Q&A WITH DR. KRAVEC | COVID-19 is tamer and becoming endemic. What does the future hold?

State health officials will now report new COVID-19 data weekly instead of daily, Dr. Bruce Vanderhoff, Ohio Department of Health director, announced during a Thursday media briefing.

Mercy Health’s Chief Clinical Officer Dr. James Kravec told Mahoning Matters he believes that’s the “appropriate thing to do” since there is no day-to-day change happening with COVID-19 cases, compared to the beginning of the pandemic in March 2020.

Mahoning, Trumbull, Columbiana, Lawrence and Mercer counties each now have a “low” COVID-19 community level, according to the U.S. Centers for Disease Control and Prevention.

“This is normal life. … We don’t need to see data every day,” he said. “It’s not going to change what [health care workers] need to do. This should be longer-term information gathering.”

It’s been two years since the first case of the novel coronavirus in Ohio. With the virus retreating and public health restrictions relaxing nationwide, Mahoning Matters asked Kravec for insight on the virus’ perceived transition from being pandemic to endemic, the potential for seasonal flare-ups and the best practices for living with the virus permanently.

Will COVID-19 become more of a seasonal respiratory virus?

“Every month, and every season has changed,” Kravec said. “I think it’s too soon to tell whether or not it’s seasonal — in the sense of if we have spikes with the cold and less with the warm weather. We don’t exactly know that yet.

“We have seen spikes in the last several winters. We’ve also had spikes in this late summer as well,” he said. “I do think the more infections that have happened in the community, the more vaccines that are out in the community, the more immunity we have and the chance of having a spike is less than it was before.

“Now that we have the flu again, it’s seasonal [too]. The question is what the seasonal impact will be. We don’t know yet whether it’ll be the same type of pattern as the flu, whether it’ll be different times a year or whether there’ll be any rhyme or reason to when there’s a spike.”

How can people still enjoy the warmer months while staying safe?

“The most important thing is [to do] what you’re comfortable with,” Kravec said. “Most important is to get vaccinated if you’re not, get boosted and stay home when you’re sick. Personally, I’m going to enjoy my spring, interact with people and travel.”

When is the right time and place to wear a mask?

“Masks are still mandated in health care settings and I don’t know the future of that,” Kravec said. “The rest of it is doing what you’re comfortable with and then using common sense as you go about your interactions.”

What has living with this virus for two years done for public health awareness?

“There is a common-sense component. People need to stay home when they’re sick, cover their cough, wash their hands more and use hand sanitizer,” Kravec said. “Those are things that we probably always knew that we didn’t necessarily always practice. I think that’s probably one of the most common-sense outcomes from the last two years that we’ve seen.”

He said before COVID-19, people generally did not practice basic hygiene when out in public — including putting on hand sanitizer and covering their mouths to cough. Though there was little-to-no social interaction early in the pandemic, there’s now a good balance between having good public health consciousness and interacting in public again, he said.

Will we still need booster shots? Will there be variant-specific boosters?

“The boosters are recommended, and for those immunocompromised, a fourth dose actually is recommended as well. I can’t recommend boosters enough. They do help with the safety of the people that receive them.”

According to the CDC, people 12 years and older are eligible for all three doses of the Pfizer booster shot, and people 18 years and older are eligible for all three Moderna or Johnson & Johnson shots. An mRNA COVID-19 vaccine series — Pfizer or Moderna — is preferred over the Johnson & Johnson vaccine, according to the chart:

With the omicron variant surge waning, relieving overcrowded hospitals, how is the morale of health care workers?

“I’m so proud of the health care workers over the last two years and those that work in our hospitals, our medical practices, walk-in clinics, intensive care units, emergency department, the COVID units. … The staff has just been amazing,” Kravec said. “It’s been very hard for them, and I think thankfully, there is relief.

“I think this is certainly a deserved break from COVID. What we’re seeing is that patients are still arriving in large numbers for their medical care for their diabetes, high blood pressure management and their vaccines that are non-COVID related. … All that medical care that may not have happened over the last few months — or sometimes even the last couple of years — is happening.

“This is absolutely somewhat back to normal, realizing that we have an illness called COVID-19 that probably is here to stay at some level, hopefully at low levels, but it’s probably here to stay just as we had the flu,” he said.

Are we overdue for a new variant? Is it likely the next variant will be more or less severe than omicron?

“I think we will [see a new variant] because that’s what viruses do. … This is normal,” Kravec said. “This is nothing scary, unique or surprising when I hear about variants, because viruses mutate. This is what the flu does every year. There’s different versions of flu every year because the flu mutates.

“The good news is after the delta [variant], the variants we’ve been seeing have been less severe, and that’s a good thing. We won’t know but I sure hope it continues to drop.”

What are some crucial things we know now about COVID-19 that we didn’t know two years ago?

Kravec said health care officials know now that the vast majority of people who are hospitalized or die due to COVID-19 were not vaccinated.

“I think the knowledge on vaccines, their effectiveness and safety is tremendously high — [it’s] no different than the flu vaccine, reduces hospitalizations and reduces deaths from the flu. This does the same with COVID,” Kravec said.

They say COVID-19 is becoming ‘endemic.’ What does that mean?

“Endemic is a lower level of infectivity across the population that stays around for a longer period of time, potentially into the future, as opposed to a finite period of time where a lot of people are sick. We probably are [endemic] because over Christmas and New Year’s, there were so many people stick with omicron. That did cause a level of immunity out there [that was] very good.

“Since everyone didn’t either get COVID-19 or be vaccinated, there still will be infection. … That’s what makes it endemic.”