Feb. 28, 2020, was the date of the first COVID diagnosis in Oregon.
Three years later, we are still navigating the waters of the pandemic, but the storm has calmed considerably. After three years of uncertainty, lockdowns, masks, and immunizations, a return to normalcy seems within grasp.
To find out the state of the pandemic and where we go from here, The Pilot spoke with Kaiser Permanente Northwest Chief of Infectious Disease Dr. Katie Sharff.
“COVID is never really over. I mean, we’re anticipating that this virus will be here, circulating for the next several years, decades; it just may not be at the forefront,” Sharff said.
Public health regulations rolling back
On Jan. 30, 2023, the Biden Administration announced its intent to end the national emergency and public health emergency declarations on May 11, 2023, related to the COVID-19 pandemic. This cessation of the state of emergency does not mean COVID will resolve itself completely, but it marks a new stage for dealing with the virus.
“I think the ending of the public health emergency is more a signal that we will start to treat COVID like a routine illness, such as Influenza or RSV,” Sharff said. “I think that what will happen is that this pandemic will transition to what we call the ‘endemic phase,’ which means that the infection will impact a stable number of individuals but not be causing substantial illness across the globe all at the same time. It’s going to be a respiratory virus that we manage along with all of the other respiratory viral infections that we’re already currently managing.”
Oregon is seeing policy changes that also reflect the decreasing threat of COVID. On Mar. 3, the Oregon Health Authority announced that it would rescind the mandate that requires workers in healthcare settings to wear masks. The requirement had been in place since August 2021. In some ways, Dr. Sharff feels that these official changes reflect the sentiments of the public.
“I think the U.S. population has kind of declared COVID over just by our own behavior. We’re focusing our attention on other risks, other things, and accepting a certain level of disease and risk within the community,” Sharff said. “So, I think the U.S. population has already moved on, and the end of the public health emergency is really just catching up with the current opinion of the U.S. population.”
The current scope of COVID
Currently, the most common variant is the XBB1.5 Omicron variant. According to Sharff, the CDC is actually reporting that transmission numbers are up through their detection of wastewater and case counts. However, case count data is not as reliable as it was earlier in the pandemic.
“In the beginning of the pandemic, we really paid such close attention to case counts, but as people are testing at home, or not even testing, or not reporting, those case counts have really lost accuracy,” Sharff said. “But based on wastewater and what is being reported, it appears that case counts have gone up, but I guess the silver lining is that hospitalizations have been very stable; they’ve plateaued at about 250 per day and are forecasted to stay at this rate.”
Sharff attributed this drop in hospitalization rates to the increased immunity to COVID through vaccination or prior infection. Sharff said that experts are not sure what the future of the virus will look like. One of the concerns would be a variant that evades immunity from immunization or prior infection. However, Sharff said this has not happened yet, and so the next steps are difficult to predict.
Sharff said what health officials expect will be handling COVID on a more seasonal basis. Like a seasonal Influenza vaccine, an updated shot may be administered to help address the ebbs and flows of illness.
In the future
In terms of vaccines, there’s this shift toward an annual COVID vaccination, similar to an annual Flu shot. [The advisory committee] are actually evaluating this right now,” Sharff said. “I think for high-risk populations, so those who are elderly, or those who are immunocompromised, or those who have significant medical conditions, it makes sense to have that boost in immunity each year with an updated COVID shot. Although the timing, should it be in the fall or should it be in the spring, or when it should be administered, is still uncertain.”
As COVID becomes more embedded in our society, Sharff wanted to ensure people that the measures our health systems have put in place do work. Vaccines provide good protection against the disease, according to Sharff. Additionally, anti-viral medications like Paxlovid are good measures for preventing severe illness.
“If you haven’t been infected, you will probably get infected at some point, and if you’ve already been infected, there’s a very high likelihood that in the future, you will get reinfected; that’s just the nature of this virus. But the tools we have through vaccination and anti-virals do work,” Sharff said.
Takeaways from the first three years
Three years into the pandemic, Sharff wanted to draw attention to the loss of trust in public health messaging. As a result, there has been a dip in routine childhood vaccinations such as Flu, Measles, and Polio. Sharff wants the public to know that these routine childhood vaccines are “safe and important.”
“Despite the polarized discussions that we’ve had, with all of the politics of COVID, that it’s really important to stay up-to-date on your routine vaccinations,” Sharff said. “We don’t want to see a resurgence on some these diseases that we’ve finally gotten control of, like Measles, like Polio, like Pertussis.”
As a worker on the front lines, Sharff said that the pandemic has taught us about “humility, and constantly learning new information, and flexibility to shift our thinking as new information arises.” Despite issues with bed shortages or lack of healthcare workers, this pandemic has been an exercise in “humility and collaboration” for Sharff and our public health systems.
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