(WASHINGTON) — As the “extraordinarily contagious” omicron variant surges across the United States, Dr. Anthony Fauci warned that COVID-19 cases will likely continue to climb.
“Every day it goes up and up. The last weekly average was about 150,000 and it likely will go much higher,” Fauci told ABC This Week co-anchor Jonathan Karl.
While Fauci said studies show omicron is less severe in terms of hospitalizations, he stressed, “we don’t want to get complacent” because “when you have such a high volume of new infections, it might override a real diminution in severity.”
“If you have many, many, many more people with a less level of severity, that might kind of neutralize the positive effect of having less severity when you have so many more people,” he explained. “And we’re particularly worried about those who are in that unvaccinated class … those are the most vulnerable ones when you have a virus that is extraordinarily effective in getting to people.”
On Tuesday, President Joe Biden announced a plan to distribute 500 million free at-home rapid tests to Americans beginning in January. The tests will be delivered by mail to Americans who request them. A website to request the tests will launch in January, according to the administration.
But the omicron surge created a massive rush for tests as Americans prepared to see relatives for the holidays, and they instead faced empty pharmacy shelves and massive test lines.
On Wednesday, ABC News’ World News Tonight anchor David Muir, asked Biden if that was a failure.
“I don’t think it’s a failure,” Biden replied in the exclusive interview. “I think it’s — you could argue that we should have known a year ago, six months ago, two months ago, a month ago.”
“I wish I had thought about ordering” 500 million at-home tests “two months ago,” he told Muir.
Biden added “nothing’s been good enough” when it comes to the availability of at-home tests.
When Karl asked about the comments, Fauci admitted to This Week he is frustrated with at-home test availability and said “we’ve obviously got to do better.”
“The beginning of the year, there were essentially no rapid point of care home tests available. Now, there are over nine of them and more coming,” Fauci said. “The production of them has been rapidly upscaled, and yet because of the demand that we have, which in some respects, Jon, is good, that we have a high demand because we should be using testing much more extensively than we have.”
“But the situation where you have such a high demand, a conflation of events, omicron stirring people to get appropriately concerned and wanting to get tested as well as the fact of the run on tests during the holiday season — we’ve obviously got to do better,” he continued. “I think things will improve greatly as we get into January. But that doesn’t help us today and tomorrow.”
Karl also asked about the FDA last week granting emergency authorization to both Pfizer and Merck’s antiviral pills to treat COVID-19.
“Is this really the breakthrough that you’ve been waiting for?” Karl questioned.
“That’s part of the comprehensive approach to this outbreak. Vaccines and boosters, masks and now very importantly, a highly effective therapy is really going to make a major, major difference,” Fauci replied. “We’ve just got to make sure that there’s the production of enough of that product that we can get it widely used for those who need it as quickly as possible.”
“I assume that will be a top priority going forward, right? I mean, possibly including Defense [Production] Act … and the like?” Karl pressed.
“Absolutely, Jon, absolutely,” Fauci said. “We’ve got to get that product into the mouths of those who need it.”
Only 61.7% of the U.S. population is fully vaccinated against COVID-19, according to CDC data. Many Americans remain against COVID-19 vaccines over one year into their use.
The omicron surge doesn’t appear to sway unvaccinated Americans. According to a Kaiser Family Foundation poll this week, just 12% percent of unvaccinated Americans polled said the variant makes them more likely to get a vaccine.
Former President Donald Trump showed his support for vaccinations, who has spread conspiracy theories about vaccines and didn’t get vaccinated publicly, showed his support for COVID-19 vaccines in a Wednesday interview with The Daily Wire’s Candace Owens, saying, “The results of the vaccine are very good. … People aren’t dying when they take the vaccine.”
Karl asked Fauci whether Trump’s supporters might listen to that message.
“I think that his continuing to say that people should get vaccinated and articulating that to them, in my mind is a good thing. I hope he keeps it up,” Fauci responded.
Fauci also said he was surprised when Trump was booed by some of his supporters in Texas last weekend after the former president revealed he’d gotten his booster shot.
“I was stunned by that,” Fauci said. “I mean, given the fact of how popular he is with that group, that they would boo him, which tells me how recalcitrant they are about being told what they should do.”
(NEW YORK) — For weeks now, as public health experts have warned about the COVID-19 omicron variant and its incredible ability to infect people, they’ve followed the bad news with good: booster shots available to every adult in the U.S. drive protection against omicron back up.
One of a few glimmers of scientific optimism in the omicron era is that the variant can be held at bay or kept to a very mild infection when people get a boost. And yet, just four in 10 eligible Americans have gotten a booster shot.
Among the most vulnerable Americans — those over 65 years old — it’s slightly higher, but still low: Just over 60% have gotten their booster shots, according to White House data presented last week.
