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Mayo vaccinologist says COVID-19's future is impossible to predict

Voicing his concern about the so-called "stealth omicron" sub-variant that now makes up 25% of new COVID cases in the U.S., Dr. Greg Poland cautioned that the relaxation of mitigation now underway was premature.

Mayo Clinic in Rochester, Minn.jpg
The Mayo Clinic in Rochester, Minn. Bloomberg photo by Ariana Lindquist
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ROCHESTER, Minn. — When it comes spotting the predictions that can be trusted about the future of COVID-19, Mayo Clinic vaccinologist Dr. Greg Poland has a simple message:

Trust the ones that have no idea about the future of COVID-19.

"Is this going to be our path to endemicity?" Poland asked during a forum organized by Mayo Clinic Health System on Wednesday, March 24, calling up the question of whether today's low case numbers are the sign of a hoped-for post-pandemic status for the virus.

"There is no way to know. When you hear people say, 'Yes, this is the end of it,' they are speaking out of ignorance, frankly. We do not understand the biologic, virologic and immunologic rules by which viruses become endemic."

Dr. Greg Poland
Dr. Gregory Poland, Mayo Clinic physician. Contributed / Mayo Clinic

Coming from the clinic's point person on the virus, the message landed in stark contrast to a loosening of pandemic precautions, not to mention the announcement by the White House on Monday, March 21, that federal money has dried up for COVID-19 testing, treatment and vaccines.

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Voicing his concern that BA.2 — or the so-called "stealth omicron," an omicron sub-variant believed to be responsible for 35% increase in European hospitalization rates — now makes up 25% of new cases in the U.S., Poland cautioned that the relaxation of mitigation now underway was premature.

"It began right as non-pharmaceutical interventions were relaxed," he said of the spread. "It's about 50-60% more transmissible than omicron was. It has been doubling about every week since we decided to pretend that the pandemic is over ... In my opinion, we declared victory too soon and too aggressively."

On the acquired immunity now believed to be tamping down cases in the U.S., at least for the short term, Poland cautioned that "getting infected with a virus is not natural immunity; that is illness-induced immunity."

In my opinion, we declared victory (over COVID-19) too soon and too aggressively.
Dr. Greg Poland

"Let's be clear about that," he said. "There is a tendency to kind of glamorize the idea of natural immunity, because quote-quote 'natural' sounds good ... Prior infection does not lead to long-term immunity. That's why even after infection we immunize individuals."

On the possibility of a fourth-shot booster, the vaccinologist said a forthcoming Food and Drug Administration hearing will address the question.

"If I had to speculate, I'd say that if BA.2 continues the direction it is going, we probably will allow boosters in people who will have certain co-morbidities and who are, say, 65 or older. If we have a new variant or a surge this summer or fall ... then I think we'll have a more general recommendation for boosters in all eligible populations."

The hope for a permanent, low-level rate of the virus is one that envisions intense need for local case surveillance, isolated periods of regional masking, ongoing protection of the vulnerable, and seasonal vaccination against new variants.

"But right now it's so hard to speculate," he said. "It goes back to the destructive effects of human behavior by eliminating masks, and pretending the pandemic is over. That is almost a guarantee of seeing new infections, which leads to new variants, which can lead to increased transmission and illness."

"When you look at waning immunity and the announcement the White House made last night that they do not have money to purchase a booster dose for every American, that they only have enough for people under the age of 5 and over 65. You put those together and if a new variant were to take off, we would be in a very bad way."

Paul John Scott is the health reporter for NewsMD and the Rochester Post Bulletin. He is a novelist and was an award-winning magazine journalist for 15 years prior to joining the FNS in 2019.
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