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By Eliza Mackintosh and Isabelle Jani-Friend

Wednesday, February 23

WHAT'S NEW THIS WEEK

At the start of the pandemic, the World Health Organization (WHO) had one very clear message for countries around the world: "Test, test, test." 

Two years later, the advice remains the same, but not all governments are listening to it.

This week, Britain's Prime Minister Boris Johnson hailed England's new "living with Covid" strategy, dropping its remaining pandemic restrictions despite the reality that tens of thousands of people are still testing positive each day — including, on Sunday, Queen Elizabeth II. 

The plans unveiled by Johnson, who says the next phase is all about "encouraging personal responsibility," include an end to England's free coronavirus testing scheme. At the program's peak, more than 2 million swabs per day were being carried out and logged in the United Kingdom — yielding arguably the most robust data set in the world.  

The UK's move to axe free mass testing after March was met with backlash from public health experts, who fear it could have major consequences on global efforts to track Covid-19. The WHO's special envoy for Covid, David Nabarro, said on BBC radio over the weekend that he worried Britain's decision to drop all rules and adopt "a line that is against the public health consensus," could "create a bit of a domino effect around the world." 

The dismantling of these surveillance systems would have a dire impact on our understanding of the virus as it continues to evolve and spread, WHO epidemiologist Maria Van Kerkhove said during an online question-and-answer session on Tuesday. Though global infections have fallen about 20% this week, compared to the previous week, she warned that the decline "may not be real" due to reduced testing. "We are very concerned about a reduction in testing around the world. We need to continue to test for SARS-CoV-2. We cannot abandon our testing practices," Van Kerkhove added.   

Still, some countries and regions are hanging on to testing as a major strand of their pandemic strategy.

A temporary Covid-19 testing site in Hong Kong.

Hong Kong's chief executive, Carrie Lam, announced a massive mandatory testing drive Tuesday as the territory grapples with its worst coronavirus outbreak yet, spurred by Omicron. The entire population — nearly 7.5 million people — will undergo three rounds of compulsory Covid-19 testing in March, and testing capacity is expected to increase to 1 million a day or more, according to Lam. Hong Kong has largely stayed in lockstep with mainland China's "zero-Covid-19" policy, which has meant that as other countries like Britain have shifted their approach to treating the virus as endemic, the city has been stuck in a never-ending cycle of lockdowns to quell outbreaks.  

The extremely transmissible Omicron variant put a massive strain on testing programs around the world earlier this year, making rapid tests even more scarce. As cases surged, vaccinated and boosted people trying to ensure they were not positive before contact with vulnerable individuals or attending gatherings found themselves scrambling to find available test kits.

The United States poured billions into scaling up test manufacturing capacity, but still failed to avert a shortfall amid the Omicron spike. In a briefing by the White House Covid-⁠19 response team last week, Dr. Tom Inglesby, senior adviser to the task force, said that the administration was seeking to address supply chain challenges and expand domestic testing capacity, to "be ready if we face a new variant or surge in the future." The US government said it has secured 1 billion tests, 200 million of which have already been shipped free of charge to Americans across the country. 

"Testing will remain a critical part of our overall COVID response strategy.  We're making investments now for whatever this virus brings in the time ahead," Inglesby said. 

THE LATEST NUMBERS

Source: Johns Hopkins University

YOU ASKED. WE ANSWERED.

Q

How can we keep kids safe as Covid-19 rules change?  

A

After two years of pandemic restrictions, several states have announced they will end indoor mask mandates, including at some schools. Against this backdrop, the US Food and Drug Administration has said that it will delay authorization for the Covid-19 vaccine for children under 5. 

That has left many parents wondering whether it is safe or not to allow their kids to resume indoor activities such as playdates, going to the movies and attending extracurricular activities.

"Just because restrictions are being lifted doesn't mean that suddenly everything's safe. Covid-19 infection levels are still quite high in many communities. Government-required measures are ending, but that doesn't mean that individuals should make every risky choice," CNN Medical Analyst Dr. Leana Wen says.