Despite the demand for other pandemic tools, like at-home rapid tests or new treatment pills from Pfizer and Merck, many experts point to booster shots as the best method to actually prevent sickness — and they’ve been there, widely available, for weeks.
“The booster is exponential. It’s not just a little bit different. It’s a lot different,” said Janet Hamilton, an epidemiologist and the executive director at Council of State and Territorial Epidemiologists, a group that works closely with the Centers for Disease Control and Prevention.
“I don’t know that we have really communicated that effectively enough for people to say, ‘I really need to get this, this is a big deal,'” she said.
Why are the rates so low?
Public health directives can take a long time to circulate and have historically reached marginalized populations even slower.
But when it comes to boosters, that message was particularly muddled.
“The recommendation for the booster has come out in bits and pieces, and the most recent recommendation for everyone to get a booster is pretty new still,” Hamilton said.
The confusion began after President Joe Biden and his administration called for boosters for everyone eight months after their second dose. But experts at the CDC and Food and Drug Administration didn’t jump onboard, instead spending the summer months debating if there was a need for boosters for the whole population or only the most vulnerable.
By the time boosters were recommended in November — a recommendation that applied to all adults who’d been fully vaccinated for six months — the data was strongly backed by most in public health.
But, as Hamilton noted, “it takes time for people to hear the information.”
Unfortunately, the country didn’t have the luxury of time. It took just a few weeks for omicron to gather steam in the U.S. By Dec. 18, it was nearly 75% of all cases in the U.S., and nearing 90% along the East Coast and Midwest, the CDC found.
And because the variant evades vaccine immunity — whittling down protection from the first shot to somewhere between 30-40%, according to a study out of the U.K. — the booster shot, which brings protection up to nearly 70-80%, became an urgent public health missive.
Among nursing home residents
In nursing home patients, the CDC released data last week that showed the highest COVID cases were among the unvaccinated, but cases were also increasing among fully vaccinated patients without a booster.
Meanwhile, fully vaccinated and boosted nursing home patients had a 10 times lower rate of getting COVID, the CDC found.
“We’re sitting on an enormous vulnerability right now,” said Dr. Ali Khan, a primary care physician and executive medical director at Oak Street Health, a practice in Chicago.
MORE: Fauci says omicron can evade vaccine protection, but boosters help
Khan, who treats patients at nursing homes, said he thinks omicron has shed new light on booster urgency — but only in certain areas.
“I think it’s leading to increases in booster enthusiasm around relatively privileged populations,” he said.
“But we have a lot of work to do in people receiving those messages like nursing home residents, like minority communities that may have had more complex reactions to vaccines in the first place, to really say, ‘Hey, this is super crucial’,” he said.
Disparities in messaging
Dr. Jay Bhatt, an internist also practicing in Chicago, said among his patients on the city’s Southside, largely low-income people of color, the reasons about half have rejected a booster shot is because of “changing messages.”
Patients say they “lost trust in government,” and the different timelines on when to get a booster led to feelings that it was optional.
“They feel like they can wait longer before they get it,” Bhatt said.
But the doctors noted that the same investments the country made in the initial vaccine rollout can be made on boosters, with positive results.
“I’d say most of my patients, if they’ve already been vaccinated and we can reach them, they’re often very willing to do what’s right to protect themselves and get boosted,” said Dr. Atul Nakhasi, a physician and policy advisor with the Los Angeles County Department of Health Services.
Only a handful of vaccinated patients are hesitant to get a booster, Nakhasi said, and through discussions, he’s able to walk through their concerns — particularly if they’re logistical, like taking off work.
If that effort is not made, Nakhasi warned that disparities that have already manifested will only continue to grow, erasing much of the progress that has been made to close the racial gaps on vaccine uptake.
Outreach is needed
In Los Angeles County, Black and Hispanic people account for 60% of the population, but only 30% of people who have gotten a booster — a much smaller proportion.
“Disparities are again appearing within the data on who is getting the boosters,” Nakhasi said.
And the omicron variant has made it clear that the outreach, especially among communities that already have a shortage of health care, will need to be a long-lasting effort, not a one-and-done.
“I think that goes to the core. We want that closure but unfortunately COVID is not giving it to us,” he said. “So we need to make sure we build long lasting bonds to our communities, because it’s become evident that there’s a need for more than just the initial series.”
Khan, the physician in Chicago, also said outreach has been effective. While more patients have reached out to doctors asking for a booster in light of surging omicron cases, far and away it’s the doctors who are initiating the conversation.
“If we’re prompting them, they’re saying yeah I’ll take it. But only now is that message starting to turn,” Khan said.
(NEW YORK) — COVID-19 has been a major challenge for schools.
From shutting down in March 2020 to reopening and trying to stay open, the task has been varied and in some cases monumental.
