Covid cases are skyrocketing again. The States have no new plans.

“When you say the same thing over and over again about vaccination, revaccination, that if you are vulnerable and are in a room with people who are not members of your family and you cannot distance yourself, you need to wear a mask – I mean, that the message has not changed since the beginning,” said the Governor of Louisiana. This was stated in an interview with Politico by Democrat John Bel Edwards. “But messaging receptivity, I mean, is only what people are going to consume, and at some point that becomes diminishing returns too.”

There are no new plans or bold initiatives on the horizon, officials in 10 states told POLITICO, even though much of the South remains unvaccinated and vaccination rates among children nationwide is well below what state and federal officials would like. Instead, state and federal government strategies for managing 130,000 new daily Covid cases in the US are basically the same as they were for managing 30,000 new daily cases four months ago.

Fear, expressed in both red and blue states, is that if government officials sound the alarm too soon about this surge in Covid, the public will not listen later if hospital capacity is overwhelmed or the number of daily deaths starts to rise rapidly. Louisiana, for example, has the second-highest per capita cases in the nation, but it’s only seeing a quarter of the new daily hospitalizations that were during the Omicron wave and about 15 percent of deaths.

“If you bench press 100% of the time, no matter what your numbers look like, then people will set you up faster,” Edwards said. “Whereas if you wait until the problem clearly gets worse, especially affecting hospital capacity, I think your messages will actually perform better.”

Instead of pushing the panic button, governors are keeping a close eye on their actions. long-term Covid response plans announced this spring, and in some cases by continuing to scale down their response to the pandemic.

Last week, Illinois Democratic Gov. J. B. Pritzker, who tested positive for Covid this week, announced he was easing testing and vaccination requirements for workers in certain industries even as daily cases rose. by 30 percent. Health officials in Hawaii have said they are waiving mandatory school mask-wearing in the state, the last in the country, as of August. And in New York, where cases have risen more than 70 percent in the past two weeks, the governor. Kathy Hochul, a Democrat, said she has no plans to change her administration’s approach to Covid-19.

“We are on top. We do not currently change our policy – ​​we always reserve the right to do so,” Hochul said. “Right now, we just want people to be smart and recommend in a variety of settings, including transportation – we still want everyone to wear a mask.”

While BA.5, which is currently responsible for at least 78 percent of infections in the US, is by far the most contagious and most immune-evading strain of Covid-19, doctors have yet to see a surge in serious illnesses caused by the disease. Hospitalizations – currently hovering around 40,000 in the US, according to New York Times tracker – grew steadily, not exponentially as it did with Omicron in the winter, and there was no dramatic increase in the number of people requiring intensive care or ventilators.

The number of daily Covid deaths is over 400, up 25 percent from a month ago, but recognition is growing. little more can be done — even if, as previous waves of the virus have shown, a more contagious variant means more cases, more cases means more hospitalizations, and more hospitalizations means more deaths.

“Each of these people… have a family, have colleagues, have friends. There is room for these people at the dinner table,” David Scraze, cabinet secretary for the New Mexico Department of Health and Human Services, told reporters last week. “I think no death is acceptable and I would prefer zero to be the goal. But there is also a dynamic in society between freedom and public health.”

The official case count is still below Delta’s peak surge last summer and well below Omicron’s winter surge, but it is generally accepted that current numbers are understated due to the proliferation of home testing for those who are tested at all.

However, the spike has alerted Biden health officials, who have been trying to determine how much more BA.5 could result in hospitalizations in recent weeks.

“There is concern, and I think it is universal,” one senior administration official said of the mood within the administration’s Covid response operation.

White House Covid team explores whether allow Americans under 50 to get a second booster shot to provide additional protection over the next few months, two people with knowledge of the matter said.

But they have taken no action, and officials are still debating whether to vaccinate just a few weeks before the fall campaign to offer updated vaccines that they hope will better target the current strain.

There has also been little renewed interest in mandatory mask use, although the Centers for Disease Control and Prevention’s community-level map now shows more than a third of counties are experiencing “high” rates of Covid-19 transmission, meaning the agency recommends people wear indoor mask in public. While many state and local health departments individually recommending wearing a maskFew have embraced a return to mandates like Los Angeles County. considers.

Axios / Ipsos poll published on Tuesday and spent over the weekend showed that only 13 percent of Americans think the government should tighten mask-wearing and vaccine requirements, up from 21 percent in February.

“Politicians, politicians are very sensitive to public opinion. And right now, public opinion is that we’re kind of done with it,” said Marcus Plescia, chief physician of the Association of State and Territorial Health Officials. “It would take a pretty brave politician or politician to go against this, and right now there’s not much reason to do so.”

Instead, the White House has piloted a low-key approach in recent weeks to target individual communities most at risk from the virus. Covid coordinator Ashish Jha has made several media appearances emphasizing the need for seniors to get their boosters and for everyone to consider wearing masks in high transmission areas.

But public health officials say the advice doesn’t seem to carry the same weight as mask-wearing requirements, even in blue states where mask-wearing is higher. Paul Cislak, senior health advisor and medical director for infectious diseases and immunizations at the Oregon Health Authority, said few people have returned to wearing masks in Portland despite Multnomah County strongly encouraged people to do this.

“Frankly speaking, wearing a mask hasn’t changed much since April,” Cheslak said.

Aside from encouraging more vaccines and boosters, White House aides say there is little they can or should do at the moment. White House Covid funding has been cut by months of congressional refusal to allocate more money, administration officials said. And like state health officials, Biden’s team admits that trying to get people to treat every new option as a national emergency doesn’t make much sense.

“Trying to strike the right balance between protecting people from this ugly disease and ensuring that other aspects of their health are also not affected is tricky,” said Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association. “I’m not sure anyone thinks they know exactly the right strategy.”

Hospitals say they are not overwhelmed, but are monitoring the progress of BA.5. While Covid-19 hospitalizations are on the rise, both intensive care unit workloads and ventilator use have dropped dramatically since Omicron’s surge earlier this year. Currently, about 6 percent of intensive care beds are used for Covid-19 among 5,406 people. hospitals that report this data to HHS.

Hospitals count both patients hospitalized for Covid-19 and patients hospitalized for other reasons who test positive for Covid-19 when reporting their counts. The hospital administration says it can be difficult to separate the two groups and that, practically speaking, once a patient tests positive for Covid-19 in the hospital, they require the same follow-up as they would for Covid-19 hospitalization.

In parts of the country where fewer people are vaccinated, hospitals are taking more precautions, stocking PPE for staff and making sure they have more Covid-19 drugs like Paxlovid for patients.

“Where we have high vaccination rates, healthcare providers, especially hospitals, are a little more confident that they won’t be overwhelmed with patients,” Foster said. “Where we have lower vaccination rates, there is more anxiety.”

And while they may not be overwhelmed with Covid-19 cases, hospitals are experiencing persistent understaffing in all positions due to a combination of pandemic burnout and Covid staff sickness during disease spikes.

Some working in large hospital systems would like public health officials to be much clearer about wearing masks during high transmission, with officials strongly encouraging boosters.

“Even if it hit the echo chamber,” said David Wohl, an infectious disease expert who leads the Covid-19 response at UNC Health in North Carolina, where cases have increased by 26% over two weeks ago.

Instead, he said, public health officials have taken a back seat to encouraging people to protect themselves and others. “It’s like they’re saying, ‘We’re out of this fight.'”