As Europe faces a new surge of Covid-19 cases, U.S. health officials are discussing how to handle another potential surge in the United States—considering reinstating indoor mask mandates and recommending another booster dose.

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Will the US soon see another Covid-19 surge?

Currently, Covid-19 cases in several European countries are once again rising, and many health experts believe a new surge in the region may now be underway.

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According to data from Johns Hopkins University, several countries have seen double-digit percentage increases in their weekly Covid-19 case numbers. For example, Finland saw its weekly Covid-19 case numbers increase 84% to 62,500, while the United Kingdom saw a 31% increase over the past week to 414,480 cases. Other countries that saw significant increases in new cases include Switzerland, France, Germany, and Italy.

In addition, data from Our World in Data indicates that Covid-19 hospitalizations are also increasing in several European countries, including Ireland, the United Kingdom, and the Netherlands.

According to Eric Topol, founder and director of the Scripps Research Translational Institute, several factors are likely driving this uptick in European cases, including relaxed Covid-19 restrictions, the spread of omicron subvariant BA.2, and waning vaccine protection.

Many of these factors are also present in the United States, leading health officials to voice concerns about whether the country could see another potential surge in the coming weeks.

"We have all three of those factors right now in this country," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "I would predict that we are going to see a bit of an increase, or at least a flattening out and plateauing of the diminution of cases. And the question is how do we deal with that."

Fauci added, "We'd better be careful, because history has taught us that what's gone on in the U.K. generally happens to use three or four weeks later."

However, it's possible that the total number of Covid-19 cases could rise in the United States, while severe cases remain low. A study published last week found that vaccinated individuals infected with omicron still had high antibody levels that would likely protect against BA.2—meaning if that protection remains, it could blunt the impact of a surge.

Fauci also noted that Covid-19 cases are rising in the U.K., but "their intensive care bed usage is not going up, which means they're not seeing a blip up of severe disease."

Federal officials debate new restrictions, booster shots ahead of a potential surge

According to Politico, federal health officials are keeping a close eye on the situation in Europe, including information on the prevalence of the omicron subvariant and how hospitals are handling the influx of patients, to predict how a similar wave could impact Americans.

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Recently, officials from the White House Covid-19 task force and CDC met to plan how the administration will respond if cases begin to surge in the United States again. Some discussed possibilities include recommending communities reinstate indoor mask mandates and ensuring hospitals have enough capacity for a potential spike in patients.

In addition, officials are debating whether and when a fourth Covid-19 vaccination would be needed. Currently, both Pfizer-BioNTech and Moderna have requested FDA authorize a second booster dose of their Covid-19 vaccines, although Pfizer-BioNTech's request is currently limited to adults ages 65 and older and Moderna's request applies to all adults.

However, the administration's response to a potential new surge may be hindered by a lack of Covid-19 funding. Previously, the Biden administration had requested $22.5 billion in Covid-19 funding as part of a broad government spending bill, but the funding was ultimately removed before the bill was passed.

According to administration officials, state allocations of monoclonal antibodies will be reduced by 30% starting next week, and no new orders, including one planned for March 25, will be made without new funding. The government will also be unable to purchase more oral antiviral pills, such as Pfizer's Paxlovid, as well as more vaccine doses. Testing capacity and a program to pay for testing and treatment for uninsured individuals will also be negatively affected by a lack of funding. 

"People who do get sick, to lose monoclonal antibodies, that testing plan ... there's a long list of stuff that would really help combat this imminent BA.2-related wave and then the next one," Topol said. "Nobody wants these waves. But we have to face the music and the music isn't pretty."

"There are so many things we could be doing, yet the United States has time and time again chosen to be reactive, rather than proactive, and that has cost us dearly," said Anne Rimoin, an epidemiologist at the University of California, Los Angeles. "We've been wearing rose-colored glasses instead of correcting our vision."

"[A lack of pandemic funding] really will be a very serious situation," Fauci said. "It just is almost unconscionable."

Surgeon General Vivek Murthy on Sunday said the past two years have shown that "when cases increase in one part of the world, that often leads to increases in other parts of the world." However, Murthy said the United States needs to focus on "preparation, not on panic."

"We're in that mile 18 of a marathon," he said. "We can't quit, because Covid's not quitting." (Banco et al., Politico, 3/17; Carbajal, Becker's Hospital Review, 3/17; Doherty, Axios, 3/18; Mueller, New York Times, 3/19; Shapero, Axios, 3/20; Jewett, New York Times, 3/20)