Covid-19 cases in many parts of the world have been surging, suggesting that another Covid-19 wave may be on the way in the United States. But experts say high vaccination and prior infection rates, along with many available therapeutics, mean the next wave might not be as severe as previous ones.

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What the next Covid-19 wave might look like in the US

While cases have been rising in different areas of the world, many of those areas are not seeing significantly more severe cases of Covid-19. For example, in the United Kingdom, hospitalization rates and ICU admissions per Covid-19 case remain low, and according to U.K. Health Secretary Sajid Javid, 60% of people in the hospital with Covid-19 were not hospitalized because of Covid-19.

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Similarly, deaths per million in New Zealand, a country with strong vaccine coverage, are fairly low. But countries like China, which used a less effective vaccine and where only a small portion of its population has been boosted, are seeing death rates increase.

While early research has shown that omicron subvariant BA.2 is around 30% more contagious than the original BA.1 omicron variant, BA.2 doesn't cause more severe disease than BA.1.

Research has also found that BA.2 isn't especially different from BA.1 in its ability to escape immunity from vaccines or prior infection. One study published in the New England Journal of Medicine, found that those with booster shots had antibodies that were equally effective against BA.1 as they were against BA.2. And a preprint study from Denmark found just 47 cases of BA.2 reinfection following infection with BA.1, out of more than 1.8 million Covid-19 cases.

In addition, the European wave appears to be short-lived. According to Eric Topol, founder and director of the Scripps Research Translational Institute, Our World in Data indicates that many countries that have been experiencing a Covid-19 surge over the past few weeks are already seeing a drop in daily new cases.

The BA.2 wave in Western Europe is just starting to turn around ~ 3 weeks in, while there is no sign of increase in cases to date in the US. It's surprising, not easily explained, but gratifying to see —and hope it holds up pic.twitter.com/FYRWPCaNSd

— Eric Topol (@EricTopol) March 22, 2022

Experts say that, given the high rate of vaccination in the United States and the number of people who were infected during the first omicron wave, a surge driven by BA.2 may not be as severe as previous waves.

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According to the Institute for Health Metrics and Evaluation, as many as 80% of Americans have some level of immunity that will protect them against another omicron wave. Given that level of immunity, fewer people are likely to be hospitalized with Covid-19, even if there is a rise in Covid-19 cases, Vox reports.

There are also a number of therapeutics available to those with Covid-19, including monoclonal antibodies and antiviral medications.

The tools to fight Covid-19 are available, it's just a matter of whether Americans will use them, Joshua Sharfstein, a professor at Johns Hopkins University's Bloomberg School of Public Health, said. "The fundamental question [is], can we be nimble and flexible to the facts of the pandemic?" he said.

Potential roadblocks

If another surge of Covid-19 cases occurs in the United States, Covid-19 restrictions may be reimplemented, but the level of pandemic fatigue could be a roadblock, according to Panagis Galiatsatos, a physician and professor at the Johns Hopkins School of Medicine.

If health leaders ask the public to stop gathering in large groups again, Galiatsatos said he's concerned the public may lose faith in health leaders. "I think we're going to lose our audience," he said. "So I think what's different now is definitely the fatigue is there."

That's why public health authorities and scientists should change their messaging in the next wave, Galiatsatos said. "If it's not going to be public messaging, let's do private messaging," he said, which would include compassionate listening by experts and officials.

"People aren't switches to turn off and on," he added. "We're not going to be ignorant of the next wave, but we're definitely going to discuss it in a way, like, 'How do you make it adaptable?'"

Funding for Covid-19 therapies could also be a problem in the next wave. Congress recently removed coronavirus funding from its budget bill, Bloomberg/Washington Post reports, meaning there could be fewer treatments and less testing.

"Without funding, the United States will not have enough additional boosters or variant specific vaccines, if needed, for all Americans," the White House said in a statement. "The federal government is unable to purchase additional life-saving monoclonal antibody treatments and will run out of supply to send to states as soon as late May."

"Not all of the policymakers have learned their lesson," said Dial Hewlett, an infectious disease physician and deputy commissioner of the Westchester County health department in New York. Without enough money put towards research, public health infrastructure, and regulatory agency staff, "[w]e may be doomed to repeat history," Hewlett said. (Raphael/Fazeli, Bloomberg/Washington Post, 3/22; Landman, Vox, 3/21; Wen, Washington Post, 3/21)