Covid infections ‘a much less scary beast’ now for region, health experts say

Hospital systems and experts say covid-19’s impact on healthcare and everyday lives is decreasing, while cautioning that the virus is and will remain present in Western Pennsylvania.

New Centers for Disease Control and Prevention data shows that nationally, the number of people dying in the United States every week has fallen to normal levels, as it was before the pandemic.

According to Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, the lack of excess deaths reflects a stabilizing of covid’s impact on the healthcare system, in that it no longer has the ability to threaten hospital capacity.

“We’re back to what it was like before covid-19. Now, the rate of deaths is what would be expected in the past,” he said. “We’re not seeing more people than would be expected to die. … Because of the tools that science and medicines have given us, with vaccines and antivirals, it’s an incalculably more manageable disease than it once was.”

Adalja emphasized that covid-19 is not gone, though, and won’t be going anywhere anytime soon.

“People will be getting covid as long as there are humans on the planet,” he said. “It’s not a disease that can be eliminated.”

Moving forward, he says, when new variants of the virus emerge, they’re likely to have less impact.

“The virus is always going to be generating new variants. They are continuing to evolve; evolution of the virus will always be happening,” he said. “Increasingly, the new variants will not necessarily make that much of an impact. Those variants will be circulating in a population that is well-protected (by) immunity, that will protect them from serious disease, hospitalization and death.”

Covid wastewater testing, in which county and state health departments check for the amount of covid-19 prevalent in wastewater, is expected to be the future of tracking the disease, and other diseases, Adalja noted.

According to the Allegheny County covid-19 online dashboard, this past week represented a record low level of prevalence in Allegheny County for covid variant XBB 1.5, with 152.18 copies per liter of sewage on July 9 and 703.96 on July 12.

“I think it will continue and expand to other diseases,” Adalja said. “It’s a very easy and non-invasive way to understand what’s circulating in the community.”

Upcoming boosters

This autumn, a new booster may be available that focuses on the XBB variant of Omicron, according to Adalja.

“The current boosters are tied to the BA4-BA5 variants,” he said. “There will likely be versions of XBB omicron boosters.”

The most important thing with booster vaccines is for people who are at highest risk of adverse outcomes from covid to get them, Adalja noted.

“I think with the earlier booster programs, there was too much universalizing of the boosters, and (it) was diluting the message to the high-risk individuals,” he said, arguing that prioritizing getting everyone boosted as opposed to those who need it most, like older adults, made things more confusing. “Seventy-five percent of deaths are in those above the age of 65.”

Dr. Amy Crawford-Faucher, family physician and vice chair of the Primary Care institute at Allegheny Health Network, said she has been telling her patients to think of boosters for covid the same way they think of annual flu shots — as something to refresh in the fall season.

“Even though we see that you can get covid at any time of year, typically, when people are inside in closed spaces, you share more respiratory viruses,” she advised.

Dr. Donald Yealy, chief medical officer at UPMC, said he expects to see covid vaccines updated annually. He described them as serving as a reminder to your immune system, and an introduction to any new variants.

“The goal here isn’t to prevent everybody from being infected — there’s nothing that can do that, really,” he said. “It’s to make sure that you’re best prepared, so that if you come in contact, your infection is either trivial or it doesn’t cause you to need hospitalization or intensive care.”

If someone hasn’t yet received the most recent bivalent booster, though, they can still go ahead and get it before this fall, he said.

“It won’t prevent you from being able to be vaccinated in October,” he explained. “It won’t ruin your availability to get the newer one when it comes out in a few months.”

Health system prevalence

At Independence Health System, Chief Medical Officer Dr. Carol Fox says that the system still keeps track of covid internally, but its prevalence in the hospitals has decreased significantly from the worst days of the pandemic.

Spokesperson Robin Jennings said that the health system has covid patients, but “nothing of significance.”

“The numbers of patients that have been hospitalized over the past several weeks to months have been relatively small, and very few, if any, have required ICU level care,” Fox said, noting that that is “really good news.”

Crawford-Faucher noted that only between 15 and 20 patients were hospitalized with covid throughout AHN’s hospitals as of this past Sunday.

Yealy said UPMC has recently averaged “anywhere between 25-35 people with an active covid-19 infection, roughly one or two per hospital.”

“Some require intensive care, and some require breathing assistance. It’s nowhere near the numbers we saw 18 months ago, but it’s not completely gone,” he said, advising that people should still test, mask up and avoid contact with others when sick.

“We don’t think that broad-based masking and isolation are necessary right now, But if you’re very vulnerable to covid-19 infections or you are going to be coming around people who are, masking still makes sense,” he added. “Get tested, stay away from others and wear the mask if you are uncertain or around vulnerable people. But you don’t have to wear it all the rest of the time.”

Crawford-Faucher noted that the gradual phasing-out of case-by-case tracking in favor of home tests and wastewater tracking sometimes makes it more difficult to determine the ubiquity of the virus in the community. If hospital numbers spike, though, the system will know there is a bigger issue.

“(Covid) is still there, and it seems to be a much less scary beast than it was when it was top of mind,” Crawford-Faucher said. “I think that’s good news in that it’s not as dangerous for the general public than it used to be.”

She added that covid deaths tend to be “sporadic” these days.

“They’re most likely in patients who also have multiple other complicating medical conditions,” she said.

Covid cases are still floating around, so taking precautions to prevent infection or spread is still important, Fox said.

“We are still certainly aware not only of people who present for evaluation and treatment, but also individuals who work here, individuals are still getting it,” Fox said. “The bottom line is, when you’re ill, you need to be very vigilant about washing your hands and not being around people who are at highest risks for serious illness, whether or not you might have covid or the flu or anything of that nature. We want to try to protect the vulnerable around us.”