By Adriana Belmonte

As the holiday season approaches, COVID cases are on the rise once again around the world.

Globally, there have been more than 654 million COVID cases, with more than 15 million recorded in the last 28 days, according to the Johns Hopkins Coronavirus Resource Center. The U.S. is nearing an overall total of 100 million cases, with more than 1.5 million cases seen over the last 28 days.

Despite this uptick, one NYC-based physician is optimistic about how the U.S. will fare throughout the winter, thanks to the development of booster shots.

“With the bivalent boosters that we have, it’s been very tremendous in lowering the hospitalization rates,” said Dr. Calvin Sun, an attending physician in emergency medicine and author of "The Monsoon Diaries," adding that this year's flu shots have also reduced hospitalization.

Sun compared vaccines to seatbelts in that they don’t prevent a negative outcome entirely but do significantly reduce the severity of it. The bivalent booster shot, in particular, targets the original strain of the coronavirus as well as the Omicron variant, which is able to evade earlier versions of the vaccine.

Despite the high number of COVID cases in the U.S. over the past month, only a fraction have resulted in hospitalization, according to the latest CDC data. The current seven-day average for hospitalization is 5,010, a 2.3% week-over-week increase.

“I got both [the bivalent booster and flu shot] at the same time,” Sun said. “And now I’m doing great. That was two months ago. And I haven’t gotten sick, even though I’m constantly exposed to people who are sick and have symptoms. I haven’t gotten it yet. And if I were, I know that the severity would be lessened to the point where I don’t have to worry I’ll end up in the hospital.”

'That's on your conscience'

Despite early progress, vaccine and booster uptake has slowed in recent weeks.

So far, 68.9% of the U.S. population — and 78.7% of those over the age of 18 — have completed a “primary series” of COVID vaccines, meaning they either received a single dose of the Johnson & Johnson vaccine or were double vaccinated with an mRNA vaccine such as those from Pfizer and Moderna.

Yet just 14.1% of the population (and 16.3% of those 18+) have gotten the updated bivalent booster shot.

“Obviously we live in a country where if you’re being told what to do, you may get a backlash and a worse outcome when people — out of defiance or pride or fear — do the opposite of what you would recommend,” Sun said.

Sun explained that he takes a different approach to convey the importance of vaccines.

“No one’s forcing you or looking over your shoulder or arresting you or doing whatever that you’re afraid they might be doing to you if you don’t do something,” he said. “It’s just on your conscience.”

But, he added, “there are consequences. And if Grandma gets sick and dies because you got her sick — because you refused to mask around her out of pride or fear or whatever it is or you decide not to get vaccinated when you visit your family and get Grandpa sick, and they’re in the hospital later on — those are vulnerable populations. That’s on your conscience.”

Vulnerable populations include the elderly, the very young, and those who are immunocompromised. Nearly 94% of those ages 65 and up have been fully vaccinated while 35.7% have received the bivalent booster dose.

“You have to accept those consequences because you didn’t do something that you could have,” Sun said. “If you decide not to put on a seatbelt, there are consequences when bad things happen, and you have to own that consequence. When people hear it is this way, they do consider it a little more seriously. And that tips the needle a little bit. It does make a huge difference.”

Maintaining a low hospitalization rate is key to containing the spread of the virus, Sun added. In the early days of the pandemic, most hospitals were extremely overwhelmed and lacked the capacity to meet demand.

“We don’t want it to collapse because once we run out of beds, where are people going to go?” Sun said. “People are concerned because the vaccine doesn’t prevent all illness. Well, seatbelts don’t prevent all car accidents. Bulletproof vests don’t prevent getting shot. Helmets don’t prevent a brick falling on your head but do reduce the chances that you’re going to end up in a hospital and take up an otherwise necessary bed.”