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With many areas of the country past the peak of omicron, what comes next?


As has been the case at different points over the past two years, how you experience the pandemic depends on where you live. New cases of the coronavirus are declining sharply in parts of the Northeast and the Midwest, yet many places in the South and West continue to see record numbers of new infections, and more than 150,000 people are hospitalized nationwide. NPR's Allison Aubrey is with us, as she is many Mondays. Hi, Allison.

ALLISON AUBREY, BYLINE: Good morning, Rachel.

MARTIN: So there really are areas of the country that appear to be past the peak, right? Where exactly?

AUBREY: That's right. I mean, looking at the map, the declines are most notable in places that were among the first to see a surge in omicron cases. Washington, D.C., New York have about half as many cases compared to their peaks. Cases are dropping in parts of the Midwest, including Ohio. Florida and Texas have started to see a decline in new infections. But a lot of areas are still in the thick of it, Rachel - Utah, Oregon, as well as Alabama and Tennessee.

MARTIN: And what about the hospitalization rate?

AUBREY: You know, nationwide, new hospital admissions are down slightly - about 3% over the last week. But remember; they've been at pandemic record highs. I spoke to emergency medicine doctor Jeff Pothof at UW Health in Madison, Wis., where they are at full capacity.

JEFF POTHOF: Right now it's as bad as it's ever been. We're still seeing a ton of COVID patients. And we're still in the situation where every day we're postponing elective surgical cases. We're also postponing what we call Tier 3 and Tier 4 surgical cases, which are cases that, you know, you can postpone for a week or two but not really much longer. We're doing all that, and we still can't make everyone fit.

AUBREY: He says smaller hospitals in the region transfer patients into his hospital, but his hospital hasn't been able to take them all.

MARTIN: Meanwhile, Allison, the latest CDC data has deaths rising. Is that right?

AUBREY: That's right. The U.S. is averaging just under 2,000 deaths a day. That's up from about 1,200 in early January. So it's an extraordinary loss of life. And we keep hearing that omicron leads to milder illness, and while that's true overall, keep in mind, there have been millions of infections amid this surge. Even if less than 1% of infected people end up in the hospital and some fraction of those patients die, the numbers just add up. But we do seem to be near a turning point. Some models suggest the worst is close to over, predicting deaths will begin to decline soon in the coming weeks and that cases will continue to come down. Here's Ali Mokdad of the Institute for Health Metrics and Evaluation at the University of Washington.

ALI MOKDAD: What we are seeing right now in many states - it's coming down as fast as it went up. And come March, April, we should be in a very good position. Our infections would be very low. I am willing to bet right now - I'm not into betting as a scientist, but spring breaks will happen, and we should feel for a while that we are in a very good position.

AUBREY: So you can hear some optimism there, and I think a lot of us can imagine a nice spring getaway.

MARTIN: Mmm hmm. I definitely could, though I'm struck by how he phrased the end of his comment there, right? He said, we should feel we're in a good position for a while.

AUBREY: Right.

MARTIN: I mean, is this just the nature of the beast, that there are going to be moments when we feel good and secure and then another variant's going to pop up?

AUBREY: You know, because the coronavirus has thrown so many curveballs, none of the experts I've spoken to regularly during this pandemic is willing to say emphatically, you know, this is over or near over. Scientists know the virus will continue to mutate. But there is a consensus that given the extraordinarily high number of people being infected during this surge and the fact that so many of us have protection from the vaccines and boosters, we are in a much better situation. I talked to Michael Osterholm of the University of Minnesota. He says we are likely headed into better days soon.

MICHAEL OSTERHOLM: For the everyday person, it is very hopeful that we can see that new normal where people can not feel at threat being in a public place, but I worry that we could see another variant that could put us back into the same kind of position that we saw with omicron.

AUBREY: You know, the good news is vaccine-makers continue to work on vaccines that can target variants or offer a kind of broader protection, and there are a lot more therapies to treat COVID, including the new antiviral medications.

MARTIN: Right. So then, theoretically, any future waves of infection or surges are going to be hopefully more manageable?

AUBREY: You know, that's the idea. And all the experts I talked to say the key to managing future outbreaks is for the health care system and public health officials to kind of build on what they've learned over the last two years when it comes to testing, to surveillance, to genomic sequencing, to stay on top of which variants are out there. And Michael Osterholm says if we plan for the possibility of future outbreaks, there could be systems in place to make sure that medicines, such as the new antiviral pills which are in short supply now, would be readily available.

OSTERHOLM: We need people to be able to get tested quickly, and we need to be able to provide drugs to them quickly that could surely avert any kind of serious illness, hospitalizations or deaths. So that work is going to have to go on.

AUBREY: He says it may not be noticeable to most of us. Our lives will hopefully return to something that resembles normal. But there should be planning happening behind the scenes because COVID is not going away.

MARTIN: So, Allison, I do have to ask - you know, I have a friend. I talked to her the other day. She's got two little kids, both under the age of 5. And she describes life as just freezing, right? Like, it's like the beginning of the pandemic for her because her little ones can't get vaccines. And in conversations around this, we do sort of forget that there's this huge population...

AUBREY: Right.

MARTIN: ...Having these young kids who are still vulnerable.

AUBREY: That's right.

MARTIN: Any update on when that could change?

AUBREY: Yeah. Well, both Pfizer and Moderna have ongoing clinical trials for kids under 5. Moderna has said it will report data in children 2 to 5 years of age in March. Now, Pfizer announced a while back that it had found kids 2 to 5 were not getting a strong enough immune response with two doses in their clinical trial, so the plan now is to test a third dose. I spoke to pediatrician Yvonne Maldonado at Stanford. She is one of the investigators on the Pfizer study.

YVONNE MALDONADO: We're hoping that in the next few weeks, we can start to give that third dose to the children who were already enrolled in this study. And then what we could do is just measure the blood antibody levels in those kids some weeks after they get the dose and then see if that third dose then gives the children antibody titers that are equivalent to the adult levels.

AUBREY: She says this third-dose study could be finished within the next couple of months, and then, of course, it would be up to the FDA to evaluate this data.

MARTIN: All right. NPR health correspondent Allison Aubrey. Allison, thank you as always for your reporting, perspective and context. We appreciate you.

AUBREY: Thank you, Rachel. Transcript provided by NPR, Copyright NPR.

Rachel Martin is a host of Morning Edition, as well as NPR's morning news podcast Up First.
Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.