July 12, 2022 – The BA.5 Omicron subvariant is dominating now and accounts for 65% – or about two-thirds – of the virus causing COVID-19 in the United States, federal officials said on Tuesday. Although no evidence yet points to BA.5 causing more severe disease, hospitalization numbers are up in the past few months and case numbers are on the rise with this highly transmissible strain of the virus.
But the White House and public health officials say they are ready.
"The fact that BA.5 is now the dominant variant subvariant in the United States is not a surprise," Ashish Jha, MD, the White House COVID-19 response coordinator, said at a news briefing Tuesday by the White House COVID-19 Response Team and health officials. "We are prepared. We have been planning for this moment."
If people follow CDC recommendations for masking in high- and medium-risk places, stay up to date on vaccinations, seek antiviral treatment as soon as they test positive, and follow other familiar public health measures, "we can get through whatever Mother Nature throws at us in the next 4, 6, or 8 weeks ahead, and also whatever Mother Nature throws at us this fall and winter," Jha said.
The White House also released a fact sheet outlining its plan with more detail on management of BA.5.
It's Time to Boost Boosting
One major message out of the briefing is that not enough older Americans have received their fourth COVID-19 vaccine dose, also known as a second booster.
"For people who are 50 years of age or older, my message is simple," Jha said. “If you have not gotten a vaccine shot in the year 2022 … go, get one now. It could save your life."
"Many Americans are under-vaccinated," agreed CDC Director Rochelle Walensky, MD.
For example, only 28% of those 50 and older have received a second booster so far, she said, and the figure is 34% for Americans 65 and older.
"It's essential that these Americans get their second booster shot right away."
Walensky also shared data from April 2022 showing that people 50 and older vaccinated with a primary series and one booster dose have four times the risk of dying, compared to people immunized with a primary series and two or more booster doses.
"That extra booster dramatically lowers your risk of getting into the hospital, going to the ICU, and dying," Jha said. "There are very few things we do in medicine that have the kind of benefit that we see from that extra shot."
Boosters remain important, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases. Immunity wanes whether it's immunity after infection or immunity after vaccination, "even though the immediate protection following infection or vaccine is generally good protection."
Asked about expanding second booster shots to all Americans, the experts said that’s being considered, but there is no firm timeline on when the FDA might authorize it.
Walensky also addressed the question of whether to boost now or wait for the variant-specific vaccines expected this fall.
"The reason to get a booster now is to prevent infection now. There's a lot of infections now and an increasing number of hospitalizations,” she said.
More People in the Hospital
The 7-day average of hospital admissions is 5,135 per day, or up 0.6%, Walensky said.
"And while this represents only a slight increase week over week, it does represent a doubling of hospital admissions since early May."
Fauci pointed out that BA.5 is not linked with more severe illness or hospitalization rates, compared to earlier Omicron subvariants. But because the overall number of cases is growing with BA.5, more people are in the hospital overall, he explained.
The number of people hospitalized with confirmed COVID-19 as of July 9 was 16,631, CDC data shows. On the same day, 3,380 people nationwide were newly admitted. (For comparison, the most people hospitalized in a day this year for COVID-19, 22,920, was on January 12.)
What’s more, about 300 to 350 Americans continue to die every day from COVID-19.
"That is unacceptable. It's too high," Jha said. "We will continue to use the infrastructure we have built and the tools we have to lower suffering and death as we manage BA 5."
Seek Treatment When Positive
Paxlovid continues to be able to treat COVID-19 early in the illness, Jha said.
"This is an oral antiviral that reduces the risk of hospitalizations and death by 90%,” he said. "If you test positive in the days and weeks ahead, please consult your health care provider about your eligibility for treatment, or please visit a test-and-treat location where you can get tested and treated all in one place.”
Jha recommended testing for COVID-19 before attending a large indoor gathering or visiting with a high-risk, immunocompromised person.
"You don't want to be the person who brings COVID to your grandparents or COVID to a wedding."
Fauci noted that the monoclonal antibody bebtelovimab, authorized for emergency use by the FDA in February, appears effective for treating mild to moderate COVID-19.
No Cause for Undue Alarm
"The bottom line is don't panic on BA.5," Fauci said. "We should not let it disrupt our lives, but we cannot deny that it is a reality that we need to deal with."
Higher numbers of infections related to COVID-19 can also mean more people at risk for long COVID. Jha said the Biden administration takes long COVID "very seriously" and is working on ways to prevent and care for people who have persistent symptoms.
Long COVID is likely more than one clinical condition, and more work is needed to understand and tease that apart, he said.
Fauci said it's critical to continue developing the next generation of vaccines and therapeutics for COVID-19.
"The vaccines we have right now are terrific; they have saved millions of lives. But given the virus and how quickly it's evolving, it continues to pose a challenge and we have to constantly be updating these vaccines to meet what's happening."
"We are closely monitoring BA.5," Jha continued. "We're encouraged that serious illness, hospitalizations, and deaths have remained relatively low, based on the level of infections."
"That's not by coincidence. It's not random," he said. "It's in large part due to our successful vaccination program, our efforts to get people boosted, and our incredibly focused effort on making sure that treatments and testing are widely available."