PROVIDENCE – The numbers indicate that the latest COVID surge has peaked, according to pandemic expert Dr. Ashish Jha, and while the next couple of weeks “are the critical time,” the nation as a whole can expect a better February than this January, when the Delta and omicron variants have combined to deal a coast-to-coast punishing blow. 

Looking further ahead, Jha foresees the likely emergence of more variants but maintains that the country has the tools needed to protect health. And Jha, dean of Brown University’s School of Public Health, said most experts believe COVID will become “a seasonal virus” enabling people to move mindsets away from the crisis mode of the last nearly two years and into a less stressful mentaility. 

“So here we are on January 20th recording this and the good news is that the national surge has peaked,” Jha said Thursday during recording of the latest “COVID: What Comes Next” podcast. “I think the peak number was probably sometime in the last couple of days and we are going to see what I hope is a rapid decline down.” 

Geographical differences remain, however, Jha said. 

“Let me put some caveats on it,” he said. “Some places like Rhode Island probably peaked about a week ago. But lots of other places in America have not peaked yet… But nationally, I think we have peaked and we are starting our descent. To be clear, there are a lot of infections ahead. If you think about a peak, you're going to get as many people infected on the downturn as you did on the way up.   

“So if you've not gotten infected yet, consider yourself lucky and be really careful for the next couple of weeks because I think the next couple of weeks are the critical time. My guess is after that it's going to really get down to pretty low numbers… the good news is we can see the end of this surge in front of us.” 

Jha said now is the time to prepare for possible new variants. 

“Once we get out of this surge and life begins to return more to a normal phase with low infection numbers and high vaccination rates, especially here in New England, we’ve got to start preparing like crazy for the next surge,” Jha said. “I don't know if it's going to come. I don't know when it's going to come. I don't know what the variant will be. I don't know where it'll begin, just like none of us predicted omicron specifically.” 

But, the physician said, “we should assume that we're going to have more variants… so when it hits we're going to be ready to go. There's a whole series of things that need to be done: Plenty of testing, plenty of masks, making sure that we continue plugging away on vaccinations. All these things will help us be ready.” 

Jha does not expect COVID to disappear, but with the passage of time, its presence will be experienced differently, he asserted. 

“Most of us believe this will eventually become much more of a seasonal virus,” Jha said. “I don't know that we're ready to quite declare victory and call it a seasonal virus yet, and so for the next year or two I suspect we're going to have to continue managing this in a very aggressive way and knowing that we can get outbreaks at any time. 

“That said, that shouldn't scare people. We have to do a mental shift away from thinking about this as an acute pandemic -- where ‘my God, it dominates our lives, my God we've got to think about COVID and talk about COVID all the time' -- toward a new mental model where, ‘yeah, it's around; yeah, it's going to be a problem; yeah, we need to deal with it, but we have all the tools and it's not going to disrupt our lives the same way.’ ” 

This is the 41st episode of the “COVID: What Comes Next” podcast, begun in October 2020 and available exclusively from The Providence Journal and the USA TODAY NETWORK. It is hosted by Providence Journal health reporter G. Wayne Miller, who has covered the pandemic since January 2020.

PROVIDENCE – The omicron variant has been detected in more than two dozen countries, including just this week in the U.S.  

And this much is certain, says pandemic expert Dr. Ashish Jha: it will continue to spread. 

Beyond that, Jha asserts, uncertainties at this early stage abound, just as they did when the last major variant, Delta, was first found in India about a year ago. 

During recording of the latest “COVID: What Comes Next” podcast, Jha, dean of Brown University’s School of Public Health, said he and other scientists are concerned with three major issues as they monitor developments. 

-- Ease of transmissibility, which the Delta variant has abundantly demonstrated, is one. 

“There's some data out of South Africa that suggests that it might be spreading very quickly in South Africa, but just because it does there does not mean it's going to spread more easily here,” Jha said. “The short answer is we don't know.” 

But he added: “If Omicron is as contagious or more contagious than Delta, [most regions] will end up encountering this variant as well.” 

-- A second issue is severity. 

“Does it cause more severe disease?” Jha said. “We have no idea. You may have heard stories of somebody who had mild disease, but individual cases, anecdotes, don't tell you the story. We have to look at a lot more data. We don't know if it causes milder disease or more severe disease. Obviously, we all hope it causes more mild disease, but we don't know.” 

-- A third is evasiveness, “the big issue,” as Jha described it. 

“Does it break through our vaccines?” Jha said. “We don't have the data, but here's what concerns so many of us: the mutations we see with omicron are in parts of the virus where our vaccines usually work -- the parts of the spike protein where our vaccines work. That's where we're seeing the mutations and that's what's concerning many of us.” 

Jha expects answers here relatively quickly. 

“We will get more data in the next week to 10 days,” he said. “We don't have to wait months.” 

Regarding the three current COVID vaccines – Pfizer, Moderna and Johnson & Johnson – and their potential defense against omicron, Jha was asked: “Is it better to be vaccinated than to be unvaccinated?” 

