Public health asleep at the wheel during 2nd-highest COVID surge

We never would have imagined four years ago, at the start of the COVID pandemic that we’d be here in January 2024: in the middle of the second-highest COVID surge on record with 78% of states reporting “high” or “very high” levels of COVID, according to nationwide wastewater data. 

During the last week of December 2023, the U.S. experienced a 12.5% increase in COVID deaths and a more than 20% increase in hospital admissions for COVID.

Washington state, according to wastewater data collected through Dec. 30, 2023, has “high” levels of COVID spread. And Clark County had 157 hospital admissions for COVID the final week of 2023. In nearby Skamania County, the COVID hospital admission rate spiked 120% during the final days of 2023. 

Quoting the World Health Organization, the Associated Press also reported this week that at least 10,000 people died of COVID last month and that “hospital admissions during the month jumped 42% in nearly 50 countries — mostly in Europe and the Americas.”

And yet, the general public seems to have absolutely no idea how bad this COVID surge really is. There is no widespread masking going on, no return to online meetings to avoid gathering dozens of unmasked people inside a small room, no masking mandates inside hospitals or on public transportation and — judging from this editor’s own experiences inside local grocery stores and other crowded spaces, no staying home even for those who are clearly experiencing the classic coughing, congestion and runny nose symptoms that are hallmarks of the latest COVID variant known as JN.1. 

Of course, one huge difference between now and the start of the pandemic is the fact that a significant portion of our population is now vaccinated — sometimes five times — against COVID and so we are collectively experiencing less horrific acute phases of COVID. There are far fewer deaths and hospitalizations, but that doesn’t mean we’re totally safe from the SARS-CoV-2 virus that causes COVID. 

In fact, recent studies show that repeat COVID infections increase our chances of becoming seriously ill during the acute phase of the illness or of developing long-term complications known as “long COVID,” which can have devastating impacts on our vascular systems, brains, hearts, lungs and quality of life — making it hard to exercise, remain in the workforce or even get out of bed. 

As the chief of research and development service at the Veterans Affairs St. Louis Healthcare System recently told health journalists at KFF Health News: “”Even if in a prior infection you dodged the bullet of long COVID, it doesn’t mean you will dodge the bullet every single time.” 

With so much risk connected to repeat COVID infections — even for those who are fully vaccinated, but particularly for those who are more vulnerable, including pregnant women, older folks, people with diabetes (oh, and did you know COVID may actually be a trigger for type 1 diabetes?) and all those undergoing treatment for cancer — it is mind-boggling, or maybe mind-numbing, how silent our public health agencies are when it comes to warning people that a virus that remains one of the leading causes of death in the U.S. has been rapidly spreading over the past month, evading vaccine- and natural-induced immunity, and is now at its second-highest level since the start of the pandemic four years ago. 

Where are the public testing sites? The reduced cost antivirals like Paxlovid we were promised during the Biden administration’s odd “test to treat” campaign? Where are the mask mandates in health care centers we were told would happen when community spread was high? Where are the public health announcements promoting the facts surrounding this virus and telling us that, yes, SARS-CoV-2 is airborne and can linger in the air for, according to the Mayo Clinic “several minutes to hours;” or that high-quality, N95-type respiratory masks help reduce the spread of COVID; or that even asymptomatic people can spread this virus or that even vaccinated people can experience long COVID? 

It is beyond comprehension that our public health leaders have seemingly succumb to those who bullied their way through the first years of the pandemic — insisting COVID was “just a cold;” ranting that public health measures meant to protect everyone, including those most vulnerable to SARS-CoV-2, were not a way to protect our community but, instead, “overreach by a tyrannical government;” and demanding that the government lift mask mandates even in highly risky settings such as public buses, planes, hospitals and urgent care centers.

We hope this most recent COVID surge will pass without doing too much damage to our own loved ones or our community, but we know there will be another surge on its way unless our public health institutions do more than just promote vaccination and hand washing.  

When researchers from Princeton University discovered SARS-CoV-2 “has proven hard to control in large part because transmission is often decoupled from symptoms” (in other words, because asymptomatic people can still spread the virus), they recommended reducing asymptomatic spread through “risk awareness campaigns, asymptomatic testing programs, mask-wearing indoors and in crowded environments, and through improvements in ventilation” and working on getting better treatments for symptomatic individuals, “particularly amongst older individuals at highest risk for severe outcomes.”

The research has consistently shown the far-reaching benefits of preventing the spread of COVID. Now it is up to our public health officials and government leaders to stop the spread by spreading the word that COVID is still here, still dangerous and still something we should all be taking steps to avoid catching.