Two years after Covid was first confirmed in the US, the pandemic is worse than anyone could have imagined

A 35-year-old man returned to the US from Wuhan, China on January 15, 2020, and developed a cough and fever.

He read the Centers for Disease Control and Prevention’s warning about the novel coronavirus outbreak in Wuhan and four days later sought medical attention at an emergency clinic in Snohomish County, Washington..

On January 21, the CDC publicly confirmed that it had the first known case of the coronavirus in the US, although the agency later found that the virus Arrived on the West Coast in December after testing blood samples for antibodies.

The man said he had didn’t spend time at Huanan Seafood Market in Wuhan, where a cluster of early cases was identified in December. He was placed in isolation at Providence Regional Medical Center in Everett, Washington for observation..

After confirming the case in Washington State, the CDC told the public that it believed the risk “currently remains low.” The CDC said there is growing evidence of person-to-person transmission of the virus, but “it is not clear how easily this virus spreads between people.”

President Donald Trump then told CNBC that the US was “totally in control.”

“This is one person who arrived from China. We have everything under control. Everything will be fine,” Trump told Squawk Box co-host Joe Kernen in an interview at the World Economic Forum in Davos, Switzerland.

However, Dr. Anthony Fauci confirmed the public’s worst fears on January 31: people can carry and spread the virus without showing any symptoms. Dr. Helen Chu’s research team at the Seattle Influenza Study began looking at genomic data from Wuhan. According to Chu, it was clear from the beginning that person-to-person transmission was taking place. Using the influenza research database of nasal swab samples, the team was able to identify another case of Covid in a 15-year-old who had not traveled recently, indicating it is spreading throughout the community.

In late February, a senior CDC official, Dr. Nancy Messonnier, warned that containment of the virus at the country’s borders was no longer possible. Population spread would occur in the US, she said, and the central question was “how many people in this country would have serious illnesses.”

In the two years since that first confirmed case, the virus has swept across the US with a ferocity and duration that few expected. The human toll is staggering: more than 860,000 people have died and more than 69 million people have been infected. Hospitals across the country have been pushed to the limit, with more than 4 million confirmed Covid patients hospitalized since August 2020, when the CDC began tracking hospitalizations.. The number of hospitalizations is understated because they do not include the wave of cases that first hit the US in the spring of 2020, when hospitals were caught off guard and testing was inadequate.

While the US currently has effective vaccines and therapeutics to fight Covid, the future course of the pandemic remains uncertain as the virus mutates into new variants that are more transmissible and can evade vaccine protection.. A highly contagious variant of omicron has sent infections and hospitalizations worldwide to record levels this month, a shock to a weary public who want to return to normal after two years of lockdown, canceled events, work from home, masks and mandatory vaccination.

The rapid evolution of the virus and subsequent dramatic waves of infection, from alpha to delta to omicron, came as a surprise to many elected leaders, public health officials and scientists. Dr. Michael Osterholm, a leading epidemiologist, said Covid mutations are the big unknown that will determine the future course of the pandemic.

“We don’t yet understand how these options emerge and what they are capable of,” Osterholm, director of the Center for Infectious Disease Research and Policy in Minnesota, told CNBC. “Look how omicron took us by surprise as a global community with rapid transmission and immunity evasion. Look at the delta and all the impact it had on disease severity,” he said.

As new infections began to decline in the spring of 2021 and vaccines became widely available, the US began to lower its guard. The CDC said fully vaccinated people no longer need to wear masks indoors. President Joe Biden said on July 4 that the US is closer than ever to declaring independence from the virus.

However, the delta variant was spreading in the US at the time and soon caused a new wave of infections, hospitalizations and deaths as vaccination rates slowed. Public health leaders have spent months trying to convince skeptics to get vaccinated.

More than a year after the first vaccine was introduced in the US, about 67% of Americans over the age of 5 are fully vaccinated, according to the Centers for Disease Control and Prevention. Tens of millions of Americans still have not been vaccinated, despite evidence that they are safe and effective in preventing serious illness and death.

“In January 2020, we didn’t have any sense of the policy controversy and public reaction to it that was supposed to happen,” Osterholm said. “Who could have imagined the hesitancy and hostility towards a vaccine that would arise.”

Delta was more than twice as transmissible as previous variants and studies showed it caused more severe disease in unvaccinated people. The CDC will repeal its relaxed mask use guidance and encourage everyone, regardless of vaccination status, to wear masks indoors in public places in areas of significant transmission as the delta spreads.

Vaccines suffered when omicron appeared in November. While they still protect against severe illness and death, they are less effective in preventing micromicron infection. Chu said the U.S. has primarily relied on vaccines to prevent transmission of the virus, without putting an equal emphasis on large-scale masking and testing, which are critical to controlling a variant like omicron that can evade immunity.

“Now we know that proportionately you can get re-infected, you can have vaccine breakthroughs, and that this virus will just keep mutating and keep eluding us for a long time,” Chu said.

Katrina Shi leads research team that combine models to predict the trajectory of a pandemic. In their latest update, the omicron wave of cases and hospitalizations is likely to peak before the end of the month. However, their most optimistic forecast shows between 16,000 and 98,000 additional deaths from the omicron wave by April 2.

The US is currently reporting an average of more than 736,000 new infections per day., according to a seven-day average of Johns Hopkins data analyzed by CNBC. While this is still much higher than previous waves, the average daily infection rate is down 8% from the previous week. The US is reporting more than 1,800 deaths a day, averaging seven days.

“It’s very, very frustrating and tragic to see people die from a vaccine-preventable disease,” Chu said.

The implications of omicrons for the future course of the pandemic are unclear. From a classical point of view, viruses evolve to become more transmissible and less virulent, making it easier to find new carriers.

“There are many reasons to believe that this may not be true, because the jump to the omicron was so massive that it suggests there is plenty of room for it to change quite dramatically,” said Shi, a professor of biology at Pennsylvania State University. Omicron has over 30 mutations in a spike protein that binds to human cells. Vaccinations target the spike protein, and mutations make it harder for vaccine-induced antibodies to block infection.

Physicians and infectious disease experts in South Africa, where omicron was first discovered, say the variant has peaked and started to decline rapidly, showing a significantly different trajectory than previous strains. That the researchers also said The number of hospitalizations and deaths in the intensive care unit was lower at the Steve Biko Academic Hospital, indicating a decrease in severity.

“If this pattern continues and repeats globally, we are likely to see a complete separation of incidence and mortality rates, suggesting that Omicron may herald the end of the epidemic phase of the Covid pandemic, ushering in its endemic phase.” the researchers wrote.

According to Jenny Lavin, a research biologist at biotech company Karius, over time the virus may become less disruptive to society as mutations slow down and it becomes mild as higher immunity in the population limits severe disease.

However, the head of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, warned earlier this week that the pandemic is “far from over”, warning that new variants are likely to emerge as the omicron spreads rapidly around the world.

“Everyone wants to get to what is called endemicity. I still don’t know what the hell that means.” Osterholm said, noting that he has 46 years of experience as an epidemiologist.. “With options, we can work with relatively low activity for a while, as we have seen in many places around the world, and then a new option can change all that overnight. We don’t quite understand our future yet. “