“Oh my goodness, not even a close call,” Jha said. “Let's say our vaccines work a little less well. Is there any chance vaccine effectiveness goes to zero, meaning the vaccines atop working completely against omicron? There's essentially no chance in my mind that vaccines will stop working altogether.  

“So if you've been vaccinated, you'll still have some degree of protection. And most of us believe, [given] our understanding of how boosters work, that if you are fully boosted, you actually will probably have a pretty high degree of protection against Omicron.” 

Jha’s advice? If you are not vaccinated, do so. And if you are eligible for a booster shot but not yet gotten it, do so. 

During the podcast, Jha also explained why unvaccinated people who become infected with coronavirus are much more likely than vaccinated people to serve as a sort of haven in which mutations are more likely to occur. The reason, he said, is the more frequently a virus replicates, the greater the chance that one or more replications will carry a mutation. 

 “Vaccinated people most times won't even get infected, so the virus is not going to be multiplying,” Jha said. “Even if you get infected, [the virus] will be there for a much shorter period of time and you're not going to give the virus as much chance to mutate. 

“No question there's a lot more replication happening among unvaccinated people and replication is the heart of mutations that lead us to” variants such as omnicon. 

This is the 39th episode of the “COVID: What Comes Next” podcast, begun in October 2020 and available exclusively from The Providence Journal and the USA TODAY NETWORK. It is hosted by G. Wayne Miller, health reporter for The Providence Journal. 

PROVIDENCE – “I'm very worried.” 

So declared Dr. Ashish Jha this week as the highly contagious Delta variant ravages many parts of the U.S. and some models suggest “as many as 35 million Americans may get infected over the next couple of months, the next few months,” according to the pandemic expert. 

That, Jha said, “is an astronomically large number.” 

And it is being driven in large part by the numbers of people who decline to be vaccinated -- although more people are getting shots recently than earlier in the summer, said Jha, dean of Brown University’s School of Public Health. 

 “This variant is going to spare no one,” the scientist/physician said. “If you are unvaccinated, you are almost surely going to encounter this virus up close and personal. All of us will -- but for those of us who are vaccinated, we're going to encounter it as a vaccinated person and most likely will not get infected.” 

As he and many other public-health expert have repeatedly now for months, Jha urged anyone who is unvaccinated to get inoculated. That will help in the long run, but not immediately, as weeks must pass after receiving the two-shot Pfizer and Moderna products and the one-shot Johnson & Johnson before full immunity is reached. 

Speaking this week while recording the 34th episode of the “COVID: What Comes Next” podcast, available from The Providence Journal and the USA TODAY NETWORK, Jha also addressed the record numbers of coronavirus infections, hospitalizations, and deaths among children in some parts of America. 

“We had a whole year of minimizing the infection of kids, saying ‘kids don't get sick, it's no big deal,’ ” Jha said. “Kids thankfully don’t get very sick, but some of them do and we want to be careful. The questions people are asking me right now are: ‘Is the Delta variant particularly bad for kids? Do kids get sicker with the Delta variant than they with Alpha, or the version from last year?’ 

“The short answer is, I don't know. We've been scouring the data but we don't have good data on this. So then people point to the fact that a lot of kids are getting hospitalized and are in ICUs and they say ‘how do you explain that?’ The answer is a lot of places are having very large infection numbers and if you have a massive surge, kids are not immune. They're going to get infected. Most of them will do very well, but a small number will end up getting sick and hospitalized.” 

On the topic of booster shots, Jha spoke about some fully vaccinated people who “are going surreptitiously into a [pharmacy] and acting like this is their first shot and then not showing up for their second shot. It's a mess because it totally ruins our record-keeping. Who then knows how many people have gotten vaccinated, who's gotten two shots, who's gotten three shots?” 

Jha said “this is not based on science” but then expressed the hope that the CDC, which is studying the possible need for booster shots, “should make a determination… they should guide people and they've got to push this forward. Otherwise you're going to have, you know, hundreds of millions of Americans winging it on their own. And that never turns out well.” 

During the taping, Jha also answered an audience question. A doctor in Pennsylvania wrote: 

“In the July 1 episode, Dr. Jha said there was no evidence of asymptomatic immunized people spreading COVID. Is this there any further data on this? Can pre-symptomatic immunized people spread COVID?” 

The pandemic expert’s answer, in part:   

“If the question is ‘can vaccinated people spread the virus?’ the answer is yes. We've seen it, but all the cases that I'm aware of have happened while the vaccinated person was symptomatic. What does that mean? It means that they were coughing, they had a fever when they were spreading. That's important because if you have a fever and a cough, you can isolate yourself.  

“The big question is: ‘What if you are vaccinated and you feel well, you're totally fine, can you be infected and spreading?’ We just don't know. Most of the data suggests no, but I hope you hear enough uncertainty in my voice to be very clear that I honestly don't know.”