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COVID-19

Mayo expert: refusal to vaccinate, mask 'pouring gasoline on a forest fire'

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Omicron has hit hard in the U.S. in tandem with the continued circulation of the delta variant, leading the nation to confirm over a million COVID cases in a single day earlier this week.

Dr. Gregory Poland

Dr. Gregory Poland

Infectious disease and vaccination expert Dr. Gregory Poland of Mayo Clinic says the spike was predicted, and cases are “doubling every day or two or three. ... this is an exponential surge.” While omicron may be less likely to lead to hospitalization, COVID inpatients are still up nationwide, with some cities seeing a fivefold increase in youth hospitalizations.

“Over the past week we’ve reached the highest peak ever for children (with COVID) — about 325,000 new COVID infections last week,” Poland says. “It’s not surprising given the tremendous infectious ability of omicron, and the relatively low vaccination rates in the pediatric population.”

Higher hospitalizations among youth may be attributed to omicron’s tendency “to be more in the upper airways,” Poland says. “That equates to decreased morbidity in adults, who tend to have larger upper airwaves, but is a decided negative in young kids who have narrow upper air waves.”

The transmissibility rate of omicron is over three times higher that of strains like delta, according to early research, though vaccinated individuals shed the virus during a shorter period of time. Statewide, omicron accounts for one third of sequenced infections over the last 30 days, per the Wisconsin State Laboratory of Hygiene. Poland says there is no “prognostic information” on whether an omicron peak will signal a move towards an endemic.

“It’s conditioned on are we going to see —as we have five times in two years now — an omicron derivative variant that will evade immunity? What the virus wants to do is invade immunity,” Poland says.

If a significant portion of the population remains unvaccinated and non-compliant with precautions, Poland warns, strains will continue to develop.

“As long as we have this many people unvaccinated, as long as we don’t have (everyone) masking, this will continue in one iteration or another,” Poland says. “All of your great-great-great-grandchildren will be immunized against the coronavirus, just as if you had the flu vaccine this year you were immunized against an influenza variant that first showed up in the 1918 influenza pandemic, and we have not been able to stop immunizing against it since.”

It is likely, Poland says, that the COVID vaccine and flu vaccine will be given in tandem on a yearly basis, with formulas adjusted each season to match the strains circulating. As with the flu vaccine, the COVID vaccines are not 100% effective in preventing infection. However, the Pfizer, Moderna and Johnson and Johnson shots all offer increased protection, dramatically so when it comes to preventing hospitalization and death.

“If you have a normal immune system, the ability of these vaccines to block disease is almost unprecedented,” Poland says. “It’s ability to block infection is still high but much lower than its ability to block disease. You basically convert what could have been a serious lethal case into an asymptomatic, mild or at worse moderate case. That is the value of the vaccine.”

Because protection from the vaccine declines over time, a third dose of Pfizer or Moderna or second after Johnson and Johnson is urged.

“By boosting we can increase that level of antibody and prolong the time period before one potentially becomes more susceptible,” Poland says. “You are getting that booster not only to prevent waning but to get back up to a level that is equally neutralizing against omicron as it was against delta.”

Whether a fourth dose of Moderna or Pfizer will be needed at some point is unclear.

“There is one piece of data and that is a very early preliminary report from Israel, which is doing fourth doses, and they’ve demonstrated a substantial increase in antibody level after a fourth dose,” Poland says. But stateside, he predicts a more “personalized approach,” with a fourth shot possible for select individuals at high risk due to age, medical conditions or other factors.

Poland’s overarching message is to be inoculated and adhere to prevention tactics, even if you are tired of donning a face covering and limiting socialization. Refusal to vaccinate and mask, he says, is “pouring gasoline on a forest fire.”

“The consequences of this virus — there is emerging evidence for some potential of chronic infection and this might be driving long COVID. What kind of long term organ damage will go undetected (until later)?” Poland queries. “There are consequences that will reverberate for decades.”

The Centers for Disease Control and Prevention released new guidelines for preventing the spread of COVID-19 on Monday, Dec. 27, 2021.

Emily Pyrek can be reached at emily.pyrek@lee.net.

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