1 of 5 | Although more than 218.5 million people are fully vaccinated -- meaning, they have received the two shots required with the Moderna or Pfizer-BioNTech products -- only 98.9 million booster doses had been administered as of Wednesday, according to the Centers for Disease Control and Prevention. File Photo by Gary I Rothstein/UPI | License Photo
NEW YORK, April 14 (UPI) -- With nearly 1 million people dead from the virus in the United States through Wednesday, the worst of the COVID-19 pandemic has likely passed. Still, dark days could be ahead unless the country remains prepared to respond, experts told UPI.
This means providing funding to ensure widespread availability of free virus testing and vaccination, as well as localized mask mandates and, potentially, short-term lockdowns in response to outbreaks, they said.
Ideally, it would also mean providing free, or at least low-cost drug treatments for COVID-19, above and beyond the 20 million doses of Pfizer's Paxlovid in stockpiles, the experts said.
"We may be done with the virus, but the virus isn't done with us," public health expert Michael T. Osterholm said.
"It is clear with the emergence of new variants that this virus isn't going to go away and become dormant anytime soon," said Osterholm, a professor of public health at the University of Minnesota in Minneapolis and a former adviser to the Biden administration.
However, even as new variants of the virus that causes COVID-19 continue to emerge, whether the United States is willing to continue to fund these and other pandemic response initiatives remains to be seen.
Bipartisan congressional negotiators announced earlier this month that they reached a deal to supply $10 billion in additional funding for national pandemic response, or less than half the amount requested by the Biden administration.
The decision could undercut efforts to administer first and second booster doses of COVID-19 vaccines, which research suggests have helped the country prevent more than 2 million deaths from the virus.
"It's a big, very big, mistake," infectious disease specialist Dr. Eric Topol said of the congressional budget decision.
"We need to be ready, and that includes a pan-coronavirus vaccine, oral/nasal vaccines, widescale free Paxlovid availability and other pill medications that are in the pipeline, testing and more," said Topol, a professor and executive vice president at Scripps Research Institute in San Diego.
Through Wednesday, more than 983,000 people in the United States have died from COVID-19, according to the Centers for Disease Control and Prevention.
By the end of this year, that figure could approach 1.2 million, depending on many variables, including the scale and scope of pandemic response, a Rockefeller Foundation report titled "Getting to and Sustaining the Next Normal: A Roadmap for Living with COVID" warns.
Reaching that number would also entail the "evolution of a novel [virus] variant that both infects a large fraction of the population" and causes more severe illness than the Omicron strain, the report states.
The BA.2 subvariant of Omicron has replaced its parent strain as the dominant one in circulation in the United States, according to the CDC.
The new variant appears to be fueling a rise in "breakthrough" infections, or those that occur in people who are fully vaccinated and even boosted, and they may be harder to treat, said Osterholm, one of the co-authors of the COVID-19 roadmap report.
The World Health Organization last week warned of two new subvariants of Omicron, BA.4 and BA.5, in Europe and Africa, while another, Omicron XE, has emerged in Britain, officials there said.
"One challenge we have with this virus is that we are going to continue to be bombarded by new variants, because this virus changes much faster than the flu," Osterholm said.
"We have to expect the unexpected and, if we don't, we will end up being a day late and a dollar short," he said.
Depending on how many people get infected with new variants, there may be more treatments available to care for them.
After initially promising to distribute 50 million doses of Paxlovid, currently the only approved antiviral drug for COVID-19, Pfizer now says it will increase supplies to 80 million doses by the end of the year, according to reports.
Even in the most optimistic scenarios put forth in the COVID-19 roadmap report, the United States can expect to see 30,000 to 100,000 additional deaths from the virus by the end of the year.
The number depends largely on what happens with future variants, Osterholm said.
To date, the country has seen a "relatively small BA.2 wave compared with [the] monstrous BA.1 and the BA.2 surges seen in many countries in western Europe," said ' Topol, who was not involved in the roadmap report.
However, part of the reason why BA.2 and other variants remain a threat is that "we don't know these variants have behaved differently here than they have in other countries," Osterholm said.
Until researchers can figure out how and why certain strains spread more rapidly in some areas, it will be impossible to predict where outbreaks will occur, he said.
For this reason, he and others have expressed concern over decisions to relax pandemic-related restrictions such as school mask requirements across much of the country.
Some restrictions have remained in place: On Wednesday, the CDC extended the mask mandate for airplanes and on public transportation through May 3.
"I'd like to think we weren't premature, but realistically, we just don't know," Osterholm said.
Although these restrictions have been unpopular in some areas and controversial across the board, they have been effective at preventing virus spread, he said.
Still, researchers "are learning more every day [as] each [virus] mutation provides new information that helps inform how we respond to the virus," public health expert M. Courtney Hughes said.
And, if efforts to administer booster doses of the COVID-19 vaccines are successful, it could blunt the effects of these variants, she said.
Although more than 218.5 million people are fully vaccinated -- meaning, they have received the two shots required with the Moderna or Pfizer-BioNTech products -- only 98.9 million booster doses had been administered as of Wednesday, according to the CDC.
"Much of the 'fatigue' that we've all experienced" with pandemic restrictions "has been due to confusion," said Hughes, an associate professor of public health at Northern Illinois University in DeKalb.
"We need better coordination from officials at all levels of government so that the public is hearing one definitive message about how to protect themselves from the virus," she said.
However, the scope of education and planning efforts nationally will likely be affected by the funding behind them, Osterholm said.
"We have to use common sense: Is it cheaper to offer free booster doses of the vaccine to everyone or have more people hospitalized with breakthrough infections? Our chances of seeing another large-scale public health emergency this year rise the less prepared we are," he said.
"Fatigue" with restrictions and lack of funding for testing and vaccine programs also increase that risk, Topol added.
"Poor testing, reporting and data surveillance puts us in a 'flying blind,' compromised situation," he said.