While for numerous individuals the practices of social distancing, masking, and remote working have faded into the past, the reality is that we must remember the SARS-CoV-2 virus is very much present. It continues to mutate, sicken people, and pose a constant challenge for healthcare professionals around the world, including those working in infection prevention. Indicators such as swiftly mounting wastewater virus levels and a discernible rise in hospital cases emphasize the undying presence of the virus and the need for continued vigilance in managing its spread. Despite these developments not reaching 2020’s pandemic apex, they are a poignant reminder that SARS-CoV-2 is ‘not going anywhere’, and its reckoning cannot be casually dismissed out of hand.
Cases reported at these hospitals are primarily associated with respiratory infections, albeit less severe ones compared to the pandemic’s early days. Rather than affecting the lower respiratory tract, these cases seem to be more of a nuisance to the upper respiratory tract. The availability of more effective treatments, along with these relatively less severe manifestations, has prompted a significant improvement in patient outcomes. The intensity of cases witnessed during 2020, which invariably landed patients in Intensive Care Units, is now a rarity. An important aspect to remember is that a majority of individuals testing positive do not require hospitalization. In many cases, a home test suffices which is not automatically recorded in official databases. Thus, the real quantum of prevailing COVID-19 infections may be considerably higher than hospital records may suggest.
One further significant observation is that a notable portion of individuals hospitalized for COVID-19 infections are immunocompromised and have received at least one dose of the vaccine. The evolving nature of the virus, as reflected in the generation of new strains like Omicron JN.1.11.1, Omicron JN.1, and Omicron KP.3, has managed to outpace the efficacy of the original vaccine. Among individuals who have received vaccinations, severe infections can still occur despite the vaccine’s ability to mitigate the worst impacts and limit the virus’s spread, especially among the immunocompromised. Despite advancements, vaccination rates remain sub-optimal. For those hesitant to get vaccinated, it’s worth noting that the decision to get vaccinated is not just about individual health but also about protecting the immunocompromised and other vulnerable individuals within the wider community.
The anticipated release of a new vaccine, aimed to combat the dominant strains of the virus, is set for September. It comes with a crucial message for infection prevention professionals working with immunocompromised patients – whilst face masks may not be foolproof, they offer a vital line of defense against respiratory viruses like SARS-CoV-2.
Treatment regimes prioritizing Paxlovid due to its ease of administration. However, more severe cases might necessitate Remdesivir, an intravenous drug. Molnupiravir serves as a tertiary choice given certain associated risks particularly for women of childbearing age.
Contemplating the future in the long term, the world will have to learn to live with the coexistence of these mutating viruses. With the advent of unified approaches towards managing respiratory viral illnesses such as COVID-19, flu, and the respiratory syncytial virus, we can predict that a new COVID-19 vaccine will likely be administered annually for the predictable future. So, while the current rise in COVID-19 cases is not a cause for immediate concern, stepped-up surveillance for signs of larger outbreaks, through wastewater monitoring and hospital patient data, will undoubtedly continue.