Is a surge of COVID happening? With lots of folks taking at-home tests and not reporting the results, how do we know the data that’s out there is accurate?
“The most reliable data shows that a surge is happening,” says Jeremy Kamil, a virologist at Louisiana State University Health Shreveport.
Testing data may not be as reliable as it was a few years ago before home tests became widespread, but there are other metrics to estimate the amount of COVID circulating. For one, hospitalizations and deaths due to COVID are both up. About 5,000 people in the U.S. are being hospitalized per week, up from under 1,000 per week at the last low point in June. The weekly death toll has tripled since that point too, from around 500 a week to more than 1,600. That’s got hospitals from Mass General to Johns Hopkins Medicine reinstating universal masking requirements and other precautionary measures. Abroad, governments in India, Spain and elsewhere are bringing back masks in health-care facilities. https://www.npr.org/sections/goatsandsoda/2024/01/13/1224470576/coronavirus-faq-surges-boosters-covid-paxlovid-flu-rsv?
But the clearest picture showing how much COVID is circulating among people who don’t end up in the hospital (or worse) may be in the sewage.
Kamil says that wastewater surveillance “is an imperfect but highly reliable tool to show that COVID is on the uptick” over the past few months. In places like Boston, wastewater data showed COVID peaking right before the new year. And even though the wastewater data and hospital data are showing a slight dip since that latest peak, there’s still plenty of COVID to go around.
The number of cases right now may be fewer than in past surges, but “relatively speaking, it’s a lot,” according to Dr Abraar Karan, an infectious disease physician at Stanford.
The US Centers for Disease Control and Prevention (CDC) reports there have been roughly 9,500 deaths from the flu this season and approximately 34,000 deaths from COVID in the last three months.
Not everybody shares the same level of risk, of course. But while Kamil says COVID is most dangerous for elderly and immunocompromised people, he also stresses that COVID is a disease that specializes in “making healthy people sick.”
Which is why even if you’re young and healthy, you should consider getting a booster shot. “Boosters are really important,” Kamil says. “If more Americans got them they would be avoiding the very worst that this virus can serve.”
It’s reasonable to think that COVID is just another bug joining our wintery mix of sicknesses. But experts stress that, unlike the flu, it’s not mainly a seasonal problem.
“We had an increase [of COVID cases] in the late summer,” says Dr Karan. “So it’s not exactly the same as the flu or RSV in that way.” Part of the reason COVID can pop up any time of year is because of how quickly new strains can emerge and break through our immunity. The strain currently circulating most widely in the U.S. is called JN.1, and experts say it’s highly transmissible.
The spread of JN.1 is helped, in no small part, by the fact that more people have been gathering indoors because of colder weather and holiday and other celebrations.
So even though COVID is likely to be a year-round concern, it does seem to gain strength around holidays and other big events. As Dr Kamil puts it, “COVID has joined the team of critters that are going to be attending your Christmas party, your Thanksgiving gathering and any other kind [of gathering].”
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The World Health Organization (WHO) has certified Cabo Verde as a malaria-free country, marking a significant achievement in global health. With this announcement, Cabo Verde joins the ranks of 43 countries and one territory that WHO has awarded this certification. www.who.int/news/item/12-01-2024-who-certifies-cabo-verde-as-malaria-free–marking-a-historic-milestone-in-the-fight-against-malaria
Cabo Verde is the third country to be certified in the WHO African region, joining Mauritius and Algeria which were certified in 1973 and 2019 respectively. Malaria burden is the highest on the African continent, which accounted for approximately 95% of global malaria cases and 96% of related deaths in 2021.
Certification of malaria elimination will drive positive development on many fronts for Cabo Verde. Systems and structures built for malaria elimination have strengthened the health system and will be used to fight other mosquito-borne diseases such as dengue fever. Travellers from non-malaria endemic regions can now travel to the islands of Cabo Verde without fear of local malaria infections and the potential inconvenience of preventive treatment measures. This has the potential to attract more visitors and boost socio-economic activities in a country where tourism accounts for approximately 25 per cent of GDP.
“I salute the government and people of Cabo Verde for their unwavering commitment and resilience in their journey to eliminating malaria,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “WHO’s certification of Cabo Verde being malaria-free is testament to the power of strategic public health planning, collaboration, and sustained effort to protect and promote health. Cabo Verde’s success is the latest in the global fight against malaria, and gives us hope that with existing tools, as well as new ones including vaccines, we can dare to dream of a malaria-free world.”
Certification of malaria elimination is the official recognition by WHO of a country’s malaria-free status. The certification is granted when a country has shown – with rigorous, credible evidence – that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least the past three consecutive years. A country must also demonstrate the capacity to prevent the re-establishment of transmission.
Cabo Verde, an archipelago of 10 islands in the Central Atlantic Ocean, has faced significant malaria challenges. Before the 1950s, all islands were affected by malaria. Severe epidemics were regular occurrences in the most densely populated areas until targeted interventions were implemented. Through the targeted use of insecticide spraying, the country eliminated malaria twice: in 1967 and 1983. However, subsequent lapses in vector control led to a return of the disease. Since the last peak of malaria cases in the late 1980s, malaria in Cabo Verde has been confined to two islands: Santiago and Boa Vista, which have now both been malaria-free since 2017.
Cabo Verde’s journey to malaria elimination has been long and received a boost with the inclusion of this objective in its national health policy in 2007. A strategic malaria plan from 2009 to 2013 laid the groundwork for success, focusing on expanded diagnosis, early and effective treatment, and the reporting and investigating all cases. To stem the tide of imported cases from mainland Africa, diagnosis and treatment were provided free of charge to international travellers and migrants.
In 2017 the country turned an outbreak into an opportunity. Cabo Verde identified problems and made improvements, leading to zero indigenous cases for three consecutive years.
During the ongoing COVID-19 pandemic, the country safeguarded progress; efforts focused on improving the quality and sustainability of vector control and malaria diagnosis, strengthening malaria surveillance – especially at ports, airports, in the capital city and areas with a risk of malaria re-establishment.
Collaboration between the Ministry of Health and various government departments focused on the environment, agriculture, transportation, tourism, and more, played a pivotal role in Cabo Verde’s success. The inter-ministerial commission for vector control, chaired by the Prime Minister was key to elimination. The collaborative effort and the commitment of community-based organizations and NGOs demonstrate the importance of a holistic approach to public health.
As Cabo Verde celebrates this monumental achievement, the global community commends its leaders, healthcare professionals, and citizens for their dedication to eliminating malaria and creating a healthier future for all.
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Older Americans who received a COVID-19 booster vaccine were 47% less likely to develop a heart attack, stroke, or blood clot if they got sick with the disease within 6 months after inoculation compared with those who received only an original messenger RNA vaccine, a study has found. https://www.science.org/content/article/news-glance-lobster-eye-space-telescope-psychiatrists-conflicts-and-elusive-common?
The analysis by researchers at the U.S. Centres for Disease Control and Prevention (CDC) examined Medicare records of nearly 13 million people 65 and older, who are more at risk than others for these COVID-19 complications. The study followed patients who received a booster vaccine that debuted in September 2022 and attacked both the Omicron and original strains of SARS-CoV-2. Uptake of COVID-19 booster vaccines by Americans 65 and older has been poor, at less than 45%.
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Lalita Panicker is Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi
