‘I'd lean toward being vigilant but not freaking out’ about possible COVID surge

When the leader of the Medical University of South Carolina’s COVID-19 tracking team takes his first extended vacation since the start of the pandemic, you know case numbers are low. But now, as he recovers from jetlag following a trip to South Africa, Michael Sweat, Ph.D., has his guard up again—– gently. “I’d lean toward being vigilant but not freaking out.”

That’s because there are signs another surge may lie ahead. “What’s going to happen? That’s the big question. I think the seasonality pattern has become evident. It’s been two years, and it’s been very consistent that about every six months we have a surge — one in the winter and one in the summer,” Sweat said.

That pattern is one sign. Another: what’s happening in Europe as the Omicron sub-variant BA.2 sweeps through. “It’s a little worrying. They’re having another surge,” Sweat said.

“In the U.K., they’re at 132 cases per day per 100,000 people and going up. Germany, 264 per 100,000 and going up. All of them are going up — France at 134, Austria at 499, Switzerland at 313. So those are really big numbers. Those are starting to get to the numbers we just saw here. Those are really big outbreaks happening.”

Sweat said BA.2 may be 80% more transmissible than the original Omicron. But is it anything to worry about? That’s unclear.

 

“There have been some odd findings. In Norway and the Netherlands, they had a big wave of BA.2, and it didn't seem to correlate much with hospitalization.It looked like people got it and had mild cases,” he said.

“However, in the UK, they're not seeing that. They're also having a BA.2 outbreak, and they've seen a 35% increase in hospitalizations in the past couple of weeks. It's not clear exactly why that would be. It probably has something to do with vaccination in the elderly.”

Sweat said the U.S. usually mirrors what happens in the U.K. “Their events tend to really predict ours more so than a lot of other European locations. So we may see a surge.”

But right now, the U.S. is in good shape. In the Charleston area, cases have dropped to five a day per every 100,000 people. “They’re as low as they’re probably ever going to go. These are really low numbers. It’s that way across the country, with a few exceptions.”

And Sweat said the fact that BA.2 is coming so soon after the original Omicron variant is, in a way, good news. “People who have been infected with BA.1, the older version of Omicron, have excellent immunity against this.”

The nonprofit Institute for Health Metrics and Evaluation recently said that about 80% of the U.S. population has immunity to BA.2 either from an Omicron infection or vaccination, Sweat said. “So it’s a much smaller group of people who are really at risk as we go forward.”

That doesn’t mean people won’t get sick — just that most won’t end up in the hospital. Sweat said booster shots are an important way to prime your cellular immunity. But in South Carolina, too few people are getting them.

“Only 22% of the state population has had a booster. If I were the king of the world, I would put my eggs in that basket of strongly working on getting particularly people 65 and older up to the point of boosted. I think as these waves come forward, unboosted people would be the ones I’d be a little more cautious about.”

While he’s not planning another vacation any time soon, Sweat said most people who are considering traveling this summer should be OK if they mask up in N-95s on flights and take basic COVID precautions — unless a new, more dangerous mutation arrives.

“We have to keep our eye out for more variants. I think they’re probably going to continue. And the more and more transmission you get, the more likely you are to get variants.”