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America Is About to Test How Long ‘Normal’ Can Hold in a future pandemic surge

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At this very moment, the United States, as a whole, remains in its legit pandemic lull. Coronavirus case counts and hospitalizations are lower than they’ve been since last summer. There’s now a nice, chonky gap between us and January’s Omicron peak.

And yet. Outbreaks have erupted across Asia. Massive swaths of Europe, including the United Kingdom—America’s best pandemic bellwether for much of 2021—are firmly in the grip of a more transmissible Omicron subvariant called BA.2 that’s been simmering stateside for months.

Already, scattered spots throughout the U.S. look a shade foreboding. Several states’ wastewater-surveillance sites are witnessing a rise in viral particles, which, in previous waves, has preceded increases in documented infections by several days. Many states’ case rates have now hit a plateau, and a handful are even beginning a slow march back up. The other COVID shoe seems poised to drop in the U.S. at some point, perhaps quite soon. When it does, it won’t be pretty.

“With policies, with supply, with vaccination rates, we are not prepared,” says Julia Raifman, a COVID-policy expert at Boston University.

After two years of chaos, Americans do have some factors working in our favor. COVID vaccines, when delivered in multiple doses, work well against all known Omicron subvariants. The recent Omicron infections that shredded the U.S., and the smidges of immunity they left behind, might slow BA.2’s roll as well. The weather is warming, pushing more people outside. Perhaps spring will indeed bring a surge. But most of the experts I’ve spoken with think that the U.S. is unlikely to see a BA.2 peak that mirrors the magnitude of Omicron-classic’s (BA.1’s) record-breaking winter crush.

Then again, better than Omicron’s January zenith isn’t a high bar to clear. Even in a best-ish-case scenario, in which the country’s average curve remains somewhat subdued, Sam Scarpino, the managing director of pathogen surveillance at the Rockefeller Foundation, told me, we’re likely due for a patchwork on more granular scales, with a mix of plateaus, ups, and downs at the state and county level. If that variability sounds like a relief, it shouldn’t: COVID can be a local crisis without being a national one, and can batter the vulnerable all the same.

However it manifests, the next American surge will be a stress test of the nation’s new COVID strategy, a plan that focuses on mitigating severe disease and death, and almost nothing else. Places that follow the CDC’s lead will let infections climb, and climb, and climb, until they’ve seeded a rash of hospitalizations, with more to follow. Only then will our new guidelines say that’s enough.

The Biden administration’s sights have clearly been set on minimizing disruptions to American life. The cost? By the time the government says that it’s time to act, any wave we experience will be well under way. Whatever happens next, we’re living the reality the CDC’s guidance bargained for. The country’s new COVID rules have asked us to sit tight, wait, and watch. We may soon see the country’s true tolerance for disease and death on full display.  ..

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