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(NEW YORK) — Since the beginning of the COVID-19 pandemic, the United States has closely followed what the United Kingdom had done to combat the virus from its early response to its vaccination rollout.

Outbreaks in Great Britain have been harbingers of what’s to come in the U.S., and its policies have often helped shape America’s COVID response.

Over the past several weeks, the U.K. has been lifting COVID restrictions and, on Monday, Prime Minister Boris Johnson announced he was dropping the remaining rules in England including the requirement to self-isolate after testing positive, contact tracing and free administration of rapid tests.

In a speech to the House of Commons, Johnson said the country had to pivot away from preventing COVID-19 and “learn to live with this virus and continue protecting ourselves and others without restricting our freedoms.”

Seeing America’s closest ally drop its restrictions have led some to wonder if the U.S. should follow suit.

Currently, the U.K. is recording a daily average of 39,000 cases, down from a peak of 183,000 on Jan. 2 and an average of 126 deaths from a peak of 257 on Feb. 5, according to government data. Meanwhile, the U.S. is recording an average of 75,000 cases, down from a peak of 807,000 in mid-January and approximately 1,600 deaths a day compared to the peak of 2,600 on Feb. 2, according to the Centers for Disease Control and Prevention.

Public health experts are split with some saying it’s time for the U.S. to do similarly and treat COVID-19 as an endemic disease while others say lifting rules may not work for the U.S. right now because of a lower vaccination rate and a less robust surveillance system.

COVID spread in England will be ‘minimal’ due to high rate of vaccination

The largest change to the rules in England is that people who test positive for COVID-19 will no longer be legally required to self-isolate, or avoid contact with other people for a period of time to reduce the risk of transmission.

Once approved by Parliament, the requirement ended Feb. 24, although the government will continue to recommend that COVID-positive patients self-isolate but are not required to do so.

Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University Mailman School of Public Health, called the move a step in the right direction towards the “concept of living with COVID” and a shift from a mandate to personal responsibility.

“It’s a state where we expect people to essentially take responsibility and be accountable to doing the right thing,” she told ABC News. “This means someone who tests positive is aware of what they need to do to protect others during the period of time when they are infectious.”

She added that the U.K. government needs to communicate that “this doesn’t mean do whatever you want to do if you know you have COVID-19. It means that now we have shifted the responsibility and are giving you the tools to guide you in how we should behave.”

But other public health experts don’t think that this system can be implemented in the U.S. because it has a lower vaccination rate than England.

In England, 84.9% of those aged 12 and older are fully vaccinated and 65.7% have received a booster shot as of Thursday, according to the UK government.

By comparison, 73.3% of Americans aged 12 and up are fully vaccinated and 44.9% are boosted, according to data from the CDC.

The experts say this means, even if infected people don’t self-isolate, the virus wouldn’t have a major impact on the healthcare system in England as it would in the U.S.

“​​What they are doing is going to lead to more infections, but the consequences of increased transmission in the U.K. will be minimized by their very good rates of vaccination,” Dr. Bill Hanage, an associate professor of epidemiology at Harvard T.H. Chan School of Public Health, told ABC News. “That population-level immunity is going to be maintained, so even though the virus is circulating, it doesn’t cause disproportionate damage to healthcare.”

He continued, “There are lots of places in the U.S. that are not able to do that without risking much more severe consequences” in reference to several areas in the U.S. with low vaccination rates.

Genomic surveillance is better in the U.K.

Experts said one of the reasons the U.K. may be able to drop its COVID-19 restrictions is its strong genomic surveillance system, better than that of the U.S.

Genomic surveillance allows scientists to track new mutations and variants of COVID-19 and how quickly they are spreading.

About 60,000 samples are sequenced in the U.K. each week, according to the non-profit Wellcome Sanger Institute, which is contracted by the UK Health Security Agency to sequence COVID samples.

Meanwhile, more than 48,000 samples are sequenced each week in the U.S currently, according to the CDC, despite having nearly five times the population of the U.K.

What’s more, between Feb. 14 and Feb. 20, the U.S. submitted about 1,000 samples that underwent genomic sequencing to the global database GISAID while the U.K. submitted more than 15,000 samples.

This means the U.K. would be able to detect new variants much more quickly.

“The U.K. demonstrated a really phenomenal level of surveillance for this virus,” Dr. Stuart Ray, a professor of medicine at Johns Hopkins University, told ABC News. “They were the ones that helped us recognize the alpha variant and they had a higher level of genomic surveillance for this virus than the U.S. did at many junctures.”

“I think that they have demonstrated the utility of situational awareness of monitoring and testing to try to manage this pandemic. That’s a lesson I hope we took to heart. I’m not sure if relaxing rules while case rates are high is a lesson to learn or not, but we’ll see.”