This school year — the third since the pandemic began — has presented its own promise and challenges, from vaccines being available to millions of students, to new “test-to-stay” protocols and more transmissible variants. Still, many schools were able to stay open safely with multiple protections in place.
For Elizabeth Stuart, a professor in mental health and health policy and management at the Johns Hopkins Bloomberg School of Public Health, a multi-pronged mitigation strategy has been key to keeping schools safe.
“I think it has been heartening this fall that, in general, schools have been open,” she told ABC News. “Those that had good sets of protections in place, including masks, teacher vaccinations, some sort of symptoms screening, good ventilation, have been able to open successfully with sometimes without very many disruptions.”
But as the omicron variant COVID-19 surges nationwide, schools are reflecting the high rates of community transmission — forcing officials to reassess their protocols and double down on efforts to keep classrooms open in the new year.
“Community transmission rates are just so high right now, that then the school starts to feel it as well,” she said. “That doesn’t mean the schools are contributing to the spread. But when there’s so much virus in the community, of course, the schools are going to be starting to feel that as well.”
Exactly how much COVID-19 transmission there has been in schools is unclear, but studies based on contact tracing suggest that the community transmission plays a larger role in case levels among students, especially where safety protocols are followed.
There are some areas of concern going forward, including winter sports and the unprecedented surge from the omicron variant, but experts are hopeful that the many tools officials have at their disposal can help mitigate the impact of the virus and continue in-person learning.
Recent spikes in cases
Public data on school COVID-19 cases varies, and there is no national data for this school year. However, several Northeast states with comprehensive dashboards are showing sharp increases in recent weeks, as the region leads the nation in new coronavirus cases per capita.
In New Jersey, for instance, which tracks COVID-19 data from over 60% of K-12 public schools, case rates among students and staff started spiking in early November, reaching their highest levels so far this school year. According to the latest data, more than 44,500 student cases have been reported so far this school year, including over 7,700 the week of Dec. 19 alone.
Connecticut has seen a similar growth; for the week ending Dec. 22, the state reported over 3,000 student cases, compared to under 500 the week ending Nov. 3. About two-thirds of the new cases were in students who were not fully vaccinated, the data shows.
Though not as widespread as last school year, closures have also risen in recent weeks. More than 1,000 schools or districts are virtual or closed this week due to rising COVID-19 cases in students and staff and logistical challenges, according to Burbio, a company that monitors COVID-19 policies in over 80,000 K-12 schools. That number is lower than widespread closures in November during the delta surge, though higher than what was tracked in late August, when that surge began. Recent closures are largely concentrated in the Northeast and Upper Midwest, according to its tracker.
Omicron, which has now been detected in all 50 states and has quickly become the dominant variant of new cases here, brings another level of concern. Growing research indicates it spreads more easily than any other variant identified during the pandemic, though it’s too soon to tell if it causes more mild or severe illness.
“[There’s] high level of concern from schools across the country right now,” Dr. Sara Bode, a member of the American Academy of Pediatrics Council on School Health and an author of the AAP’s interim guidance on schools amid the pandemic, told ABC News. “The concern is, as all these students are now back home with their families and in their communities with these high rates of COVID, what’s that gonna mean for the return?”
School vs. community transmission
Outbreaks can and do occur in schools, though multiple studies have shown that transmission in school settings is typically lower than or the same as that of the community when several mitigation measures are in place, such as mask-wearing, testing, ventilation and physical distancing, according to the Centers for Disease Control and Prevention.
“We know that school is not necessarily the driver of COVID transmission, it’s a reflection of the community rates of COVID,” Bode said. “School is probably one of the safest places kids can be.”
But, she continued, “at some point, do we get to such a high rate that it just makes it really challenging to be able to have in-person learning?”
That’s the question some schools are facing now.
New York City, home to the country’s largest public school system, has seen a rapid increase in school cases in recent days, forcing more than 400 out of approximately 48,000 classrooms districtwide to close, according to the latest city data. At least 11 of some 1,600 schools were also closed as of Thursday night; since the school year started, 17 schools total have temporarily closed.
As the number of new COVID-19 cases reported citywide has reached record levels in recent days, city leaders have said they are intent on keeping classrooms open, and that measures including masking, surveillance testing and mandated staff vaccinations have kept COVID-19 rates low.
The New York City school seven-day average COVID-19 testing positivity rate is also just over 2%, according to city data. The school rate has been “higher than what we’ve seen in previous weeks, but it remains relatively low,” Dr. Dave Chokshi, commissioner of the city’s health department, said during a press briefing earlier this week. Citywide, the seven-day average positivity rate is over 11%.
