The new omicron subvariant, BA.2, is causing COVID cases to rise in several European countries, and many experts believe the United States — and Florida — will see a rise in cases in the coming weeks.
As of Wednesday, BA.2 accounts for one in three cases in the U.S. and about one in four in the Southeast, which includes Florida. Europe typically is a month ahead of the U.S. in its COVID outbreaks.
In Florida, where positivity rates are low, many people are taking off their masks and returning to indoor spaces such as restaurants and theaters. In addition, Spring Break is drawing crowds of people to local beaches, restaurants, and nightclubs, often from areas where omicron transmission is higher.
BA.2 has caused concern because it is about 50% more transmissible than the original omicron strain.
So, what does the pandemic trajectory look like in Florida and how do residents stay safe this spring and summer? The South Florida Sun Sentinel asked health experts to offer guidance.
Is Florida going to get another omicron surge?
Florida is at a near-historic low in terms of new COVID cases, emerging from its largest peak in January. While the subvariant has been in Florida since January, virus samples sequenced by Helix show BA.2 has become an increasingly larger percentage of COVID cases in the state in the past two weeks.
Dr. Ira Longini, a professor of biostatistics who has created COVID-19 forecast models at the University of Florida, believes even if another omicron wave arrives in Florida, it will be a steady uptick in cases that lasts a while, rather than a sharp rise that peaks and then drops like the recent omicron wave in January.
“Florida had an enormous wave, and we still have cross-protection,” Longini said. “I don’t know how fast that protection will wane but I don’t think we are going to get a massive, explosive wave. I think it will be flatter, but it could last a long time as immunity wanes.”
If I was infected with omicron, can I get the subvariant, BA.2?
In Florida about 1 million people had COVID during the omicron surge.
Experts believe for the most part, people who were previously infected with omicron have protection against being reinfected with BA.2. A preprint study from Denmark found only a minuscule fraction of people were reinfected with BA.2 who had been infected with the original omicron strain — 47 people out of more than 1.8 million recent cases of COVID-19.
While it’s unlikely, Dr. Eric Topol, founder of The Scripps Research Institute, said there is no guarantee against reinfection: “We don’t have adequate data to be certain.” He also notes that it is unclear how long immunity from the original omicron strain will last.
The subvariant is more contagious but is it more severe?
The World Health Organization has considered all the data available from around the globe and concluded there is no major difference in disease severity between the original omicron strain and BA.2 Omicron is considered a milder variant than previous strains such as delta.
In its original strain, omicron has appeared as an upper respiratory-type infection with cold-like symptoms, rather than the lower respiratory infections that can lead toward pneumonia which had been common with delta. Cough, congestion, runny nose and fatigue are reported as the prominent symptoms with omicron.
If I had a booster shot more than six months ago, am I still protected?
Researchers are studying BA.2 in real-time, learning who is protected and who might be at risk.
Dr. Scott Gottlieb, former FDA commissioner and current Pfizer board member, thinks most people who got a booster will be well protected in the months ahead.
“If we’re in a low-prevalent environment, as we’re likely to be this summer, I think most Americans who had three doses of vaccine will have sufficient protection going through the summer,” Dr. Gottlieb told CBS News.
Meanwhile, Pfizer and Moderna have asked the FDA to allow adults in the U.S. to get fourth-dose boosters. So far, their requests have not been approved.
Infectious disease doctors note that current Pfizer and Moderna boosters are not tailored to the COVID-19 variants currently circulating, like omicron, and its subvariant, BA.2.
However, Pfizer is studying an omicron-specific vaccine and a hybrid shot that would target omicron along with earlier variants and is expected to report its findings in April.
Topol says if the level of circulating virus continues to drop as it has in March, then people can wait on boosters until the first sign of a new variant other than omicron. However, if there is a new BA.2 wave, the recommendation would be for people over age 60 or 65 to get a second booster.
In Florida, 95% of seniors are vaccinated, but only a quarter of all 21 million residents are boosted.
Topol says people over 65 without booster shots should be concerned since their protection is substantially lower for hospitalizations and deaths compared with seniors who are boosted.
What about if I never got a booster shot, just the two vaccine doses, do I still have good protection?
Two shots provide protection against severe outcomes from COVID. Three shots provide even more protection. A recent CDC study suggested that vaccine effectiveness against severe outcomes during the omicron wave in January was 88% with two shots, and 94% with three.
Experts say it’s prudent to be prepared for a possible increase in coronavirus transmission by getting up-to-date on vaccinations and boosters. Anyone who got the Pfizer-BioNTech or Moderna shot can get a booster five months after completing the primary two-dose COVID-19 vaccination series. Those who got the Johnson & Johnson can get a booster two months later.
What are the COVID therapies that are thought to work against the omicron subvariant?
Doctors are prescribing oral antiviral pills such as Pfizer’s Paxlovid tablets or Merck’s Molnupiravir to treat COVID-19 in its early stages. “Paxlovid is very potent and practical to use, but the supply is very limited and the block of COVID funds will make this situation much worse if/when another case surge begins,” Topol said.
Certain monoclonal antibodies do not work for omicron but there are some that do. For example, bebtelovimab and sotrovimab are being given as early treatment and Evusheld is being given to protect who are not infected but are immunocompromised.
Scientists have said it’s inevitable that almost everyone will get COVID. If I haven’t had it yet, should I stop worrying and live my life?
Yes and no.
Even people who have had mild cases of COVID are developing symptoms that surface weeks later, doctors report.
“Every wave just increases the spike in the number of outpatient visits related to symptoms that are thought to be associated with COVID,” Shibani Mukerji, an assistant professor of neurology at Harvard Medical School, told the Harvard Gazette.
Yet, even top U.S. infectious disease expert Dr. Anthony Fauci says it’s time for the U.S. to start inching back to normal.
In Florida, many are adapting their behaviors to the new normal as case levels drop.
Longini at UF says Floridians should monitor for rising cases in their communities.
“If there is an increase, wear a mask indoors and follow protocol about avoiding indoor crowds. It’s all a matter of taking reasonable precautions and going about our daily lives.”
Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com or Twitter @cindykgoodman.