An ‘awful’ month of Covid-19 lies ahead, doctor says, but preventative measures will still be key

By Travis Caldwell, CNN

While the highly transmissible Omicron variant continues to drive up Covid-19 cases and hospitalizations — and the numbers are likely to get worse before they get better — health experts say it’s critical Americans continue safe practices to prevent infections.

“I don’t buy the idea that we are all going to get Omicron and, therefore, just give up trying. I think that’s wrong,” Dr. Robert Wachter, chairman of the Department of Medicine at the University of California, San Francisco, told CNN’s Erin Burnett on Wednesday.

It’s likely that “the next month is going to be awful,” he said. But this does not mean that everyone should assume they will catch the virus, he said, noting the pattern of Omicron infections in the UK and South Africa.

“In a month or six weeks or eight weeks — hard to know — if we follow the pattern that South Africa has followed, if we follow what London appears to be showing us, they are starting to come down in cases,” Wachter said.

An ensemble forecast from the US Centers for Disease Control and Prevention published Wednesday predicts that more than 84,000 people could die of Covid-19 over the next four weeks, and cautions “current forecasts may not fully account for the emergence and rapid spread of the Omicron variant or changes in reporting during the holidays.”

The forecast could mean an average of 3,526 Covid-19 deaths per day, up from a current average of 1,251 each day, based on data from Johns Hopkins University.

To date, Covid-19 has killed at least 832,148 people and infected about 57.8 million in the US, according to JHU’s database.

Health care facilities are scrambling to handle staff shortages as hospitalizations for Covid-19 are increasing for both adults and children.

In the Kansas City metro area, hospitals are postponing certain surgeries due to employees out sick with Covid-19, according to more than a dozen doctors at a news conference Wednesday.

“This is, hands down, the toughest surge the medical community has had to face since the pandemic began in 2020,” according to Dr. Steven Stites, chief medical officer at The University of Kansas Health System.

Kansas Gov. Laura Kelly signed a state of disaster emergency on Thursday to alleviate some of the healthcare staffing shortages and constraints caused by the surge.

Frontline workers across other industries, such as education, retail and food services, are also facing an increased risk of exposure, with employees infected with Covid-19 needing time to recuperate.

In Massachusetts, senior administrators of Boston Public Schools stepped into classrooms Wednesday to help fill in for hundreds of teachers who have called out.

“Some of our schools are experiencing more than a quarter of staff absent because of positive Covid tests or other issues,” Boston Mayor Michelle Wu said.

In Chicago, about 340,000 students will miss a second day of school Thursday due to a showdown between the administration and the teachers’ union over in-person learning.

The best way to keep workplaces safe is to encourage mask-wearing and vaccinations, said Arthur Caplan, director of medical ethics at NYU Grossman School of Medicine.

The safety of others is also critical and well-documented in our society, Caplan told CNN’s Anderson Cooper on Wednesday

“We have restricted second-hand smoking, if you will, in public spaces due to second-hand smoke,” he said. “You can lose your ability to drive if you engage in risky behavior. So, we don’t live in a society that just says, ‘freedom means I can do what I want’ or ‘freedom means I have choice without any accountability or responsibility.’ When you hurt others, our mothers, put others at risk, you have got to take some responsibility.”

Boosters approved for those as young as 12

Access to boosters has been expanded to more children, as the CDC updated its recommendations Wednesday for the Pfizer/BioNTech Covid-19 vaccine booster to include children as young as 12, at least five months after they finish the primary vaccine series.

The decision follows the US Food and Drug Administration’s earlier expansion of the emergency use authorization for the booster.

“It is critical that we protect our children and teens from COVID-19 infection and the complications of severe disease,” CDC director Dr. Rochelle Walensky said in a statement.

More than 72 million people are fully vaccinated and boosted against Covid-19, per CDC data. That’s less than half of the nearly 180 million people who are eligible to receive their booster shot and about a fifth of the total US population.

At least 67.5 million people ages 5 and up have not received their first dose of the vaccine, according to the latest CDC data.

No vaccine is currently authorized in the US for children under 5, but ongoing studies may produce data for analysis in the first half of 2022, NIAID director Dr. Anthony Fauci said Wednesday.

CDC will hold an independent briefing

The CDC will also hold a telebriefing on Friday to give updates on the pandemic. Walensky is scheduled to speak during that briefing.

It’s been months since the CDC has held a briefing like this. The agency usually participates in joint briefings with officials from the White House or the National Institutes of Health, such as Fauci. Its last independent Covid-19 briefing was July 27, 2021.

But the CDC has faced renewed criticism in recent weeks over confusion surrounding its guidelines on testing and isolation for people who test positive for Covid-19.

In late December it shortened the recommended times that people should isolate when they’ve tested positive for the virus from 10 days to five days if they don’t have symptoms — and if they wear a mask around others for at least five more days.

This week the agency updated that guidance after criticism from outside medical experts, and said that if people have access to a Covid-19 test and want to take it, the best approach is to use a rapid test toward the end of their five-day isolation period.

Expert: If you have symptoms, assume you have Covid

A new preprint study involving a small group of patients published Wednesday found it may take several days for people infected with the Omicron variant to test positive for Covid-19 with a rapid antigen test after also testing positive with a PCR test, raising concerns about the reliability of rapid tests to detect Omicron Covid-19 cases when the infections are still early.

Researchers found on the day of and the day immediately following a positive PCR result, rapid antigen tests were all negative, even though 28 of the 30 people in the study had enough virus in their body to transmit it to others.

On average, the time from a first positive PCR test to a first positive rapid antigen test was 3 days, the study found.

“The policy implication is that rapid antigen tests may not be as fit-for-purpose in routine workplace screening to prevent asymptomatic spread of Omicron, compared to prior variants, given the shorter time from exposure to infectiousness and lower infectious doses sufficient for transmission,” the authors wrote. The results are considered preliminary and have yet to be peer-reviewed.

Individuals who are experiencing Covid-19 symptoms should act as if they’re positive, epidemiologist Dr. Michael Mina said Thursday.

“The important thing is, when you feel symptoms, assume you’re positive at this point, especially with Omicron being so prevalent,” Mina said in an interview with eMed, where he is chief science officer. “Assume you’re positive, assume you’re infectious, and wait a day or two before taking that test, because it might be a day before the test turns positive. It might be two days.”

For individuals with access to rapid tests, the FDA stated that tests should be used as authorized after several health experts on social media suggested rapid tests may be more accurate if the throat is swabbed rather than nasal passages.

“The FDA has noted safety concerns regarding self-collection of throat swabs, as they are more complicated than nasal swabs — and if used incorrectly, can cause harm to the patient,” an FDA spokesperson said in a statement Wednesday. “The CDC recommends that throat swabs be collected by a trained healthcare provider.”

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CNN’s Katherine Dillinger, Michael Nedelman, Virginia Langmaid, Naomi Thomas, Deidre McPhillips, John Bonifield, Jamie Gumbrecht, Michelle Watson, Paradise Afshar and Sylvia Walker contributed to this report.