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2 months ago, he said the omicron surge could fade fast. To his surprise, it has

AILSA CHANG, HOST:

In early January, as the U.S. was averaging over half a million new COVID cases every day, one person was optimistic about the pandemic.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

BOB WACHTER: I think the likeliest outcome for February and March is that we'll be in pretty good shape. This virus being milder than the prior variants could turn out to be very good news.

CHANG: That is Dr. Bob Wachter, the chair of the Department of Medicine at the University of California, San Francisco. His argument - that in six to eight weeks the omicron surge would be over, hospitalizations would be down and the pandemic will have turned a corner.

Well, it is now eight weeks later, so we decided to call Dr. Wachter once again to check in. Hello.

WACHTER: Hi, Ailsa. It's great to see you. And usually when people play a clip, it's usually of something you got wrong. So that was kind of nice.

CHANG: (Laughter). Well, let's hope you didn't get it wrong. I mean, I wanted you to fact-check your own prediction there. Cases in the U.S. are down to under 50,000 per day. Hospitalizations are down. Deaths are down. But are we doing as well now as you thought we would be doing?

WACHTER: Yes. I think we're doing about what I thought we would do, which is amazing because COVID has been nothing but curveballs. I think...

CHANG: Yeah.

WACHTER: ...The - you know, as we thought about COVID and omicron in December, we needed to understand three variables. We needed to understand how infectious it was, how severe it was and how much it escaped the immune system. And once we understood that and saw the curve from South Africa and that quick up and quick down, I think the most surprising thing about the last couple of months has been how unsurprising it has been. You know, many people got sick, and many people died, sadly. But once we got through that acute period, you had the vast majority of the American public that had protection, either from vaccination, vaccination plus infection and, in many cases, from infection. So that leads us to being where we are now at a pretty good place.

CHANG: Well, what are you seeing personally at your own hospital in San Francisco? Is the COVID caseload pretty manageable right now?

WACHTER: Absolutely. Four to six weeks ago, we had about 125 COVID patients in the hospital. Today, we have about 20. A month and a half ago, we had maybe 20 or 30 patients in the intensive care unit. Today we have four.

CHANG: Wow.

WACHTER: There's still COVID there. There are still people who are pretty sick with it. But it is nowhere near what we were seeing a couple of months ago.

CHANG: That's good to hear. Well, one thing that we asked you about in January were COVID pills. These are the antiviral drugs, which at the time were in short supply since they had just come onto the market back then. What's access like to these COVID pills now? Like, can patients readily get them if they need them?

WACHTER: Not readily, but there's enough so that people who are at the highest risk can get them. And if we get to a place where even people who are at modestly high risk, like older people like me, have access to the pills, that puts us in a better place - because the pills - at least in the clinical trials, the pills decrease the rate of hospitalization and death by 90%...

CHANG: Wow.

WACHTER: ...Mostly talking about the Pfizer pills called Paxlovid. And they work independent of the immune system. So even people who got vaccinated and the vaccines didn't work - and that's largely immunosuppressed people - the pills should work just fine. So that's a game changer. COVID will be in our lives in the future. There will probably be many surges. And so the availability of - widespread availability of the pills is a very big deal.

CHANG: Well, you segue beautifully into my next question. I was going to ask for another prediction - because there have been so many moments over the last two years where it felt like just when people were starting to get hopeful, starting to turn a corner in this pandemic, another wave of cases come, or another variant comes. Does this hope that we are both feeling right now - does this hope feel a little more long-lasting?

WACHTER: I think it does. I'm going to be careful 'cause I know now that you tape things and can play them back again.

(LAUGHTER)

WACHTER: But yeah, I think it does. It really has the feeling that we have not seen a variant worse than omicron now over three or four months. We have this little twist on the theme, this BA.2, that may lead to minor surges 'cause it's a little bit more infectious than the original version. But I think the next several months are going to be fine. I think we're going to continue to see lower caseloads, relatively little stress on our health care system.

And obviously, the mother of all curveballs is the possibility of a variant that's better at its job than omicron. And anybody who gives you a hard and fast prediction on that is lying to you. I don't think we have any idea what the probability of that is. It's not 100%. It's clearly not zero. And I think we just have to wait and see. So I'm pretty confident that the next several months are going to be terrific and get continually better. I really am not able to make any kind of prediction about the fall 'cause it really...

CHANG: Yeah.

WACHTER: ...Hinges on whether there'll be a new variant.

CHANG: Well, as someone who is double-vaxxed and boosted and got COVID last December, in these next couple to a few months, I'm going to start eating indoors without a mask.

WACHTER: I think you can, and I think you should. And I think you should enjoy yourself.

CHANG: (Laughter). That is Dr. Bob Wachter, the chair of the Department of Medicine at the University of California, San Francisco. Thank you so much for joining us again.

WACHTER: What a joy. Thanks so much. Transcript provided by NPR, Copyright NPR.