New York City public schools are supposed to randomly test 10% of their unvaccinated student population weekly, per city Department of Education protocols. Some city officials and the teacher’s union have charged that protocol isn’t widespread enough to provide a clear picture of COVID-19 transmission — a notion Mayor Bill de Blasio has pushed back against.
“We’re testing in every school, every week, the results are extraordinarily consistent and show very low levels of COVID,” he told reporters earlier this week. “You have all those health and safety measures in place, you have every adult vaccinated. This is one of the safest places in the city by definition.”
Los Angeles County, which has widespread school testing, has similarly found low test positivity rates in students and staff. So far this school year, it has remained below 1%, data from the county’s health department shows.
Spotlight on sports
One area that is “particularly problematic” right now in schools is sports, said Bode. “These are winter sports — they’re indoor, lots of contact.” Mask usage may also vary based on local guidelines.
As the medical consultant for the Columbus, Ohio, school district, Bode has seen high school teams needing to postpone or cancel games this season, much like professional sports, due to positive cases. On some teams, as many as one-third of the team has tested positive, she said.
“That is going to be the other consideration in these winter months — how many cases is too many?” she said. “When do we decide just to take a break from athletics for 10 days for a particular team, if it seems like there’s an outbreak?”
“I think those are other considerations schools are going to be grappling with when they return,” she continued.
Some districts are already doing just that. Springfield Public Schools in Springfield, Massachusetts, this week postponed all winter sports amid a rise in COVID-19 cases in the school and community and the new, highly transmissible omicron variant. School and health department officials plan to discuss restarting the season after the holiday break.
Connecticut this week halted guidance that would have allowed fully vaccinated students to compete without wearing masks, following policies already in place in neighboring Massachusetts and Rhode Island, citing the “the rapid rise in COVID-19 community case rates and the emergence of this more contagious variant.”
Post-winter break
Schools are heading into winter break as pediatric cases continue to surge nationwide.
Since the first week of September, there have been nearly 2.3 million child cases — nearly a third of the total pediatric cases reported since the onset of the pandemic — including approximately 170,000 in the last week alone, according to a new report from the AAP and the Children’s Hospital Association released on Monday. Though children tend to have mild infections, there can be acute cases; over the last month, pediatric COVID-19-related hospital admissions also have increased by 33%, according to federal data. Children could also transmit the disease to more vulnerable people.
Public health officials have pointed to a variety of factors that are fueling the latest COVID-19 surge, including more indoor gatherings during colder weather, relaxed protocols, the Thanksgiving holiday, unvaccinated populations and waning immunity against the backdrop of two highly transmissible variants — delta and omicron.
To limit COVID-19 transmission once students return to the classroom this new year, some leaders are boosting testing. On Wednesday, California Gov. Gavin Newsom announced that the state will be distributing 6 million free rapid tests to school children — about one or two tests per child — “so that they can get those results back quickly and make sure when they go back in person, they’re doing so safely knowing that they have not contracted the disease over the holidays,” he said.
Similarly, in Washington, D.C., the district health department will be distributing 100,000 rapid tests to schools to test children returning from the winter break, city officials announced this week. D.C. public schools will cancel classes for two days to allow for families to pick up the tests, with instruction resuming on Jan. 5.
Public health experts and school leaders are also stressing vaccination amid the latest surge to help limit transmission among children, protect against severe illness and limit disruptions due to exposure. Those ages 5 and up are eligible to get the COVID-19 vaccine, though less than a third of the pediatric population — those under 18 — is fully vaccinated, according to federal data.
D.C. this week joined a small but growing list of cities and school districts to require COVID-19 vaccination in schools for students. Students eligible for a COVID-19 vaccine that’s been fully approved by the Food and Drug Administration will have to be immunized beginning March 1, following regulations from the D.C. Council, with enforcement beginning in the 2022-2023 school year.
“This adds to the safety of our schools,” D.C. Mayor Muriel Bowser said at a press briefing Wednesday. “We urge parents right now to make a plan to have their children vaccinated, even before the deadline, because the benefit is you get the extra months and weeks of protection.”
Bode is optimistic that there we won’t see “mass amounts” of school districts going virtual in the new year, though noted that case counts and other issues like staffing shortages may lead to targeted school closures as needed.
“‘I’m hoping that we’ve learned some good lessons over the time of the pandemic to understand that we can do this, we just have to really double down with our mitigation strategies and be vigilant with the data, have frequent testing, have vaccination and have a plan that can be flexible in these smaller situations,” she said. “I think that’s the most effective.”
Stuart is also confident due to the number of mitigation measures, including vaccination and rapid testing, schools now have at their disposal.
“It feels like a scary time,” she said, “But again, we have to remember that we have a lot more tools in our toolbox, and that schools and school districts can use those tools in smart ways to help schools be open safely.”
ABC News’ Arielle Mitropoulos contributed to this report.
