US experts wonder if counting Covid cases is still the right approach | US News

Some US infectious disease experts and public health officials are questioning whether to continue to use the number of coronavirus cases as a measure to determine which mitigation efforts are appropriate, as data suggests the Omicron is less severe but much more contagious than the previous variants.

These experts argue that the United States has reached a stage in the pandemic where reports of dramatic increases in the number of cases raise unnecessary concern and that government officials and the public should instead examine death and hospitalization data when ‘they are considering precautions.

The number of cases “causes a lot of panic and fear, but they do not reflect what they were doing, which is that hospitalizations would follow cases,” said Dr Monica Gandhi, infectious disease specialist and professor of medicine at the University of California. , San Francisco.

However, other infectious disease experts say that while encouraged by data from South Africa showing that its recent Omicron wave has not been accompanied by a significant increase in deaths, the virus continues to weigh on hospitals in the United States, so the number of Covid cases remains a vital measure.

The United States had more than 580,000 new cases of Covid on Thursday, the second time this week that the country has broken its record for daily Covid cases, according to data from the New York Times. But in the past two weeks, as the number of Covid cases in the United States has increased by 181%, the number of hospitalizations has increased by 19% and the number of deaths has fallen by 5%.

“It appears to be less virulent for two reasons,” Gandhi said. “First, we seem to have so much more immunity in December 2021” than in previous waves, and “there are now five lab studies that show it doesn’t appear to infect the lungs very well.”

In reporting data on Covid, health services should now take the same approach as for influenza, Gandhi said. This means publishing the data on hospitalizations and deaths, but not the numbers regarding the number of cases because, like with the flu, it is not possible to eliminate the virus, so we should only focus on its severity. , she said.

“Once you accept that the virus is endemic, just like the flu, then you never follow cases because we never screen like that for other viruses, we follow what is causing the disease and hospitalize people. “Gandhi said.

Other countries are now implementing an approach that is not focused on the number of cases. For example, in Canada, which also saw a record number of Covid cases recently, Dr Robert Strang, Nova Scotia’s chief medical officer of health, said at a press conference on Thursday that the government agency would no longer focus on the daily count of cases.

“We no longer need to identify and have public health manage every case of variant because for most people this will result in relatively mild illness, so we need to focus our efforts and resources on our most vulnerable groups. vulnerable, ”Strang said. “Omicron is all around us and we have to recognize that you could be exposed anywhere… It’s about managing and slowing the spread, not eliminating it.”

The Philippine government also announced this week that it would stop posting case updates on social media, which was similar to an approach used by Singapore, according to Hawaii Public Radio.

But in the United States, there are areas of the country where hospitals remain overwhelmed, in large part due to unvaccinated patients with Covid. In Maryland, for example, which has seen a more than 500% increase in Covid cases and a 50% increase in hospitalizations, at least six hospitals have implemented crisis-mode care standards, according to the Baltimore Sun .

At Johns Hopkins Bayview Medical Center, which saw a 360% increase in the number of patients hospitalized with Covid in December, that means rescheduling elective surgeries and opening up additional space to treat Covid patients.

Justin Lessler, professor of epidemiology at the University of North Carolina, still sees the number of cases as a “strong leading indicator,” he said. “With Omicron, the surges are so great, even if they are on average … much less severe than the previous variants, the number of cases is such that the hospital systems will be overwhelmed and there are risks for individuals because it is so likely that you are infected. “

Mara Aspinall, professor of biomedical diagnostics at Arizona State University, also said data on the number of cases remains important because it is preventing the public from overreacting or overreacting to the pandemic.

“The challenge we’ve had all this time is finding that balance between keeping our physical health under control, but our mental health and the economy moving forward, and all of this with the best information” that we are able to. to do, Aspinall said.

For Gandhi, this balance lies in the fact that the health services track the number of cases internally and only alert the public about hospitalizations and deaths.

“The reason we have been following the cases is that we were hoping to be able to eliminate the virus, but it is not in the nature of the virus to eliminate it,” Gandhi said. “The country has not completely gotten to the idea that we cannot eliminate it.”

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