COVID still lurks; keep your guard up

Published on Monday, July 18, 2022

By: Ruth Cummins

The newest Omicron variant of COVID-19 that has swept Mississippi and the nation isn’t playing around – and is so highly infectious that those who’ve already had the virus, immunizations and boosters are still at great risk of contracting it.

“We’ve entered a new phase of the pandemic, and we know more about the virus than ever before. From what we know, the Omicron variant BA.5 is predominant and extremely transmissible. It escapes immunity,” said Dr. Bhagyashri Navalkele, associate professor and medical director of infectious diseases at the University of Mississippi Medical Center.

“If you are exposed, you are certain to get it. That’s why the case numbers in Mississippi are so high.”

Because case numbers are significantly up, so are hospitalizations and the chance of those infected getting much sicker than just experiencing symptoms of the common cold or mild flu.

“We’ve seen people who got infected in January, and then got infected last month because there were different variants in January than now,” Navalkele said. “You can get Omicron BA.1 and then still be at risk for catching the BA.5 variant.”

“Unless you take precautions, you are probably going to get the virus. When we see rises in hospitalizations, we are also seeing cases where patients require oxygen and have severe infections. This is mostly in those who didn’t follow vaccine recommendations or didn’t get their booster, or who have health issues or are immunocompromised.”

The newest variant “has only come down South in the last couple of weeks,” Navalkele said. “The case numbers aren’t doing complete justice to what is actually going on in the community. A lot of people aren’t getting tested, and a lot of people are taking home antigen tests. We are probably having many, many more cases in the community than are being reported.”

She suggests the public take steps that include:

• Resume precautions including masking indoors and while traveling, meticulous hand-washing and avoiding crowds to lessen your chances of infection. Get vaccinated and boosted. All Americans ages six months or older can get a COVID vaccine, and those 5 and older can get a booster to provide an additional layer of defense against severe illness and death.

Vaccines are used to prevent severe disease, hospitalizations and deaths, but they don’t protect you from exposure or developing the virus.

Should you wait to get boosted until a new vaccine targeting Omicron variants is available?

“Definitely get boosted now,” Navalkele said. “Omicron-specific vaccine is still in the making and might be available by fall, but it’s difficult to say what the situation will be at that time, and if Omicron or some other variant will be dominant then.”

The rise in case counts from people traveling and congregating during the long Fourth of July weekend hasn’t fully come down the pike, she said. “When the case numbers go up in the next three to four weeks, we will continue to see hospitalizations go up as well.

“We’re seeing people who are getting the virus for a second and third time because of the different variants,” Navalkele said. “If you get infected multiple times, or even one time, you are still at risk of developing long COVID. Getting infected causes you to lose time away from work and your routine activities, and you are putting everyone at home and work at risk. This can be children, grandparents. That’s what’s happening right now, in almost every household.”

• If you become infected, quickly determine if you’re eligible to take oral antivirals or monoclonal antibody infusions to significantly lessen your chance of severe illness, hospitalization or death.

Oral antiviral therapies, which can be prescribed by providers include Paxlovid and Molnupiravir. Pharmacists can prescribe Paxlovid, but not Molnupiravir. Navalkele recommends talking to your health care provider if you test positive to see whether an oral antiviral is the right option for you.

“Usually those eligible are the high risk population, but a lot of the time, people might not be aware they meet the eligibility. If you are mildly obese, for example, you can qualify,” she said.

Also available are monoclonal antibodies that fight particular infections such as Evusheld, used for prevention of severe infection in those with weakened immune systems, such as cancer or transplant patients. The FDA has limited use of certain monoclonal antibodies to treat the Omicron variants.

Evusheld is recommended only for prevention, and not for use in patients who have an active infection. Bebtelovimab, another monoclonal antibody, is used in treatment of patients who have tested positive.

“At UMMC, we have plenty of doses of the antiviral medications, and you can receive monoclonal antibodies in our Emergency Department,” Navalkele said.

The Centers for Disease Control and Prevention reported Monday that Mississippi recorded 11,259 new cases in the last seven days, or an average 378.3 cases per 100,000 population over that same time period. That’s the highest daily case average per 100,000 population in the nation, for any state, during that time period.

The CDC also reported Monday that the national daily average for new cases is 126,023, with overall cases for the pandemic standing at 89,067,445. The CDC said the seven-day national case rate per 100,000 people is 265.7 – substantially lower than Mississippi’s count.

The total cases do not reflect the true COVID count because so many people use home tests and don’t report the results to local health officials.

Most recent MSDH hospitalization data show that on July 11 there were 338 confirmed cases, 11 suspected cases, 36 patients in ICUs and eight on a ventilator. For July 5, it was 270 confirmed, 36 suspected, 45 in an ICU and 10 on ventilators.

Navalkele has a message for those who are setting precautions aside and are satisfied with “learning to live with” a pandemic.

“This is not the time to put our guards down. Putting yourself at risk of getting exposed and getting the infection is not worth it,” she said. “Even if you get infected, tomorrow, you will still be at risk for exposure, and we know that this variant escapes the immune response from a vaccine.

“I understand that it’s been two and a half years. It’s extremely frustrating. But, COVID hasn’t gone anywhere. We need to do the right thing. We can still enjoy activities. Just do it safely.”