MediaNews Group/Orange County Register/Getty Images
(NEW YORK) — Gretchen Lee, a third grader in Washington, D.C., was wrapping up her last week in school ahead of Christmas break when the unexpected happen.
A fully vaccinated 8-year-old, Gretchen tested positive at school for the virus that causes COVID-19 — likely the omicron variant that has whipped around the globe with lightning speed.
Within a matter of hours, a long-planned family trip to Seattle to visit a new baby cousin suddenly evaporated. Her parents’ tickets to the new Spider-Man movie went unused. And Gretchen, whose symptoms are mild, is now mostly isolating until her parents can figure out next steps.
“I didn’t think that they would have to separate me from my sister,” Gretchen said when asked about the worst part of getting COVID just days before Christmas.
It’s the Grinch’s dirtiest trick yet. If 2020 was the year we all stayed home, 2021 was supposed to be the year of joyous family reunions and travel splurges.
Instead, the nation has logged more than 1.1 million new coronavirus cases in the last week alone. And many of the cases are children, with 170,000 kids testing positive last week.
The Centers for Disease Control and Prevention says any person infected with the virus — vaccinated or not — should isolate for 10 days. That means staying alone in a bedroom and, if possible, not sharing a bathroom.
It’s a rule that’s never been practical for families living in small spaces or with very young children.
It’s also one that, during Christmas, seems a particularly cruel twist of fate for conscientious parents and their Santa-loving kids.
“We have done everything that we were supposed to do,” said Gretchen’s mom, Gloria Lee, who, like her husband, is both vaccinated and boosted.
Dr. Mark Kline, an American pediatrician and infectious diseases specialist working as physician-in-chief and chief medical officer at Children’s Hospital New Orleans, said there’s no one good answer for how to handle a COVID case in the family.
In lieu of strict isolation, a family could opt for masks in the house, assuming everyone else is fully vaccinated and low medical risk, he said. Upgrading to surgical masks instead of cloth masks is a good idea too. And moving the celebration outdoors or cracking the windows can make it less likely the virus will spread, Kline said.
“These are difficult questions to answer. There’s the ideal, and then there is the pragmatic approach. And I think we have to be pragmatists on this,” said Kline.
Some doctors and disease experts are questioning whether the 10-day isolation rule still makes sense if people are vaccinated. That’s because while a vaccinated person without symptoms can still spread the virus, they probably aren’t contagious for as long as an unvaccinated person.
Dr. Amesh Adalja, a senior scholar at Johns Hopkins’ Center for Health Security, estimates a vaccinated person’s infectious period is about 40% or 50% shorter than the unvaccinated. So, instead of 10 days isolation, they might only need five or six, he said.
“When people get a breakthrough infection, the period of time that they are contagious is truncated, because the immune system jumps into effect very quickly and slams down the viral load,” Adalja said.
One tactic for families, Adalja said, could be to keep doing a rapid test on the COVID-positive person until they test negative. Whereas a laboratory PCR test might still pick up tiny pieces of the virus, the benefit of a rapid test is that it is most likely to register positive while a person is truly contagious.
The approach isn’t foolproof, and families might need to think twice if anyone has a medical condition that makes them vulnerable to a more serious outcome from COVID. But a truncated isolation period for a vaccinated person is already being pushed by the airlines and some health care workers who say it doesn’t make sense to keep vaccinated personnel at home for the full 10 days.
Late Thursday, the CDC relaxed its quarantine and isolation rules slightly for health care workers out of concern that hospitals might face severe staffing shortages next month following the latest wave of omicron cases.
“We have the technology to (avoid) one-size-fits-all isolation periods for everybody. We can use antigen testing to be able to do this,” Adalja said. “If the NFL can do it, why can’t we?”
As for Gretchen, who is asking in vain for a puppy this Christmas, she isn’t too worried about getting sick because she understands the vaccine will protect her.
But her parents say they wouldn’t mind more up-to-date guidance from federal health officials on whether a 10-day isolation period makes sense for a vaccinated person and how to navigate testing other vaccinated members of the household.
“There are obvious downsides to not making memories and missing out playing and being social. Those are real harms,” said Gretchen’s father, Woo Lee.
“But you know, the other side of that is that she could continue to spread this virus,” he said, adding, “Our decisions could affect other people.”
ABC News’ producer Arielle Mitropoulos and Karen Travers contributed to this report.
(NEW YORK) — The World Health Organization is investigating a mysterious illness in South Sudan that has killed dozens of people.
So far, 97 people have died of the unknown disease in Fangak, Jonglei State, in the northern part of the country.
Fangak County Commissioner Biel Boutros Biel told ABC News on Thursday that the latest fatality occurred in an elderly woman.
Deaths have mostly been reported among the elderly and children ages 1 to 14, according to a statement from South Sudan’s Ministry of Health.
