President Joe Biden extended President Donald Trump’s declaration of a state of emergency on February 18, 2020, as reported by CNet.
A significant risk
A statement from the White House said, “the COVID-19 pandemic continues to cause significant risk to the public health and safety of the nation.”
Advances against SARS-CoV-2, the virus that causes COVID-19, have come relatively rapidly: By the end of 2021, multiple effective vaccines were approved and Pfizer received FDA authorization for its COVID antiviral drug Paxlovid, which the pharmaceutical giant says could cut the risk of hospitalization or death by up to 89%.
But, nearly two years on, as the US closes in on a million deaths from COVID-19 — and tens of millions more infections and hospitalizations — scientists are still struggling to understand these major aspects of the disease.
1. How many COVID-19 booster shots will we need?
With vaccines’ protection waning over time and the continuing evolution of variants, health experts expect more booster shots will become the norm.
In a Feb. 16 press briefing, White House Chief Medical Adviser Dr Anthony Fauci said, “The potential future requirement for an additional boost — or the fourth shot for mRNA or third shot for Johnson & Johnson — is being very carefully monitored in real-time.”
The CDC has updated its guidance to indicate that some immunocompromised people can get a fourth COVID-19 shot now, while Israel, Germany and other nations are researching the efficacy of a fourth shot for the general population.
Moderna President Stephen Hoge said we will most likely need seasonal COVID-19 boosters, much like we do with the flu, at least to protect those at the highest risk of infection and serious illness.
2. How long does immunity from vaccines last?
The first COVID-19 vaccines went into people’s arms in the US in December 2020.
While researchers have been studying mRNA vaccines “for decades,” according to the CDC, this marked the first time they’ve been made available to the public.
“We are definitely still figuring that out,” Gronvall said.
During the omicron variant wave, protection from hospitalization fell from 91% within two months of an mRNA booster to 78% after four months.
According to the World Health Organization, the Pfizer and Moderna vaccines are far less effective in preventing infection by the omicron strain than earlier COVID-19 variants.
“It’s not a worst-case scenario, where the vaccines are ineffective,” Gronvall said.
3. Will there be more variants that are dangerous, like delta and omicron?
Sometimes these mutations emerge quickly and disappear, and other times, they persist and create spikes in the rate of infection and disease.
By February, the new variant’s surge declined, but an even more contagious subvariant — known as omicron BA.2 — has been identified.
It appears to spread about 30% more easily than the original.
While can they map and identify variants, they need time to see how dangerous a new strain is as they gather data on hospitalizations and deaths.
Omicron may be less severe than delta, which doubled the hospitalization rate of the original alpha strain but is also far more contagious.
“We’re still not great at looking at new variants and projecting what that means in the real world,” Gronvall said.
4. Why does COVID-19 make some people seriously ill, including with long COVID?
We know the virus can cause symptoms ranging from headaches, chills and fever to disorientation, nausea and vomiting — and even loss of taste or smell.
Scientists are also trying to understand “long COVID” — a range of symptoms that can begin weeks or even months after a patient is first infected.
But even now, the condition’s cause is not clearly known.
“After two years, we don’t understand much about long COVID, and don’t know its prevalence with omicron after vaccination,” Bob Wachter, the chair of the department of medicine at the University of California, San Francisco, tweeted Wednesday.
“We just haven’t had enough time to tell.”
5. Where did COVID-19 come from?
Experts are still not certain how COVID-19 emerged.
The prevailing theory is that it leapt from an animal to a human.
While there has been no solid evidence for this, former President Donald Trump and his supporters pushed the lab-origin theory through 2020.
“People are looking to blame [someone],” Gronvall said.
However, she said, “certainly the Chinese have been lying” about at least one other thing: Government officials originally claimed that there were no contraband animals present at the market, she said, but researchers looking for a separate tick-borne disease photographed many illegal animals there, “stuffed together in close quarters, in poor health and stress conditions, in the months before cases were identified.”
For more, here’s what we know about the omicron variant, what we know about treating long COVID and whether you can still be considered “fully vaccinated” without a booster shot.
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