Although US federal COVID-19 public health emergency (PHE) ended in the US in May following the end of the similar global designation by the World Health Organization, recent trends have indicated that the virus and response continues to evolve.
Over the last several weeks, COVID-19 hospitalizations and deaths in the US have been trending upwards, according to the Centers for Disease Control and Prevention (CDC)—and the latest data indicate a more than 20% increase in the last week. The increase is in part due to the prevalence of the now-dominant "Eris" (EG.5) strain.
In addition, a new variant, BA.2.86, has been detected in the US, and the CDC is monitoring this virus that has multiple genetic differences from previous versions of COVID-19. Although it is still early in the variant’s proliferation and study into its transmissibility and severity are ongoing, it is thought that the new variant could be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines.
As COVID-19 numbers increase, hospitals are faced with renewed questions about whether to reinstitute mask mandates, which were dropped in many locations with the expiration of the PHE and after the CDC removed its own mandate in autumn 2022. Guidance from this period shifted to recommendation that community-level transmission data should guide local decision-making. Based on regional increases, several health system across the US have started to reintroduce universal masking mandates in their hospitals, while many continue to recommend masking.
In the backdrop of these renewed discussions is news of the likely approval of a new COVID-19 vaccine in September with a meeting of the CDC Advisory Committee on Immunization Practices, which is intended to broaden immunity to cover XBB.15 variants that have dominated in 2023. Although BA.2.86 has a relatively large number of differences from XBB.15, the CDC still expects that the updated vaccine will be effective at reducing severe disease and hospitalization.
Currently, there are no reports of hospitals canceling or delaying elective surgeries due to COVID-19 numbers. The most recent guidance related to COVID-19 infection and elective surgery was released in June in a joint statement by the American Society for Anesthesiologists and Anesthesia Patient Safety Foundation. The guidance loosened previous recommendations to delay elective surgery from 7 weeks after infection to between 2 and 7 weeks post infection, so long as the surgical team has performed a risk assessment and found the patient is capable of safely being operated on and provided informed consent.
