Healthcare workers at the windows of NYU Winthrop University Hospital in...

Healthcare workers at the windows of NYU Winthrop University Hospital in Mineola as the 750th COVID patient is discharged, on April 21, 2020. Credit: Howard Schnapp

With little fanfare, COVID-19 seems to have entered a new phase.

Nationally, deaths for the week ending April 19 were at the lowest level since March 2020, according to the Centers for Disease Control and Prevention. Cases and hospitalizations in New York have dropped compared to previous years. 

Meanwhile, infectious disease experts are monitoring a new subvariant, XBB.1.16, also known as Arcturus, but believe it is unlikely to spark a surge of cases. While there have been reports that children infected with the subvariant are more likely to develop conjunctivitis or pink eye, experts said there is currently no hard evidence linking the two.

Newsday asked infectious disease experts about the new subvariant gaining steam in the United States, what to expect in the coming weeks and who should be getting COVID-19 booster shots.

Hospitalizations across the state have dropped to less than half compared to the same time last year — 647 as of April 26, compared to 1,588 at the same time last year. In 2021, there were 3,184 hospitalized, and 12,819 hospitalized on April 26, 2020 — a grim reminder of the early days of the pandemic.

New York deaths in the third week of April have dropped to 46 in 2023, compared to 82 in 2021, 389 in 2021 and 4,438 in 2020.

Immunity across the population has increased due to prior infections and vaccinations, according to Dr. Leonard Krilov, chief of pediatric infectious diseases at NYU Langone–Long Island. The currently circulating variants also appear to cause milder illness, and statistics have not shown increases in COVID-19 hospitalizations or emergency department visits.

XBB.1.16 is believed to be more transmissible than previous variants, but does not appear to be associated with more severe illness, Krilov said.

Estimates by the Centers for Disease Control and Prevention said it comprises 9.6% of new cases across the country. Based on those models, the subvariant is “growing rapidly,” said Dr. Stuart C. Ray, an infectious disease expert and professor of medicine at the Johns Hopkins University School of Medicine. “But it’s not clear that this will become dominant and it seems unlikely that dominance of XBB.1.16 would significantly change the course of the epidemic in the U.S.,” Ray said.

Krilov said reports from India suggest the subvariant might be associated with conjunctivitis in children.

Ray pointed out that conjunctivitis long been has recognized as one symptom of COVID-19, but not a specific one because it's found in many viral infections. “I haven’t seen strong evidence that this is a major difference for this variant,” he said, adding that conjunctivitis also can be associated with allergies that are common this time of year.

Experts are cautiously optimistic there will not be another wave in the coming months, but are hesitant to predict the path of COVID-19 and the virus that causes it, SARS CoV-2. 

“We seem to be in an endemic phase where many people continue to get infected and some of them get sick, some severely so, and I don’t expect a major surge of severe disease in the coming months,” Ray said. “This could change, so we need to continue monitoring, but we’ve built up a lot of immunity and need to focus on those most vulnerable — we need effective treatments, which are few at this point. Vaccines that offer stronger and more durable protection are also needed."

Krilov said while there could be an undercount of cases — due to a drop in testing requirements and reporting — there hasn't been an increase in COVID hospitalizations or emergency room visits, including among high-risk or elderly patients.

"It is likely the case numbers are truly low at present," he said.

In addition, there has not been a jump in school absences for respiratory illness, which might be expected with high levels of circulating virus.

Krilov said people who are 65 and over as well as those with high-risk medical conditions such as diabetes, heart disease, asthma and who have suppressed immune systems, should get the updated booster, which provides protection against the original strains of SARS-CoV-2 as well as the omicron variant.

It's less clear for younger, healthier people.

Ray said there is not enough evidence at this point to urge young, healthy people at low risk for severe disease to get the booster, but there may be specific instances at home or work that make getting the shot worthwhile. "At this point, they should consider their own situation, the people around them, and any special circumstances they face," he said.

The U.S. Food and Drug Administration has discussed recommending an annual COVID-19 vaccine administered in the fall, similar to flu shots. In June, an advisory committee will meet to discuss which SARS-CoV-2 variants are expected to be circulating in the upcoming year. The FDA said it expects manufacturers to make updated formulations of the vaccines by the fall.

With little fanfare, COVID-19 seems to have entered a new phase.

Nationally, deaths for the week ending April 19 were at the lowest level since March 2020, according to the Centers for Disease Control and Prevention. Cases and hospitalizations in New York have dropped compared to previous years. 

