Covid-19 cases are once more on the rise in the US, but this time there is little impetus for new restrictions or funding to help combat them.
The number of daily new cases in the US has increased by 14 per cent since the beginning of April, according to figures from Johns Hopkins University, reaching about 32,000 cases a day. The rise is being fuelled by the BA.2 variant, which has caused surges in Europe over the past few weeks.
Unlike in other waves, however, the US policy response has so far been muted, with Congress still wrangling over $10bn in extra pandemic spending and mask mandates largely abandoned.
Dr Ezekiel Emanuel, a medical professor at the University of Pennsylvania and a former Covid adviser to US President Joe Biden, said: “We want this thing to be over, but it is not over. If we do not do things like reintroducing mask mandates it would be a big mistake.”
Public health experts have been warning for weeks about the likelihood of another wave of infections in the US, having seen the UK and EU recently suffer their second biggest spike in confirmed cases since the pandemic began.
These warnings have not prompted a major political response however. Officials in Philadelphia have reintroduced a mask mandate, while the federal government has extended its mask mandate for public transport by another two weeks. But most states and cities have so far resisted reimposing the kinds of public health restrictions seen earlier in the pandemic.
Cases have started to rise, but so far in a far more patchy way than experienced in Europe. New case levels are nearing pre-Omicron peaks in many states in the north-east, such as Vermont and Massachusetts, as well as cities including Washington, DC. Several senior politicians, including Merrick Garland, the attorney-general, recently contracted the disease after attending the annual Gridiron Dinner in Washington.
But elsewhere infections appear to have remained low. In Texas, for example, the average rate of daily new cases has changed little since the beginning of March.
Some experts believe the true extent of the surge is being obscured by a huge drop in the amount of testing being done. At the peak of the Omicron wave in January there were over 2m tests being taken every day in the US. Now the figure is around 540,000.
Others, however, believe the US BA.2 wave is proving less potent than the one that struck Europe, partly because many Americans were infected by Omicron and partly because better weather is enabling more outdoor socialising.
Leana Wen, a professor of public health at George Washington University, said: “I do not think a huge spike is coming. BA.2 currently accounts for around 82 per cent of infections, and by the time it was that dominant in Europe, it had already triggered a dramatic surge. I do not think we are going to see that here.”
While public health professionals worry about what might come in the next few weeks, members of Congress have gone on recess without having agreed to approve more Covid-19 spending.
As a result, doctors can no longer claim the cost of testing and treating uninsured people back from the federal government, while the Biden administration has not been able to purchase the treatments it wants.
LabCorp and Quest, two of the country’s biggest test makers, both told the Financial Times they have started charging uninsured people, of which there are 30m in the US. Quest charges between $100 and $125 for a PCR test, while the cost of two rapid antigen tests is $70.
Doctors believe this is likely to deter millions of people from getting tested and treated for Covid-19 and so exacerbate the effects of the BA.2 wave.
Dr Sterling Ransone, the president of the American Academy of Family Physicians, said: “A lot of people know that funding is drying up and some of them are not seeking the care they need because of worries about cost.
“We are quite concerned that folks are not coming in to be tested and that patients are spreading the disease more.”
Drug companies have also started to warn that they might not be able to keep supplying vaccines and treatments without fresh funding. Albert Bourla, Pfizer’s chief executive, said he was “very concerned” by the delays to funding, which risked creating a “big problem” as the virus and pandemic had not gone away.
David Ricks, chief executive of Eli Lilly, warned: “These medicines are running out now.”
The rise in cases is likely to prove the first major test for Dr Ashish Jha, Biden’s new chief Covid-19 adviser. So far Jha has sought to reassure Americans about the risks of another wave, rather than trying to persuade people to alter their behaviour to slow the spread.
“I think we’ve got to be careful,” he said this week. “But I don’t think this is a moment where we have to be excessively concerned.”