phase of the pandemic.