Signs of the Times

Credit CDC

#17,637

While we wait to see just how much of an impact the newly emerged and heavily mutated BA.2.86 COVID variant could have this fall and winter (see CDC Initial Risk Assessment On COVID BA.2.86), we are already seeing a significant increase in COVID cases, hospitalizations, and deaths across the country.

Based on very limited surveillance (see map below), it appears likely that this increase is due to a mix of older variants, like EG.5 and a plethora of XBB sub-variants. It should be noted, however, that during the month of August, surveillance reports from most of the country have gone absent. 

Global surveillance (see WHO chart below) is similarly sparse, with some regions (like the Western Pacific & Eastern Mediterranean) reporting large increase in cases, while the WHO has not received an update from the Americas in nearly a month (Aug 6th).  

Despite repeated pleas (see WHO: Standing Recommendations for COVID-19 In Accordance With IHR (2005), 90% of the world's nations no longer regularly report COVID cases, hospitalizations, or deaths to the World Health Organization.  

But even in those countries that still do report, surveillance and testing has been massively scaled back. In many ways, we are Flying Blind In a Viral Storm. 

This policy of don't test, don't tell may have some short term political or economic advantages, but it only works if the virus is truly on the wane.  Unfortunately, COVID continues to exceed expectations.  

We may get lucky, and this current COVID surge may fizzle.  BA.2.86 may not turn out to be the next big threat.  And as long as we're wishing, bird flu may falter as well.  

But viral evolution isn't going to stop just because we've grown tired of dealing with a threat. BA.2.86 shows that even after nearly 4 years, big changes can still occur with COVID. 

Just as H5N1's recent global surge, and penchant for infecting mammals, is proof that after 20+ years, avian flu can still learn new tricks. The same can be said for the international spread of Mpox, Zika, and CHKV.

We live in a threat rich environment, that seems to be offering up new threats at an increasing rate.

Yet somehow the world has decided the best way forward is to declare victory, scale back surveillance and reporting, and hope for the best. 

But at least, when the next global crisis does inevitably arrive, they can say `No one saw it coming'.