A year later, Omicron is still causing spikes and concerns about COVID

A year after omicron launched its attack on humanity, the ever-revolving mutant coronavirus has led to a spike in COVID-19 cases in many places as Americans gather for Thanksgiving. It was a prelude to the wave that experts expect will soon hit the United States

Phoenix-area emergency physician Dr. Nicholas Vazquez said his hospital has seen an increasing number of chronically ill people and nursing home residents with severe cases of COVID-19 this month.

“It’s been quite a while since we’ve needed COVID wards,” he said. “It’s a clear comeback.”

Nationally, the number of new COVID cases averaged about 39,300 a day as of Tuesday — well below last winter, but much lower due to reduced testing and reporting. About 28,000 people with COVID were hospitalized every day, and about 340 died.

Cases and deaths rose from two weeks earlier. However, a fifth of the US population has not been vaccinated, most Americans have not received their latest boosters, and many have stopped wearing masks.

Meanwhile, the virus continues to find ways to avoid defeat.

The omicron variant arrived in the US just after Thanksgiving last year and caused the largest wave of cases of the pandemic. Since then, it has spawned a large extended family of subvariants, such as the most common in USA now: BQ.1, BQ.1.1 and BA.5. They pushed out competitors by improving immunity evasion from vaccines and previously experienced diseases – and making millions sick.

Kerry Johnson’s family has been hit twice. She contracted COVID-19 in January during the first wave of omicron, suffering from flu-like symptoms and excruciating pain that kept her awake for a week. Her son Fabian Swain, 16, suffered much milder symptoms in September when the BA.5 variant predominated.

Fabian recovered quickly, but Johnson had a headache for weeks. Other problems took longer.

“I was like, ‘I can’t pull myself together.’ I could not gather my thoughts. I couldn’t muster my energy,” said Johnson, 42, of Germantown, Maryland. “And so it went on for months.”

Hot spots occur

Some communities are particularly hard hit right now. Tracking by Mayo Clinic shows an upward trend in cases in states such as Florida, Arizona, Colorado and New Mexico.

In Navajo County, Arizona, the daily average number of cases is more than twice the state average. Dr. James McAuley said 25 to 50 people a day test positive for the coronavirus at the Indian Health Service, where he works. They used to see only a few cases daily.

McAuley, Clinical Director White River Indian Hospital, which serves the White Mountain Apache Tribe, said they are “basically back to where we were with our last big summit” in February.

COVID-19 is part of a a triple threat this also includes the flu and a virus known as RSV.

Dr. Vincent Hsu, who oversees infection control at AdventHealth, said the system’s pediatric hospital in Orlando is nearly full with children sick with the viruses. Dr. Greg Martin, past president of the Critical Care Society, sees a similar trend elsewhere.

Pediatric hospital emergency rooms and urgent care clinics are busier than ever, said Martin, who practices primarily at Grady Memorial Hospital in Atlanta. “This is a record compared to any month, any week, any day in the past,” he said.

Looking to the future, experts see the seeds of a broad American wave. They point to what’s happening internationally – the BA.5 surge in Japan, a combination of variants driving cases in South Korea, the beginning of a new wave in Norway.

Some experts say the American wave could start during the holidays, when people gather indoors. Trevor Bedford, a biologist and genetics expert at the Fred Hutchinson Cancer Research Center, said it could peak at about 150,000 new cases a day, about what the country saw in July.

The new wave will be serious, said Dr. Mark Griffiths, medical director of the emergency department at Children’s Hospital Atlanta-Spalding. “So many systems are on the brink of total overload that if we get another spike of COVID on top of that, it’s going to cause some systems to break down.”

One bright spot? The number of deaths is likely to be much lower than at the beginning of the pandemic. About 1 in 2,000 infections now results in death, compared with about 1 in 200 in the first half of 2020, Bedford said.

OMICRON ANNUAL REPORT

The same widespread immunity that reduced mortality also pushed the coronavirus to mutate. By the end of last year, many people had been infected, vaccinated, or both. This “created an initial niche for omicron to spread,” Bedford said, as the virus evolved significantly in its ability to evade existing immunity.

Omicron thrived. Mara Aspinall, who teaches biomedical diagnostics at Arizona State University, noted that the first omicron strain represented 7.5% of circulating variants by mid-December and 80% just two weeks later. At one point, the number of cases in the US soared to a million a day. Omicron generally caused less serious illness than previous variants, but the number of hospitalizations and deaths increased due to the huge number of people infected.

The giant wave slept until mid-April. The virus rapidly mutated into a series of sub-variants capable of evading immunity. A a recent study the journal Science Immunology says this ability to evade antibodies is due to more than 30 changes in the spike protein that coats the surface of the virus.

Bedford said Omicron has evolved so much in a year that it’s now a “meaningless term.”

This rapid mutation is likely to continue.

“There is a lot more pressure for the virus to diversify,” said Shishi Luo, head of infectious diseases at Helix, a company that supplies virus sequence information to the US Centers for Disease Control and Prevention.

Doctors say that the best protection against the subvariant bubble remains vaccination. And officials said the Americans have received a new combination booster targeting Omicron and the original coronavirus at the present time better than others protected against symptomatic infection.

Dr. Peter Hotez, co-director of the Vaccine Development Center at Texas Children’s Hospital, said getting a booster if you’re eligible is “the most effective thing you can do.”

Doctors are also urging people to continue testing, take preventive measures such as wearing masks in crowds, and stay home if they are sick.

“Covid is still a very significant threat, especially for the most vulnerable,” said Dr. Laolu Fayanju of Oak Street Health in Cleveland, who specializes in senior care. “People should continue to think of each other. We haven’t fully figured out this issue yet.”

___

Associated Press writer Heather Hollingsworth contributed from Mission, Kansas.

___

The Associated Press Department of Health and Science receives support from the Department of Science Education at the Howard Hughes Medical Institute. AP is solely responsible for all content.