Almost all adults in England are estimated to have COVID antibodies

As of the week beginning Jan. 31, more than 98% of the adult population in England are estimated to have detectable COVID-19 antibodies either from previous infection or from vaccination, according to the UK government, which some have pointed to as a reason for why restrictions should be dropped.

But the U.S. is not very far behind, with a nationwide seroprevalence survey of blood donors conducted by the CDC estimating 94% of those aged 16 and older have antibodies to the virus from vaccination or infection.

Of those, 28% in the U.S. are believed to be from infection. It’s unclear what the U.K. level from infection is.

Ray pointed out that it’s not clear from antibody tests whether people are immune to infection, severe complication and so on and that a high percentage of people with antibodies does not equate to high levels of immunity from high vaccination levels.

“I think if we had a very high vaccination rate, a very high level of immunity in the U.S., that relaxing some restrictions would make a lot of sense, and we would just need to articulate guidance for people for voluntary protections for themselves and the people around them,” he said.

Other infectious diseases experts say even though the U.S. vaccine rate is not as high as in the U.K, there is enough immunity in the nation.

Dr. Ali Mokdad, an epidemiologist with the University of Washington’s Institute for Health Metrics and Evaluation in Seattle, told ABC News the omicron wave infected as many as 60% of all Americans, giving them some form of immunity.

“We do not have as high a vaccination rate as the U.K., but we have the combination of vaccination and infection,” Mokdad, who helps lead a model that projects COVID-19 cases around the country, said. “In our estimate at IHME, 75% of Americans have immunity against omicron so we are basically very close to the U.K. in that regard.”

Studies have indicated infection with omicron, which is the ​current dominant variant, among vaccinated individuals can boost previously acquired vaccine immunity against other variants.

“Even if they had higher vaccination, we had higher infections, so you add the two together and we’re in the same boat as they are. So, whatever they did, we should do here in the U.S. In my opinion we should also stop these mandates in the U.S.,” Mokdad said.

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(NEW YORK) — A year ago, Denmark culled thousands of minks in an effort to slow the spread of COVID-19 in mink farms and curb any potential threat of transmission back to humans.

And just a few months ago, thousands of small animals, including hamsters in Hong Kong were culled after scientists and public health officials became concerned over cases of humans becoming infected with COVID-19 from their pets.

Pets, in particular, are problematic because there are no disease surveillance programs for them or zoo animals, said Dr. Tracey McNamara, professor of pathology at Western University of Health Sciences College of Veterinary Medicine.

While minks and hamsters have been the only animals believed to have transmitted the virus back to humans in some cases, scientists are increasingly concerned that the next coronavirus variant might emerge not from people, but animals, as COVID-19 likely did.

Scientists are monitoring animals both to try to identify any new pandemic-causing viruses, and to try to identify the next COVID-19 variant. If a new variant emerges that is significantly different from any of the variants we’ve seen previously, and if nobody has immunity — that’s effectively a brand-new pandemic.

“There are hundreds, thousands of coronavirus in many animal species,” said Dr. Jeff Taubenberger, deputy chief of the Laboratory of Infectious Diseases at the National Institute of Allergy and Infectious Diseases (NIAID). “We don’t really know where they all are, we don’t know the full extent of the reservoir. We don’t know what the risks are.”

Bolstering animal surveillance

Now, scientists are hoping to shore up defenses against COVID-19 by monitoring the way the virus circulates in animals.

“Tufts University recently received $100 million for pandemic prevention work globally,” said McNamara. “There is a lot of money going into finding potential pandemic threats in animals before they spread to people internationally, but not enough domestically.”

According to McNamara, the new Tufts funding will fund teams of scientists to bolster surveillance in the Africa and Asia — testing wild animals for any virus that might cause a future pandemic, to better understand how those viruses are circulating in nature.

In North America, scientists have found more and more cases of the COVID-19 virus being transmitted among wild white tail deer. Each case of transmission increases the chances of a new variant developing.

“If the virus is able to infect other species, it will evolve differently,” said Taubenberger. “It could give us a variant that is very different from what we’ve been exposed to, and wouldn’t be covered by our current vaccines.”

Universal vaccine and new pandemic plans

This concern for new variants arising, especially from animal populations, has scientists calling for the development of a universal coronavirus vaccine, which would address a number of coronaviruses, including COVID-19, but likely not all.

“A universal coronavirus vaccine is one that would work against multiple strains or variants,” said John Brownstein, Ph.D., chief innovation officer at Boston Children’s Hospital and a medical contributor for ABC News.

Scientists at the Walter Reed Army Institute of Research have been working on developing such a universal vaccine, which is currently undergoing the first phase of human trials.

This universal vaccine would include multiple coronavirus fragments that could trigger immune responses to different strains of COVID-19, with the hopes of boosting immunity against more variants.

It would also be stable at room temperature, potentially making it more globally accessible.

“With the omicron variant, we saw a huge number of breakthrough cases, though the vaccine was holding up against severe illness from COVID-19. In the future, we would like to be providing core support instead of chasing new variants,” Brownstein said.

Meanwhile, the U.S. government has launched a new Pandemic Preparedness Plan to better defend against new viruses that might cause the next pandemic.

As part of this plan, the NIAID will focus research efforts on two areas, “prototype pathogens” and “priority pathogens.”

“Prototype pathogens are viruses that could potentially cause human illness,” said Brownstein. “And priority pathogens are viruses that we know already cause human illness and death.”

By expanding knowledge of these viruses, the Pandemic Preparedness Plan hopes to shorten the time it takes to develop medicines or vaccines effective against future variants that may emerge.

Jonathan Chan, M.D., is an emergency medicine resident at St. John’s Riverside Hospital and a contributor to the ABC News Medical Unit.

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(NEW YORK) — Approximately 5.2 million children have lost a parent or caregiver during the pandemic, according to a new study published in The Lancet medical journal Thursday.

An analysis by the same team of researchers in July 2021 had estimated 1.5 million children were orphaned during the first 14-months of the pandemic, meaning they lost at least one parent. But with new variants and a rising death count, the researchers said they felt compelled to re-evaluate the analysis.

Between May 2021 and October 2021, deaths globally nearly doubled compared to the months prior, a jump attributed predominantly to the delta variant. This new study estimates that approximately 5.2 million children are experiencing COVID-related orphanhood.

“What we found was shocking,” said Dr. Susan Hillis, the study’s lead author and a senior research officer at Oxford University, who completed this work while at the Centers for Disease Control and Prevention.

The number of children who lost at least one parent at the end of the first 20-months of the pandemic was greater than the total number of COVID deaths, and this gap is increasing, according to the study.

Children aged 10 through 17 were more likely to have lost a parent, with 2.1 million children affected. Still, over 490,000 children between ages 0 and 4, and 750,000 children between ages 5 and 10 lost a parent or caregiver.

Among all children, 3 out of every 4 lost a father, which is even more significant in low-income countries where the father is more likely to be the primary earner.

“COVID-related orphanhood does not come in waves,” Hillis said. “It is a steadily rising slope with the summit still out of our sight.” Although many may recover from an infection, losing a parent is not something that can be easily recovered from, she said.

“These are 5 million kids in one generation that will be living the rest of their lives in a very different way, and this affects us all,” said Dr. Natasha Burgert, a pediatrician and spokesperson for the American Academy of Pediatrics. Burgert was not involved with the study.

As part of their work, Hillis and her team said they developed a real-time calculator to predict loss of parent or caregiver by current mortality data for every country in the world. By the end of January 2022, the estimate had risen to 6.7 million children worldwide affected by COVID orphanhood, according to the research. In the United States, the researchers estimate over 149,000 children have lost a parent or caregiver.

However, despite these staggering numbers, Hillis say there is hope.

For the last 20 years, the U.S. government has been investing in evidence-based programs to ensure orphaned and highly vulnerable children affected by the HIV/AIDS pandemic could be protected and supported to reach their potential, the researchers noted.

“We actually know the models that work,” Hillis says. “We have an opportunity to lead by example.”

Experts say these findings underscore the importance of vaccinating adults across the globe.

“Vaccines are keeping people alive in the face of this terrible virus and keeping families whole,” says Burgert.

While authors continue to call for equitable access to vaccines and treatment globally, the millions of children already orphaned still need support, they said.

“We need to be supporting our childcare centers, local schools and larger university systems with the resources needed to create a cushion of support and a safe place for social-emotional learning,” says Burgert. “Educators, counselors, administrators, physicians and legislators need to be preparing for the upcoming impact, and they will need everyone’s help.”

The CDC, WHO and many top experts around the world have agreed to the importance of adding an additional pillar to the world-wide COVID response: Caring for and protecting these children.

There is currently no governmental funding in the United States aimed at acknowledging and protecting these children in their hidden pandemic, the researchers noted.

“We have an unprecedented opportunity to change the narrative in our country away from divisiveness towards shared hope,” says Hillis. “It is a moral imperative for us to do what we know works to help the ones at home and to encourage every country in the world to do the same.”

Emily Molina, MD, an internal medicine resident physician at the Johns Hopkins Hospital, is a contributor to the ABC News Medical Unit.

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