A MARTÍNEZ, HOST:
The omicron outbreak has slowed so dramatically in the U.S. that many people talk about COVID in the past tense. But the assumption that it's over doesn't square with what's happening in the U.K., where cases from the fast-growing omicron subvariant, BA.2, have been rising along with hospitalizations. And there are some signs in the U.S. - could see some bumps in cases, as well. NPR's Allison Aubrey joins us now. Allison, so how significant is this outbreak in the U.K.?
ALLISON AUBREY, BYLINE: Good morning, A. Well, daily case counts have more than doubled over the last few weeks throughout the U.K. Hospitalizations are on the upswing, and the country has documented a slight increase in deaths, too. Now, throughout the pandemic, the U.S. has tended to be a few weeks behind Great Britain, following the same pattern. So this has led to concern the U.S. could see a bit of a boost, too. Dr. Anthony Fauci spoke about the BA.2 variant on ABC yesterday.
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ANTHONY FAUCI: It has a degree of transmission advantage over the original omicron, but not multifold advantage. So the bottom line is we likely will see an uptick in cases, as we've seen in the European countries, particularly the U.K., where they've had the same situation as we've had now.
AUBREY: Now, officials in the U.K. attribute the increases there to the quick-spreading omicron subvariant, the removal of COVID restrictions - namely masking, more gatherings - and waning immunity. And, to some extent, the same factors are all in place in the U.S.
MARTÍNEZ: So is there any sign of a rise in the U.S. yet?
AUBREY: The Johns Hopkins University tracker shows the rate of decline in cases has slowed and may be on track to sort of level off. Now, cases are at the lowest levels we've seen since July of last year. But the point is the virus is still circulating. And another signal, A, is coming through wastewater surveillance. The program lead for the CDC's National Wastewater Surveillance System, Amy Kirby, told me on Friday they are seeing some changes in viral concentrations.
AMY KIRBY: The power of wastewater surveillance is that it's that early warning system. It's going to give us that four- to six-day heads up that increases may be happening in a community. And we are seeing evidence - early evidence - of increases in some communities across the country.
AUBREY: There are now about 700 different wastewater sampling sites all over the nation, and the CDC's dashboard shows increases at about 35% of them.
MARTÍNEZ: OK, so wastewater surveillance - how does this work? What exactly are they measuring at these sites?
AUBREY: Well, when people have COVID, they may be asymptomatic, not know it, or they may do a rapid test at home, which never gets reported to the system. So it becomes tougher for public health officials to kind of track the virus. That's why analyzing wastewater is very helpful. It's a form of passive surveillance. I mean, not everyone gets tested, but everyone goes to the bathroom. And when people are infected, viral RNA is detectable in feces and can be measured in sewage, and there are now about 88 million Americans now represented in wastewater surveillance.
MARTÍNEZ: Wow. All right. How big are the increases? I mean, are they big enough to be concerned?
AUBREY: You know, for now, Kirby emphasizes that because concentrations had dropped so low with the swift decline in the omicron surge here in the U.S., the increases being seen now here may be just small temporary bumps. I mean, about 60% of sites are not showing an increase. So they're focused on the 35% of sites where concentrations are going up consistently. In particular, the agency has begun to see consistent increases in Florida, in Rhode Island, in West Virginia. That was as of Friday.
KIRBY: We have seen a lot of change. So what looked like noise at the beginning of the week is starting to look like a true signal here at the end of the week. And so the situation is changing quickly, and we're watching it very closely.
AUBREY: She says they're getting new data every day so they can stay on top of it. Now, I should point out, infectious disease experts are not expecting a huge, big surge, but it is a reminder the virus is not gone and long-term strategies are needed to help prevent or manage future outbreaks.
MARTÍNEZ: So this wastewater surveillance program - is that one of the things the Biden administration is going to be looking for funding on?
AUBREY: That's right. This type of surveillance program allows the CDC and local public health authorities, which is very important, to stay ahead of outbreaks and potentially help curtail them. And Amy Kirby says this doesn't just apply to COVID, but potentially to a whole bunch of other conditions.
KIRBY: We've seen a huge uptake in this type of surveillance across the country. And we're adding new sites every week, so it's continuing to grow. And we're going to build off of this infrastructure that we've built for COVID and expand it to other health targets, including antibiotic resistance, foodborne infections and influenza.
AUBREY: So, for example, if flu is spreading quickly in an area or, say, a foodborne illness outbreak occurred somewhere, the CDC could use this real-time tracking to spot increases in the wastewater and potentially limit the number of people who end up getting very sick by giving communities a heads up that it's happening. And then when it comes to managing COVID in the long term, public health officials say these surveillance programs are key and need to be funded.
MARTÍNEZ: Thing is, though, ongoing funding for COVID is up in the air, right? I mean, so is Congress - something that it's not approved for more relief yet?
AUBREY: That's right. Biden administration officials are really trying to get the attention of lawmakers to approve about $15 billion in coronavirus aid. That was stripped of the bipartisan spending bill that was passed earlier this month. So, you know, there's a kind of growing sense of urgency as I talk to public health officials. And they point out everything that's at stake if the funding does run out. I spoke to Zeke Emanuel at the University of Pennsylvania about the situation.
ZEKE EMANUEL: We're going to run out of money for the monoclonal antibodies and other treatments for the immunocompromised - getting those antivirals to people who test positive, continuing innovation on our vaccine.
AUBREY: All of that could be coming to a halt and more. So we're kind of back to where the conversation began, A. Given what's happening in England right now, it is a reminder that COVID is still out there, circulating widely in Europe - a potential bump in the United States in some areas. And so public health officials are saying, look, long-term management strategies are needed, and that's going to take funding.
MARTÍNEZ: NPR's Allison Aubrey, thanks a lot.
AUBREY: Thank you, A.
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