U.S. health experts are sounding the alarm that COVID-19 infections may rebound in coming weeks, spurred on by the BA.2 version of the omicron variant.
But Florida may be shielded from the worst of the next wave.
Health experts said the state’s winter omicron wave — unfettered by protective measures such as mask and social distancing mandates — could make it difficult for BA.2 to gain footing here because so many Floridians have already contracted the virus.
Florida is “in a better place now, but paid a heavy price for it,” said University of Washington epidemiologist Ali Mokdad. “I would rather be in a state with less infection and deaths.”
The state has seen nearly 6 million infections and 73,000 deaths in two years, which is the 16th highest per-capita death rate in the country.
The highly-contagious omicron BA.2 variant has emerged as the dominant COVID-19 strain in parts of Europe and Asia. It could soon drive up cases in some parts of the U.S., White House chief medical advisor Anthony Fauci said in a March 19 interview with NPR.
“I would not be surprised if in the next few weeks we see either a plateauing … of cases or even (the curve) rebounds and slightly goes up,” he said.
The U.S. should look to the U.K. as a warning, Fauci said, where cases have increased by more than 230 percent in the past four weeks.
U.K. cases began rising again in late February, just days after British Prime Minister Boris Johnson announced the end of England’s remaining COVID-19 restrictions in an effort to move “back towards normality.” At the same time, the BA.2 variant quickly spread to become the U.K.’s dominant COVID-19 strain.
That matters for the U.S. because its pandemic curve tends to follow the U.K. by a few weeks, Fauci said. Parts of the U.S. relaxed COVID-19 restrictions weeks ago, which along with waning immunity, puts many Americans at risk of reinfection.
But some experts, including Mokdad, don’t think the U.S. will see the same spike in cases seen elsewhere in the world.
“What we’re seeing in the U.K. is mostly a change in behavior and waning immunity,” Mokdad said. “But in the U.S. and especially in Florida, (safety protocols) ended long ago.”
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The latest strain is spreading
The BA.2 subvariant first arrived in the U.S. in January but has spread rapidly in recent weeks, pushing aside the earlier version of the omicron variant that swept the country last winter.
Nationally, 35 percent of new COVID-19 infections last week were the BA.2 strain, according to analysis from the Centers for Disease Control and Prevention. That’s up from just 13 percent two week earlier.
The BA.2 variant is about 30 percent more infectious than the original omicron strain, but early studies indicate that it doesn’t cause more severe illness. It’s already the dominant strain in the Northeast, accounting for more than half of infections in New York and New England last week.
But the strain isn’t spreading as quickly in southern states, many of which were hit hardest during the winter omicron wave. BA.2 accounted for 20 percent of last week’s cases in the southeastern region — which includes Florida — up from 7 percent two weeks earlier.
Studies suggest that a prior omicron infection helps defend against BA.2, which means Florida could be spared from a delta or omicron-like wave in the next few months, said University of Florida immunologist Michael Teng.
“I’m a little less worried than I would be otherwise,” he said, “because of all the infections that we just went through.”
Florida officials reported more than 2.1 million COVID-19 cases since the omicron variant was first detected in the state on Dec. 7. Omicron spread so fast that it accounts for more than a third of total cases during the 2-year pandemic. The true number of infections is likely much higher because of gaps in testing and accounting for infections.
By the time the omicron wave subsided last month, more than 73 percent of Florida residents had some sort of immunity to omicron, whether through vaccination or previous infection.
States like Arizona and Washington, which saw milder omicron waves or were slower to roll back restrictions, may see a bump in infections, Mokdad said. But no one state should expect a wave like the one Florida saw this past winter, he said.
No sign of danger — yet
Florida reported just over 8,000 cases last week, according to CDC data. It’s the fewest weekly recorded cases since the state’s first wave started in June 2020.
But that may be an undercount. Florida reported 60 percent fewer tests last week compared to the peak of the omicron wave in early January.
Last week Hillsborough officials shuttered the county’s last public testing site, making it harder to get tested in Tampa Bay’s largest county. And while the shortage of home antigen tests appears to be over, those positive results are not reported to the state, so they’re not included in the positivity rate.