Meanwhile, infectious disease experts are monitoring a new subvariant, XBB.1.16, also known as Arcturus, but believe it is unlikely to spark a surge of cases. While there have been reports that children infected with the subvariant are more likely to develop conjunctivitis or pink eye, experts said there is currently no hard evidence linking the two.

Newsday asked infectious disease experts about the new subvariant gaining steam in the United States, what to expect in the coming weeks and who should be getting COVID-19 booster shots.

What's the status of COVID hospitalizations and deaths?

Hospitalizations across the state have dropped to less than half compared to the same time last year — 647 as of April 26, compared to 1,588 at the same time last year. In 2021, there were 3,184 hospitalized, and 12,819 hospitalized on April 26, 2020 — a grim reminder of the early days of the pandemic.

New York deaths in the third week of April have dropped to 46 in 2023, compared to 82 in 2021, 389 in 2021 and 4,438 in 2020.

Why have COVID cases, hospitalizations and deaths dropped?

Immunity across the population has increased due to prior infections and vaccinations, according to Dr. Leonard Krilov, chief of pediatric infectious diseases at NYU Langone–Long Island. The currently circulating variants also appear to cause milder illness, and statistics have not shown increases in COVID-19 hospitalizations or emergency department visits.

What do we know about the latest subvariant?

XBB.1.16 is believed to be more transmissible than previous variants, but does not appear to be associated with more severe illness, Krilov said.

Estimates by the Centers for Disease Control and Prevention said it comprises 9.6% of new cases across the country. Based on those models, the subvariant is “growing rapidly,” said Dr. Stuart C. Ray, an infectious disease expert and professor of medicine at the Johns Hopkins University School of Medicine. “But it’s not clear that this will become dominant and it seems unlikely that dominance of XBB.1.16 would significantly change the course of the epidemic in the U.S.,” Ray said.

Is it more likely to cause conjunctivitis (pink eye) in people who are infected with it?

Krilov said reports from India suggest the subvariant might be associated with conjunctivitis in children.

Ray pointed out that conjunctivitis long been has recognized as one symptom of COVID-19, but not a specific one because it's found in many viral infections. “I haven’t seen strong evidence that this is a major difference for this variant,” he said, adding that conjunctivitis also can be associated with allergies that are common this time of year.

Can we expect another wave of COVID-19 cases later this spring or this summer?

Experts are cautiously optimistic there will not be another wave in the coming months, but are hesitant to predict the path of COVID-19 and the virus that causes it, SARS CoV-2. 

“We seem to be in an endemic phase where many people continue to get infected and some of them get sick, some severely so, and I don’t expect a major surge of severe disease in the coming months,” Ray said. “This could change, so we need to continue monitoring, but we’ve built up a lot of immunity and need to focus on those most vulnerable — we need effective treatments, which are few at this point. Vaccines that offer stronger and more durable protection are also needed."

How do we know that COVID-19 cases are dropping since many people are testing at home?

Krilov said while there could be an undercount of cases — due to a drop in testing requirements and reporting — there hasn't been an increase in COVID hospitalizations or emergency room visits, including among high-risk or elderly patients.

"It is likely the case numbers are truly low at present," he said.

In addition, there has not been a jump in school absences for respiratory illness, which might be expected with high levels of circulating virus.

Is it worth it to get the latest COVID-19 booster shot?

Krilov said people who are 65 and over as well as those with high-risk medical conditions such as diabetes, heart disease, asthma and who have suppressed immune systems, should get the updated booster, which provides protection against the original strains of SARS-CoV-2 as well as the omicron variant.

It's less clear for younger, healthier people.

Ray said there is not enough evidence at this point to urge young, healthy people at low risk for severe disease to get the booster, but there may be specific instances at home or work that make getting the shot worthwhile. "At this point, they should consider their own situation, the people around them, and any special circumstances they face," he said.

Will federal health officials recommend a new COVID-19 booster in the fall?

The U.S. Food and Drug Administration has discussed recommending an annual COVID-19 vaccine administered in the fall, similar to flu shots. In June, an advisory committee will meet to discuss which SARS-CoV-2 variants are expected to be circulating in the upcoming year. The FDA said it expects manufacturers to make updated formulations of the vaccines by the fall.

Donald Sutherland dead … Ronkonkoma Beach closed … What's up on LI Credit: Newsday

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Donald Sutherland dead … Ronkonkoma Beach closed … What's up on LI Credit: Newsday

Six charged in slashings at Hofstra ... Donald Sutherland dead ... Man killed by cops suit settled ... LI spring sports all-stars

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