The symptoms of the mysterious illness include cough, diarrhea, fever, headache, chest pain, joint pain, loss of appetite and body weakness, officials said.
Biel said the WHO team that traveled to Fangak has since left, but did not communicate their findings to local officials.
In a statement to ABC News, Collins Boakye-Agyemang, a spokesperson for WHO Africa, said the agency began investigating the outbreak in November but did not provide further details.
According to BBC News, because the area has recently been hit with heavy floods, the WHO tested samples from patients for cholera, which is typically contracted from infected water supplies.
However, the samples returned negative for the infectious bacterial disease, the outlet reported.
Sheila Baya, a lecturer in the College of Medicine at University of Juba in South Sudan, told BBC News that WHO scientists had to reach Fangak by helicopter due to the flooding to conduct testing.
Biel told ABC News that some nongovernmental organizations have delivered medical supplies to Fangak and are in the process of setting up mobile clinics to help treat people.
In a statement last month, international humanitarian group Médecins Sans Frontières (Doctors Without Borders) called the floods a “perfect storm” for disease outbreaks.
“People do not have enough water or options for water storage, and there is no garbage collection, while dead goats and dogs are left rotting in the drainage systems,” the statement read. “With the conditions further worsened by the influx of new arrivals [at camps], people are at higher risk of outbreaks and waterborne diseases such as acute watery diarrhea, cholera and malaria.”
ABC News’ Morgan Winsor contributed to this report.
The Food and Drug Administration on Thursday authorized Merck’s COVID-19 pill for certain adults.
The authorization is limited to adults who have a high risk of severe illness and for whom alternative FDA-authorized treatment options are not accessible or medically appropriate.
This is the second COVID-19 treatment in pill form after Pfizer’s pills were authorized Wednesday.
This is a developing story. Please check back for updates.
ABC News’ Sony Salzman contributed to this report.
With omicron’s explosive spread threatening to outpace current COVID-19 treatments, the race is on to find new options that will stand up to the variant.
The first oral antiviral treatment for the virus was authorized by the Food and Drug Administration Wednesday. Pfizer’s Paxlovid has proved effective against severe illness and death from COVID, and is expected to hold up against omicron. The news lent a glimmer of hope amid the latest surge, but supply is expected to remain limited for months as production ramps up.
Meanwhile, omicron’s high transmission rate is squeezing what was already a finite arsenal of COVID treatments. Of the currently authorized monoclonal antibody therapies — which have become a primary treatment for COVID to help keep patients out of the hospital — two of the main ones bought in bulk by the U.S. government have not been successful against the omicron variant.
The third option, one so far expected to remain effective against omicron, is in scant supply with federal health officials moving quickly to stockpile the drug, called sotrovimab, from Vir Biotechnology and GlaxoSmithKline.
Dr. Anthony Fauci, the nation’s top infectious disease expert, said the low supply of sotrovimab is “something we need to worry about” in a private call this week between the White House COVID response team and the nation’s governors obtained by ABC News.
The Biden administration is aiming to double its sotrovimab supply to more than 1 million treatment courses, making 300,000 doses available in January.
So far about 55,000 doses of sotrovimab have been allocated to states, with federal health officials promising shipments would arrive as soon as this week. But as the omicron variant rapidly advances — nearly three-quarters of all COVID cases are now omicron — health officials are bracing for a winter surge while potentially lacking ample defense from treatments that hold up against the new variant.
Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, told ABC News that state leaders gearing up for omicron face a multi-pronged challenge: what was a “compelling tool” against the virus is now compromised, and what now works is still in limited supply. In addition, with hospital staffing shortages, there are looming concerns that manpower to administer the treatment will also be scarce.
“We can’t just hope it’s delta and give the older therapies,” he said. “Even if all of these monoclonal treatments still worked against all the variants, and we had an abundant supply, I’d worry we would get to a place where we just didn’t have the capacity to administer them.”
Evusheld, the pre-exposure monoclonal treatment from AstraZeneca, authorized earlier this month and expected to hold up against omicron is another treatment that could help out health officials. It can be given to a small subset of people for preventative use against the virus, such as those where the vaccines are not effective because of compromised immune systems.
“We’re in a very tight situation now where the virus is increasing faster than our access to the drugs that can treat it,” said Dr. Andrew Pavia, a fellow with the Infectious Diseases Society of America and a treatment guidelines panel member with the National Institutes of Health, told ABC News. “Once we have an adequate supply of sotrovimab, of Evusheld and of Paxlovid, we’ll have some pretty good tools for fighting omicron. But the virus is going to wash over the country before we have an adequate supply. So I’m worried January is going to be ugly.”
