As America casts a wary eye on rising cases caused by the BA.2 subvariant in Europe, the immune status of adults over the age of 65 will be a key indicator of how future variants will affect the US
"It's really looking at that older age group and how much prior immunity they have, either from previous infection or vaccination, that I think has been the best indicator so far of how severe a given number of cases is going to end up being in terms of hospitalizations and deaths," said Stephen Kissler, who specializes in infectious disease modeling at Harvard's TH Chan School of Public Health.
"It's that group that's most problematic when it comes to the severe critical and fatal disease. It doesn't mean that younger folks don't wind up in the hospital at times; it's just not at the same rate," said Jeffrey Shaman, who specializes in modeling the spread of infectious diseases at Columbia University's Mailman School of Public Health.
US officials don't expect BA.2 to hit here as hard as it has in Hong Kong. That's because the city has pursued a zero-tolerance Covid strategy. That policy kept cases and deaths low up till now, making it a model for Covid control. Health officials are looking to the UK for clues to how BA.2 may behave in the US. But the they're not analogous in all ways; mostly notably, the UK is more highly vaccinated.
Boosters restored much of that protection, but their benefits have faded, too. Four to six months after a third dose, boosters were about 40% to 50% effective at preventing Omicron infections and 75% to 85% at preventing hospitalizations, for all adults. "I do still think it's a potential cause for concern that we may still see a higher case fatality rate and higher hospitalizations for Covid in the US than the UK because of the differences in underlying immunity," Kissler told CNN.
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