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Covid forecast: Major fall surge unlikely, but variants are a wild card

Cold weather favors the coronavirus. But as summer gives way to fall, infectious-disease experts are guardedly optimistic that the spread of covid-19 this autumn and winter won’t be as brutal as in the previous two years of the pandemic.

Coronavirus scenarios from multiple research teams, shared in recent weeks with federal officials, foresee stable or declining hospitalizations in early fall. The scenarios show the possibility of a late-fall surge. A new variant remains the biggest wild card. But several factors — including the approval this week of reformulated boosters and the buildup of immunity against the latest strain of the virus — could suppress some of the cold-season spread, experts say.

There’s sort of even odds that we would have some sort of moderate resurgence in the fall. But nothing appears to be projecting anything like an omicron wave,” said Justin Lessler, a University of North Carolina epidemiologist who helps lead the collection of covid-19 planning scenarios from a group of research organizations.

The scenarios assume that reformulated vaccine boosters will be embraced by the public at a rate similar to that of the annual flu shots — possibly an optimistic assumption given that more than half of Americans eligible for boosters have yet to receive their first dose.

Peter Marks, the top vaccine official at the Food and Drug Administration, said in a briefing Wednesday that the approval of reformulated boosters comes as the agency is “looking at a possible fall wave, with a peak around December 1st.”

Predictions about the pandemic rarely age well. In the United States, the pandemic appeared to be winding down in May 2021 amid a vigorous vaccination campaign, only to get wound up again with the rise of the new variants.

The emergence of a new variant in September could result in a wave of infections and severe illness in December, according to Lauren Ancel Meyers, director of the University of Texas Covid-19 Modeling Consortium. A variant emerging in October would push the peak to January, she said.

ny new variant that could change the pandemic’s trajectory would have to be more transmissible than the omicron subvariant BA.5 currently circulating. It might emerge from an obscure branch of the virus’s family tree — which is exactly what happened last November, when omicron, with its stunning package of mutations, appeared in southern Africa and immediately overtook the reigning delta strain.

Vaccines remain highly effective at lowering the infection fatality rate and keeping people out of the hospital, and the Biden administration continues to lean heavily on vaccination and boosting as the most powerful weapon against the virus. Anthony S. Fauci, the president’s chief medical adviser for the pandemic, told The Washington Post that the fall campaign against the virus will demand widespread uptake of booster shots.

We’re not going to eradicate it. We’re not going to eliminate it,” Fauci said. “But we do have the capability to get it to a low enough level so that it doesn’t continue to disrupt the social order.”

The federal government, meanwhile, is turning much of the fight against the virus over to the private sector. As of Friday, the government would no longer mail free coronavirus tests to the public. The plan is to transition the payment of treatments to insurers, pharmacy benefit managers, hospitals and patients themselves by the middle of next year. Updated boosters have already been purchased by the federal government and will remain free to consumers.

But booster uptake so far has been underwhelming. Of the 62 million people over the age of 50 who are eligible for a second booster, only 22 million have received it so far, according to CDC data. Of the 95 million people between 18 and 49 who are eligible for their first booster, only 38 million have availed themselves of it.

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