If the COVID Threat Grows Again, How Prepared Are We?

Jan. 18, 2024 – We’ve been done this before. A caller COVID-19 version emerges location successful nan world, grows successful strength, and comes to dominate, bringing pinch it an summation successful hospitalizations and deaths. 

It’s happening now. But truthful far, nan JN.1 variant, while causing a spike successful cases and worse outcomes, isn’t expected to beryllium nan sky-is-falling-variant galore person worried about. 

But what if nan adjacent 1 is? Will we beryllium prepared?

What keeps experts up astatine nighttime is nan anticipation of thing we haven’t seen yet. 

A version that emerges pinch small notice, 1 that gets astir each our immune defenses, could america group backmost to time one. That intends facing a microorganism without an effective vaccine aliases tailored antiviral curen again. It’s difficult to foretell really apt this threat is, but nan consequence is not zero. 

On nan positive side, nan microorganism cannot “learn,” but we humans can. We’ve sewage vaccine exertion now that is basal for responding to caller COVID variants much quickly. In nan past, creating a vaccine, ramping up production, and distributing it could return 6 months aliases much – arsenic it still does pinch nan flu vaccine each year. The mRNA vaccine technology, however, tin beryllium updated astatine little costs and deployed overmuch faster, starring experts to mention to them as “plug and play” vaccines.

“We are a batch for further up pinch nan mRNA exertion and nan measurement those vaccines are made. That makes it really easy to accommodate to caller variants reasonably quickly,” said Kawsar Rasmy Talaat, MD, an infectious illness and world wellness master astatine Johns Hopkins University successful Baltimore. 

“Those are awesome things,” Talaat said. “We person nan devices disposable to mitigate nan wellness impacts and prevention lives.”

JN.1 Has nan Lead

At nan moment, we’re successful a surge. The JN.1 variant now accounts for much than 60% of circulating microorganism successful nan United States. As of Jan. 6, compared to nan erstwhile weeks, hospitalizations were up 3% and deaths were up much than 14% in CDC data.

So far, while JN.1 has caused a spike successful immoderate COVID data, nan CDC remains assured it does not coming a higher consequence to nationalist health. Yes, it has proven tin of evading immunity, but it does not look to make america sicker than different variants.

When it comes to COVID variants, we’ve already been done respective variations – from mini ones that don’t alteration overmuch to variants that toggle shape into family names – for illustration Delta and Omicron. 

Millions to Drive Next-Generation Vaccines

Ideally, COVID vaccines could do more, Talaat said. Current vaccines activity good successful reducing nan consequence of terrible illness, hospitalization, and death. However, they are not arsenic effective astatine preventing transmission and caller infections. “And nan immunity to nan vaccine doesn't past astir arsenic agelong arsenic we thought it was going to.” So a longer-lasting vaccine that prevents COVID from spreading from personification to personification would beryllium optimal. Through emergency usage authorizations and different regulatory flexibility, nan FDA “has shown accrued nimbleness” successful responding to erstwhile changes to COVID variants, Talaat said.

Speaking of nan feds, nan Department of Health and Human Services is spending $500 cardinal connected 11 promising next-generation COVID vaccines, portion of an wide $1.4 cardinal committedness to objective tests and different initiatives designed to amended hole america for nan future. 

The processing technologies could beryllium bully news for group who debar needles and syringes arsenic overmuch arsenic possible. Strategies successful improvement see a nasal spray, a micro-array tegument patch, and self-amplifying mRNA (basically, a measurement to summation mRNA instructions to nan immune strategy without nan request to get into compartment nuclei) to present COVID vaccines successful full caller ways.  

These caller formulations are successful nan early stages, truthful it could beryllium respective years earlier they summation FDA clearance for wide use.

Accelerating this investigation is nan government’s public-private Project NextGen, dedicated to “enhancing our preparedness for COVID-19 strains and variants." In October 2023, nan HHS, nan National Institute of Allergy and Infectious Diseases, and nan Biomedical Advanced Research and Development Authority (BARDA) announced the most promising caller vaccine technologies to person first backing arsenic portion of this project. 

Ensuring that early vaccines are developed quickly astatine little cost, that they activity better, and that they are accessible to each Americans are further task goals. 

It Could Take a Village

As perchance promising arsenic these caller technologies could beryllium for staying astatine slightest 1 measurement up of immoderate threatening early COVID variant, location is different hurdle to overcome: nationalist acceptance. 

Unlike nan original vaccine bid that astir 80% of U.S. adults received, nan astir caller updated vaccine bid has stumbled. Regarding uptake of nan caller boosters, for kids, it's nether 10%. For adults, it's hardly better, and moreover among nan elderly, it's only astir one-third,” said Daniel Salmon, PhD, MPH, a vaccinologist astatine Johns Hopkins Bloomberg School of Public Health.

As of Dec. 30, 2023, 19.4% of American adults, 8% of children, and 38% of adults 75 aliases older received an updated 2023-24 COVID booster immunization.

“It's a problem because nan vaccine has benefit. I think it's complacency ... that is astir apt nan correct connection for it,” Salmon said. The benefits of vaccination outweigh nan risks, “so group would do good to get vaccinated.”

Asked if we don’t person amended herd immunity astatine this point, Salmon said, “Herd immunity does not activity arsenic good pinch COVID.” In contrast, it does activity good pinch measles, wherever astir 97% of group are vaccinated and wherever protection remains agelong lasting. “But successful nan lawsuit of COVID, some from nan illness and from nan vaccine, nan immunity goes down complete time.”

“While nan acute situation of nan COVID-19 pandemic appears to beryllium down us, SARS-CoV-2 continues to evolve,” Robert Johnson, PhD, head of Project NextGen, said successful a video statement. The vaccines are still effective astatine preventing superior illness and death, and effective antiviral treatments stay available.

However, “the American group request vaccines that not only protect against existent strains but immoderate caller version that comes our way.”