Experts worry that Floridians will have a harder time gauging their risk of infection than ever before.
Earlier this month state officials decided to release COVID-19 data every two weeks instead of weekly, increasing the time it takes for the public to learn about rising infections.
Under the CDC’s new color-coded system, Tampa Bay and most of the nation are labeled green, indicating a low level of risk. But those guidelines measure the risk of overwhelming local hospital systems — not the risk of infection.
There are other indicators that don’t rely on reported test results, but they have their own drawbacks, experts said.
Researchers can also look for the coronavirus in sewage to estimate the trend in infections, but the tool is underutilized and difficult to interpret. Only two cities in the bay area, St. Petersburg and Clearwater, perform wastewater analysis.
Traces of the coronavirus are present at both locations, and the St. Petersburg treatment site found a substantial uptick in virus particles in recent weeks, according to data collected by the CDC. But experts are wary of making concrete conclusions based on wastewater data alone.
Florida Department of Health Spokesperson Jeremy Redfern said the state’s epidemiologists “don’t really know what to make of it” because there is no standardized methodology for wastewater analysis and the method is too new to understand what changes are meaningful.
Regardless of whether the state sees a serious rise in cases, many Floridians remain at risk of infection.
“The state is basically restriction-free in terms of masking and distancing,” Teng said. “So if cases do start going up, that will be concerning for the elderly and people with comorbidities who are still vulnerable to severe COVID.”
More than 5 million residents are unvaccinated, including 1.2 million children under 5 who are not yet eligible.
Another vulnerability is waning immunity. Those with prior infection won’t stay immune for long and those who have been vaccinated could see their immunity slip after six months. Booster shots would help them, but nearly 60 percent of Floridians who are due for a booster haven’t gotten one.
State leaders have repeatedly vowed not to reinstate any COVID-19 precautions and have no plans to promote vaccination or boosters in the future.
”Our stance is essentially that they’re available if you want one,” Redfern said.
Editor’s note: This analysis relies on Florida’s daily COVID-19 case, vaccination and death data reported by the Centers for Disease Control and Prevention. The Tampa Bay Times had relied on data provided by the Florida Department of Health for previous stories. But on March 11 the state announced it would release COVID-19 data every two weeks, which means there will be times when the data is no longer current enough for the Times to use in its reporting. While the state reports the same data to the CDC, there is a lag time when the CDC posts it and discrepancies because the CDC counts Florida residents who tested positive outside the state.
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How to get tested
Tampa Bay: The Times can help you find the free, public COVID-19 testing sites in Citrus, Hernando, Hillsborough, Manatee, Pasco, Pinellas, Polk and Sarasota counties.
Florida: The Department of Health has a website that lists testing sites in the state. Some information may be out of date.
The U.S.: The Department of Health and Human Services has a website that can help you find a testing site.
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How to get vaccinated
The COVID-19 vaccine for ages 5 and up and booster shots for eligible recipients are being administered at doctors’ offices, clinics, pharmacies, grocery stores and public vaccination sites. Many allow appointments to be booked online. Here’s how to find a site near you:
Find a site: Visit vaccines.gov to find vaccination sites in your ZIP code.
More help: Call the National COVID-19 Vaccination Assistance Hotline.
Phone: 800-232-0233. Help is available in English, Spanish and other languages.
Disability Information and Access Line: Call 888-677-1199 or email DIAL@n4a.org.
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More coronavirus coverage
OMICRON VARIANT: Omicron changed what we know about COVID. Here’s the latest on how the infectious COVID-19 variant affects masks, vaccines, boosters and quarantining.
KIDS AND VACCINES: Got questions about vaccinating your kid? Here are some answers.
BOOSTER SHOTS: Confused about which COVID booster to get? This guide will help.
BOOSTER QUESTIONS: Are there side effects? Why do I need it? Here’s the answers to your questions.
PROTECTING SENIORS: Here’s how seniors can stay safe from the virus.
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