A spokeswoman for GSK told ABC News the company is “working with urgency and exploring options to expand our supply capacity in 2022,” including securing additional batches of the ingredients they’ll need to amp up sotrovimab manufacturing, and pushing up their next year supply plans to make more available sooner.
“The challenge is that the supplies [of sotrovimab] are still very limited,” Pavia said. “It’s going to require some very careful prioritization of who needs the drug the most.”
It’s not the first time new variants have hindered mainstay COVID treatments: for several months earlier this year federal health officials paused distribution of Eli Lilly’s monoclonal antibody treatment when it was shown to be ineffective against the gamma and beta variants. The Food and Drug Administration recommended health care providers use alternative authorized antibodies — like Regeneron and GSK — which had shown to hold up against the main variants of concern.
The government spent billions of dollars purchasing Regeneron and Eli Lilly’s monoclonal antibody cocktail to ensure there would be enough supply; GSK’s had not been as widely purchased and distributed. When delta became the dominant variant of concern and all three antibody therapies were effective against it, Eli Lilly’s authorization was renewed.
Health officials have increasingly turned to these therapies as breakthrough cases have ticked up and vaccination rates have not ticked up enough. These antibodies are synthetic versions of the body’s natural line of defense, meant for COVID patients early on in their infections and who are at high risk of getting even sicker in order to help keep them out of the hospital.
The currently authorized COVID-19 vaccines and their booster doses have still shown to be highly effective at preventing severe illness and death.
But as omicron gains steam, some hospitals, like Mount Sinai in New York, have already put a pause on using Regeneron and Eli Lilly’s treatments, given they are not effective against the variant. Some jurisdictions, however, are still clamoring for more supply amid the new crush of cases.
Miami-Dade County exhausted its supply of Regeneron’s treatment this week, shutting down its infusion site for a day while more was secured, a spokesperson for the mayor’s office told ABC News. They now have enough to last until Monday.
“What’s emerging is a realization that this virus is going to be with us for a while, and it’s going to be challenging,” Plescia said. “We’re just going to have to get through this as best we can and find new tools to meet that challenge.”
ABC News’ Eric M. Strauss and Cheyenne Haslett contributed to this report.
Lindsey Nicholson/Education Images/Universal Images Group via Getty Images
(NEW YORK) — Urgent care chain CityMD announced it is temporarily closing more than a dozen of its 150 locations in New York and New Jersey amid a surge in COVID-19 cases and increased demands for testing.
The 19 shuttered clinics include 13 in New York City — impacting every borough except Staten Island — two on Long Island, one in Westchester County, and three in New Jersey.
“To preserve our ability to staff our sites, we are temporarily closing certain locations effective December 22,” a statement on CityMD’s website read. “It is our hope that closing sites now will best allow us to avoid future closures as this surge continues.”
It is not clear when the locations will reopen, with CityMD directing patients to visit nearby locations for testing in the meantime.
This is not the first time that CityMD has closed locations due to the pandemic.
During Thanksgiving last year, the urgent care chain announced all locations would close 90 minutes earlier, citing staff working longer hours than scheduled due to long COVID-19 testing lines
CityMD did not immediately respond to ABC News’ request for comment.
The closures come as states in the Northeast continue to report record-breaking numbers of COVID-19 cases.
On Wednesday, New York reported record-high infections for the fifth time over six days, with more than 28,000 people testing positive, state data showed.
Additionally, New York City has the country’s highest new case rate, with 1,019 cases per 100,000 people over the last seven days, according to data from the Centers for Disease Control and Prevention.
To meet the demand for testing, Mayor Bill de Blasio announced the city would be opening more than 20 testing locations this week.
Gov. Kathy Hochul also said the state intends to set up an online portal through which New Yorkers can order at-home rapid tests. The tests will mostly be sent to areas where vaccination rates are lagging and cases are rising.
New Jersey also reported a record number of COVID-19 cases on Wednesday, with 9,711 confirmed infections.
The state already has a program in place for residents to request a free COVID-19 test kit in the mail. The sample is then sent back to a laboratory with results available within 48 hours.
(WASHINGTON) — D.C. Mayor Muriel Bowser announced Wednesday that certain establishments, including restaurants, bars, nightclubs, gyms, events and meeting spaces, will require proof of COVID-19 vaccination beginning in January.
Patrons above the age of 12 will be required to be partially vaccinated by Jan. 15 and fully vaccinated by Feb. 15.
“If you are a resident that is not yet vaccinated and you want to continue enjoying these activities, now is the time to get vaccinated,” Bowser said.
Citing new data from the Centers for Disease Control and Prevention reporting omicron as now the dominant strain in the U.S., D.C. Department of Health official Patrick Ashley said it was only “a matter of time” before that played out in the district, which currently has 25 confirmed cases of the new variant.