But nearly everything we do carries some level of risk when it comes to contracting Covid-19. The question families should ask is: How much do we want to keep avoiding the coronavirus? And what's the price we're willing to pay to do so?

Send your questions here. Are you a health care worker fighting Covid-19? Message us on WhatsApp about the challenges you're facing: +1 347-322-0415.

READS OF THE WEEK

Queen Elizabeth experiencing mild Covid symptoms
 

Britain's Queen Elizabeth II canceled her planned virtual engagements on Tuesday as she continued to suffer from mild Covid-19 symptoms, Buckingham Palace has said. The palace announced Sunday that the 95-year-old monarch had contracted the virus. 

"As Her Majesty is still experiencing mild cold-like symptoms she has decided not to undertake her planned virtual engagements today, but will continue with light duties," the palace said. Light duties likely refer to her head of state responsibilities such as reading and answering documents and letters, which she receives daily in her famous red dispatch boxes, Max Foster and Lauren Said-Moorhouse explain.

The Queen's diagnosis is the latest Covid case to hit the royal household. Her eldest son and heir to the British throne, Prince Charles, contracted the virus for a second time on February 10, and had seen his mother "recently." Days later, his wife, Camilla, also tested positive. Additionally, a royal source told CNN Sunday that there had recently been "a number of cases ... diagnosed in the Windsor Castle team." UK media have reported that the Queen is fully vaccinated.

As the US looks to move on from Covid-19, high-risk and disabled Americans feel forgotten

Tasha Nelson's 10-year-old son Jack, who has cystic fibrosis, a progressive genetic disease that causes persistent, damaging lung infections, held back tears when he heard the news. The two were in the car when the announcement came through the radio: Virginia's freshly sworn-in governor had signed an order attempting to ban mask mandates in schools. "My son looked up at me and he had tears in his eyes because he knew what it meant. He said, 'Mom, does that mean I can't go to school anymore?'" Nelson said. "He said, 'Can't we let the governor know about kids like me? I want to go to school too.'"

As local and state leaders across the US remove mask and vaccination rules, immunocompromised, disabled and chronically ill Americans say that doing away with protections will leave them more vulnerable — especially as they, or family members, return to in-person work or school. And for some, Covid-19 vaccines are not as effective in staving off a severe bout with the virus, Christina Maxouris writes.

The high-risk people CNN spoke to said as the country eagerly looks to move on from the pandemic, they feel forgotten — and worse, like they don't matter to the rest of the American public. Some say they feel like they've been left to adapt to a more dangerous reality, while others are now mapping out a permanently isolated lifestyle.

Reinfections of Omicron subvariants are possible, but rare 

A WHO advisory group met to discuss the latest evidence on Omicron, including subvariants BA.1 and BA.2, on Tuesday, after reports that the latter was not only spreading faster than its distant cousin, but may also cause more severe disease. Based on available data on transmission, severity, reinfection and impacts of vaccines, the group advised that that BA.2 should continue to be considered a variant of concern and remain classified as Omicron.  

WHO's experts considered real-world data on clinical severity from Denmark, where BA.2 is currently the dominant cause of Covid-19. A new Danish study found that getting reinfected with two different Omicron subvariants was possible, but that it was a rare occurrence, largely afflicting those who are unvaccinated and resulting in mostly mild infections. The group also received a briefing from Japanese scientists, who recently conducted lab and animal studies with BA.2. The new lab experiments from Japan show that BA.2 may have features that make it as capable of causing serious illness as older variants of Covid-19, including Delta. And like Omicron, it appears to largely escape the immunity created by vaccines.  

Why you might need a fourth shot

As the world approaches the second anniversary of the declaration of the Covid-19 pandemic by the WHO, on March 11, more nations are rolling out — or considering — fourth doses of coronavirus vaccine for their most vulnerable. 

Israel was the first nation to roll out fourth doses, and Sweden and the UK have recently said they would follow suit. In the US, leading public health officials say they are "very carefully" monitoring if or when fourth doses might be needed, with signs that it might be recommended as we move into fall — coinciding with the administration of flu shots.

Here's why Dr. Anthony Fauci and other public health experts say boosting will be critical.

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