Covid-19 hospitalisations and deaths in the US have been steadily rising for weeks, and some experts say Americans’ delayed response to the uptick could have serious consequences.
Dr Deborah Birx, who served as White House coronavirus response coordinator under then-president Donald Trump, said in a new interview with ABC News that by ignoring Covid, Americans are living in a “fantasy world”.
From August 13 to 19, Covid deaths jumped 21.4 per cent and hospitalisations rose 18.8 per cent compared to the previous week, according to the most recent data from the Centers for Disease Control and Prevention (CDC). Hospitalisations are lower than they were during the same time in 2020, 2021, and 2022. Global health authorities are monitoring EG.5.1, a new variant that is gaining traction.
“We’re pretending that Covid is not relevant,” Dr Birx said. “But I can tell you…you know two or three people who have Covid. That means that five to 10 per cent of your friends already have Covid.”
Dr Birx criticised the Biden administration’s response plan, claiming that the boosters set to roll out in September will come too late. “What does it mean when someone recommends a fall vaccination? It means that you’re ignoring the summer wave,” she said.
She said the current vaccination strategy the US is employing — by which everyone gets an annual shot before a potential winter surge — isn’t ideal for protecting people against Covid-19. It shouldn’t have been modeled off the influenza vaccine strategy, Dr Birx said. Instead, she argued the US should use mRNA technology to quickly tailor boosters to new variants no matter what time of year they emerge.
“I think we wanted to make [Covid] like flu, because that was easier. But it’s never going to be like flu,” she said. “It stays with us in between the waves.”
She added that the current administration should have addressed the summer wave more aggressively. “What the federal government needs to do is lay out the plan that says, ‘We’re not done with Covid, Covid’s not done with us. 250,000 Americans died in 2022. We’ve got do to a better job in 2023. And this is part of our better job.’”
ABC News interviewer Brad Mielke asked Dr Birx why she didn’t stop Mr Trump from spreading misinformation about Covid when the pandemic started. She said, “I was active-duty military. That is not within my repertoire.”
The decision to administer an annual shot in the fall was based, in part, on Americans’ behavior, William Schaffner, MD, a professor in the division of infectious diseases at Vanderbilt University Medical Center, told The Independent. Only a quarter of US adults got the bivalent booster that was made available in September 2022, according to data from KFF, a health policy research group. This is one reason health authorities opted not to consider producing multiple boosters throughout the year.
“The response of the CDC, the Food and Drug Administration [FDA], and the like has been to try to integrate the best science with what’s practical and what works, and you have to be realistic about that,” Dr Schaffner said. “The currently available booster has been underutilized and under-accepted.”
Dr Birx isn’t the only expert who believes we may need to produce and administer different boosters throughout the year, Dr Schaffner said. “Her point of view was amply represented in the discussions,” he said. “But it was thought that, ‘How different would the variants have to be? Can the manufacturers produce the millions fast enough? Then, will the public accept more than one booster a year?’ After deliberation, it was decided that we don’t think we can persuade the American public to get more than one booster a year.”
Other preventative tools — like masks and home tests — should also be used to slow the current Covid wave, Dr Birx said. “Not only should it be part of the conversation, but it should be very clear when there is the need to use it and what families should be alerted to using it,” she said. “A lot of our elderly, particularly those in memory care, really can’t mask. And that means the people around them need to test and mask.”
Dr Schaffner said wearing a mask could prevent the spread of Covid-19 right now, but that the American people may be hesitant to comply if a mandate is reinstated. In light of this, individuals need to consider whether they’re at-risk from severe disease from Covid and respond accordingly, he said. “Nationally, we could be putting more emphasis on this. Who’s at greatest risk? Older persons, people with underlying serious illnesses, immune-compromised, pregnant people — those people should be thinking more about [masking].”
Though it might be challenging to convince the American public to start masking again, providing free tests may help authorities contain the current wave, Dr Schaffner said. When Covid-19 was considered a Public Health Emergency (PHE), from January 2020 to May 2023, tests and treatments were free. Now that people have to pay for their own tests, they may be less likely to use them, Dr Schaffner said.
“One of the things we could have thought about from a federal point of view is continuing to make testing materials widely and freely available,” he said. Free Covid tests were briefly made available by mail during the PHE, but people should be able to access free tests at their pharmacy, he added. This way, people who don’t have access to the internet — which was needed to place an order — or a permanent home address can still get free tests. Dr Schaffner said he’s planning to need to test for Covid regularly in the coming days. “I expect to expend a fair amount of money,” he said. “If people don’t have the resources, they won’t do that.”
