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About the series
U.S. cases of COVID-19 and hospitalizations have risen over the past 30 days, raising the possibility that we may be at the start of another surge. The graph below shows reported cases, which are likely an undercount of the true number. The Institute for Health Metric Evaluation (IHME), for example, estimates that actual cases are 10 times higher than reported cases, in part because of widespread use of at-home tests, which are not tracked.
Source: Centers for Disease Control and Prevention (CDC)
The CDC reported recently that up to one-third of the U.S. population lives in areas with transmission and hospitalizations high enough to warrant a return to indoor masking. Here are two more ways to prepare for a possible coronavirus surge:
Masking, testing and continuing to encourage vaccinations and boosters for those eligible are important tools to keep ourselves and our communities healthy.
As cases continue to climb, businesses may be asking how to respond to the current situation. This table provides suggestions as to what companies can do. More information is available in this Harvard Business Review article, which Jeff Levin-Scherz, John Bremen and I published last week.
| Level of community risk | Company response |
|---|---|
| Foundational efforts regardless of community risk | Prioritize air filtration and ventilation, encourage vaccination and boosters, maintain inventory of personal protective equipment, make rapid tests easily available, ensure sick individuals stay home, communicate through an exposure notification system |
| Low community risk | Offer workplace accommodations, make masks optional for those at higher risk |
| Medium community risk* | Recommend masks for all, encourage social distancing and testing, restrict business travel |
| High community risk | Allow remote work where possible, encourage testing and as much distancing as possible for those at the workplace |
The virus continues to evolve and new variants are taking over. The Omicron BA.2 virus now represents 51% of the cases in the U.S., and Omicron BA2.12.1 is 48% and seems on track to replace BA.2.
In South Africa, Omicron BA.4 and BA.5 have become dominant, and the CDC and the European Centre for Disease Prevention upgraded both to variants of concern (VOCs). Very preliminary evidence suggests that these variants may have mutations that make them more transmissible, but they do not seem to make people sicker.
There have been a handful of cases of BA.4 and BA.5 in the U.S. (AZ, MO, CA), and these variants may become a factor in U.S. cases in the coming weeks/months. To put it in perspective, Omicron BA.4 and BA.5 currently represent less than 1% of cases in the U.S. A leading South African researcher, Tulio de Oliveira, has tweeted that in South Africa, breakthrough reinfections with Omicron BA.4 or BA.5 after Omicron BA1 are happening “easily.” It is unknown if the U.S. will follow the same pattern if these VOCs become dominant in North America.
The FDA approved the first direct-to-consumer at-home nasal swab that tests for COVID-19, influenza and respiratory syncytial virus (RSV), another common respiratory virus. The test will be available for ages two and older without a prescription.
On May 17, the FDA granted Emergency Use Authorization of a single Pfizer vaccine booster dose for children ages five to 11 years old. This can be given five months after receiving the two-dose primary series. The CDC’s Advisory Committee on Immunization Practices met May 19th and announced that they also approve this recommendation.
Fewer than a third of children ages five to 11 have had their initial vaccination series, so there remains a large opportunity to educate parents about the value of pediatric vaccination. We expect the FDA’s decision on COVID-19 vaccination for children six months to five years in the next month.
Implications for employers
Patricia is a physician and infectious disease specialist who consults with employers to improve the quality and cost-effectiveness of health care delivery. She has guest lectured at Harvard Medical School and currently develops pandemic responses and programs to address chronic conditions.
