“If COVID-19 were a person, how would you describe its characteristics?”
It was an unusual question, perhaps, but Dr. Mati Hlatshwayo Davis (pronounced “Shla-ch-why-o”), director of the St. Louis Department of Health, answered with little hesitation:
“We are currently in a surge. If you’re looking at overall volume or impact from other surges, we have surpassed the Delta wave of last summer. – Dr. Mati Hlatshwayo Davis, director of the St. Louis Department of Health.“Oh my God, it would be one of the most intentional, focused, and stubborn people that you can ever meet,” Hlatshwayo Davis answered, adding, “COVID knows who he or she is, what it has the capacity to do, and it hasn’t grown tired. It’s constantly reinventing itself.”
The “reinventing” part of Hlatshwayo Davis’ description pertains to new variants. The latest, BA.5, has become the dominant strain, making up more than 65% of all COVID-19 cases in the United States. In the St. Louis region, according to Hlatshwayo Davis, BA.5 has outmuscled previous strains and now makes up approximately 56% of all new cases.
“We are currently in a surge,” Hlatshwayo Davis warned. “If you’re looking at overall volume, we have surpassed the Delta wave of last summer. It’s not really a fair comparison though because there are different numbers, different metrics, and different variants. But overall, we’ve surpassed last summer. And this new variant is predominant in the St. Louis region.”
This week, the World Health Organization (WHO) announced that coronavirus cases have tripled across Europe in the past six weeks, accounting for nearly half of all infections globally.
Hlatshwayo Davis compares COVID-19 stubborn mutations as a form of evolution.
“We know that this (BA.5) is one of the most transmissible variants that we’ve dealt with to date. We can expect that. These variants have that characteristic. They become dominant because they have conferred a chain of mutation that gives them superiority over prior variants…that’s Darwinism, right?”
Although there’s little evidence that BA.5 causes more serious illness or is more deadly than previous variants, it appears vaccines and previous infections do not offer as much protection against it as past variants.
Hlatshwayo Davis urges those who may have taken a more relaxed attitude about the dangers of COVID due to lower mortality rates to think outside themselves.
“I think we have to shift the way we think about this, to thinking about protecting other members of society. People who are high-risk are more likely to get infected. We cannot, as a society, turn our backs on the elderly, the immunocompromised and Black and brown communities who are disproportionately impacted.”
Hlatshwayo Davis cited another reason people who have been lulled into a false sense of complacency about COVID need to recognize:
“People aren’t focusing on long COVID’s impact,” she said. “Even if you aren’t hospitalized there are people who have been on oxygen for over a year who can’t walk a block even though they used to run miles. We still don’t know how COVID impacted their bodies in the long term.
“While you may say something is ‘mild’ you don’t know what kind of inflammatory response is happening on the inside. For example, some people may have had a minor inflammation around the heart (Myocarditis). While that may be a short-term thing, we don’t know what impact that may have on the heart long-term and that’s not something I’d ever gamble with.”
The new variants are also challenging prevailing theories. Many believe if they were previously infected with the virus, they are now immune. But researchers are alarmed by the growing number of Americans who seem to be contracting the virus more than once. As of early July, there have been more than 1.6 million reinfections across 24 states. Experts warn that the numbers are likely much higher because many people are testing at home and not reporting their diagnoses.
Although COVID infections and reinfections are on the rise nationwide, Hlatshwayo Davis grapples with high concern mixed with reassuring facts.
“What concerns me about the true impact in the city is how it impacts hospitalizations,” Hlatshwayo Davis explained. The Omicron surge in December was bad because hospitals were at capacity, we were running out of healthcare workers to take care of people. It was not only highly transmissible, but it also spread very fast and put a lot of people on ventilators and overwhelmed hospitals. Although we have seen a small uptick in hospital cases, we haven’t reached that level of overwhelming capacity and that is somewhat reassuring.”
Like the Harry Potter book and movie franchises, COVID keeps churning out mind-numbing soul-sapping sequels to its original rendition that seem more and more convoluted. Studies suggest that vaccines to previous versions may not offer much protection against the latest form, BA.5. So, even though, according to Hlatshwayo Davis, 73.8% of adult city residents are partially vaccinated and 59.8% are fully vaccinated, that doesn’t mean they’re fully protected.
“Vaccines have some efficacy,” Hlatshwayo Davis said, “but there isn’t a vaccine that specifically targets BA.5 at this time. some of the leading pharmaceutical companies are working to come up with boosters and vaccines that will cover more of these variants.”
The virus with its “intentional, focused, and stubborn” characteristics has been a constant in Hlatshwayo Davis’ personal and professional life since her appointment as the city’s health director last year. Yet with all its tenacious mutations and the incessant politicization of the pandemic, the infectious disease physician has found upsides in her career. She credits her husband, pediatrician, Dr. Jesse Davis, who she said, “believes in me and this position and is, in every sense, ‘a partner’.”