Ashley also pointed to huge spikes in the weekly and daily case rate in D.C. from a month ago, attributing them, in part, to the winter surge and the omicron variant.
A month ago, D.C. reported a daily case rate of 13.7 cases per 100,000 people. As of Wednesday, the rate had jumped nine times to 123.8 cases per 100,000 people.
Bowser noted that some exceptions to the new mandate will be made for patrons not staying long at a restaurant, for example, a patron picking up an order.
The move follows in the footsteps of other major U.S. cities like New York City, San Francisco and Los Angeles that have similar vaccine requirements.
Approved proof of vaccination includes vaccination cards or photos of vaccination cards, immunization records or verification apps like CLEAR and VaxYes.
Further guidelines on the requirements are still to come, Bowser said. Wednesday’s initial announcement of the new guidelines was made to give businesses enough time to prepare.
Bowser also announced that to meet the increased testing demand among residents, the district will order another five million rapid antigen tests, for a total of six million.
Students in D.C. schools will also have to be immunized beginning March 1, following regulations from the D.C. Council.
Bowser also encouraged residents to celebrate safe holidays and asked people to have small gatherings, wear masks and gather outdoors.
(NEW YORK) — A month after the omicron variant was first identified, it has become the dominant strain in the United States, responsible for about three-quarters of new COVID infections.
As of Wednesday, cases have been identified in 49 states and Washington, D.C. South Dakota has not reported any omicron infections yet.
While there is still much to learn about omicron, more research is being done every day furthering health officials’ understanding of this highly transmissible variant.
Spreads more easily than any other variant
A growing body of evidence suggests the omicron variant may spread more easily than any other variant identified during the pandemic.
Health officials, such as Centers for Disease Control and Prevention Director Dr. Rochelle Walensky, say early data shows omicron doubles in prevalence every two to three days.
This is much faster than the delta variant which, at its peak, had a doubling time of about seven days.
“This is an incredibly fast-moving variant,” Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor, said. “We only identified it on Thanksgiving and it’s already the dominant variant in the U.S. The level of certainty we have in the U.S. that it is more transmissible than any variant before is high.”
Omicron partially impacts vaccines, but a booster helps
Omicron seems to evade — at least partially — protection offered by COVID-19 vaccines more easily than previous variants, but it’s unclear by how much. However, studies have been showing boosters help restore much of that lost protection
Preliminary data from Pfizer-BioNTech showed that people who received two doses of their vaccine had low levels of neutralizing antibodies against the variant.
Those who received their booster shot, however, saw their levels of antibodies increase 25-fold compared to pre-boost levels.
Additionally, early data from Moderna released on Monday showed its 50-microgram booster increases antibody levels 37-fold.
Two-dose vaccines still dramatically reduce the risk of severe illness and death, health officials say.
”It’s still an open question about what relative protection you get,” Brownstein said. “It appears vaccines still provide incredible protection around severe illness and death, especially if boosted.”
Additionally, it does not appear that previous COVID infection protects against reinfection from omicron the same way that it did against the delta variant.
A recent study from Imperial College London, which has not yet been peer-reviewed, suggests that the risk of infection with omicron is five times higher than with delta.
Monoclonal antibodies are less effective, but not pills
Treatments also appear to have been affected by the emergence of omicron.According to a readout of this week’s private call between U.S. governors and the White House, which was obtained by ABC News, two of three monoclonal antibody therapies used to treat COVID are less effective against the new variant.
The antibody treatments made by Regeneron and Eli Lilly are not as effective while the third option, made by Vir Biotechnology and GlaxoSmithKline, may be effective but in short supply.
Dr. Anthony Fauci stated that pills produced by Merck and Pfizer do not appear to be impacted by omicron, according to the readout.
Too early to tell if omicron causes severe illness
Health officials still do not know if omicron causes mild or severe illness.
Studies that have been published have offered conflicting findings. A study from South Africa found that the risk of hospitalization for adults was 30% lower compared to the delta-fueled surge during the fall.
But the study from ICL found that omicron did not show any signs of being milder than delta.
In a recent statement, the World Health Organization said it’s too early to say whether omicron causes more mild or severe illness.
So far, only one death from the omicron variant has been identified: An unvaccinated Texas man in his 50s who had previously been infected with the virus. It’s important to remember that not every COVID-related death is reported to health authorities.
Until we learn more about omicron, Brownstein said the best way to protect ourselves is to follow mitigation measures that are known to work, including vaccination and mask-wearing.
“The No. 1 thing that people can do is make sure they’re vaccinated and boosted. That is still our absolute No. 1 line of defense,” he said. “Use rapid tests as a way to identify if you may be contagious and wear a high-quality mask in indoor settings, especially if you’re around people with unknown vaccination status.”
ABC News’ Sasha Pezenik contributed to this report.
