PROVIDENCE – As difficult as COVID-19 has made this December with omicron now the dominant variant, “we are looking toward a month of January when we’re just going to see an extraordinary number of infections across all of the country,” Dr. Ashish Jha, dean of Brown University’s School of Public Health, said on Tuesday. “As it has been throughout, the pandemic is going to hit different parts of the country at different times,” jha said. “We're seeing pretty substantial increases in the Northeast. We're seeing Florida’s numbers just skyrocket. We're seeing this really in Los Angeles. New York City has been one of the epicenters in the U.S. So we're really seeing this across the country.” Jha said that while the number of reported new cases has hit record levels, the true numbers are likely even higher. “I actually think we're way under-counting,” he said. “Because of the holidays, people are not testing. Lot of states are not reporting. So I would argue that right now, we have more people infected in America than at any moment during the entire pandemic, no question about it. In my mind, this is pretty staggering. And we are not anywhere near peak infection.” According to The New York Times on Monday, 543,415 new cases were reported in the U.S. based on the latest data, with a daily average of 243,099. Rhode Island, according to The Times, had a daily average of 1,382 new cases with a positivity rate of 130 per 100,000, fifth highest in the nation, after Washington, D.C., New York, New Jersey and Puerto Rico. https://www.nytimes.com/interactive/2021/us/covid-cases.html In Rhode Island, as elsewhere in the nation, the strain on hospitals concerns Jha, who spoke during recording of the latest “COVID: What Comes Next” podcast. “All of our major hospitals are incredibly stressed largely because of staffing shortages, because of nursing shortages,” Jha said. “So I am very worried about both the cases we saw just before Christmas and what will happen over the Christmas and New Year's holidays in terms of the number of new infections. Even if it turns out that Omicron is milder, which it probably is, there will still be enough new infections to really cause a serious problem.” https://www.providencejournal.com/story/news/coronavirus/2021/12/11/covid-fourth-wave-rhode-island-hospitals-short-staffed-omicron-ri/6461357001/ Jha and others on many occasions have urged people to get vaccinated and boosted when eligible. Experts also have repeatedly advised people to wear masks in many settings, particularly indoors; limit the size of gatherings; make provisions for proper ventilation, and continue hand-washing. These measures can also help prevent influenza and other diseases. Isolation after testing positive has also been advised -- and on Monday, the Centers for Disease Control and Prevention issued new guidelines. Among them is shortening the time that infected patients should isolate from ten to five days after a positive result. https://www.usatoday.com/story/news/health/2021/12/27/omicron-airlines-cancel-flights-covid-updates/9021308002/ Overall, Jha said he agrees with the new guidance. “I'm in favor of the CDC changes, but I understand that not everybody loves them,” he said. Looking deeper into 2022 and beyond, Jha said “there is no question in my mind that COVID-19 is going to be with us, probably forever but certainly for a very, very long time.” The question then becomes, he said, “How do we manage our lives with the virus?” Similar to “the way we manage our lives with lots of other respiratory viruses” such as flu, which has never disappeared, he said. “We’ve got to figure out how to really lower the virulence, the way in which this virus gets people sick,” the scientist said. Progress has already been made, according to Jha. “Vaccines are going to be our primary tool,” Jha said. “We're also going to have therapies that will lower the severity of the disease, such as monoclonal [antibody therapy], oral pills like PAXLOVID from Pfizer. There will be hopefully others. It's going to become something that we manage and live with.” https://www.providencejournal.com/story/news/coronavirus/2021/12/12/monoclonal-antibodies-hasbro-childrens-hospital-treat-covid-at-risk-kids/6478053001/ Jha foresees seasonality, just as with flu. “We'll see surges maybe even in the summer in the south, in the winter in the north, and that will become a feature of this virus,” he said. But the bottom line, according to the scientist, is that COVID-19 “It will not continue to torture us the way it has so far.” This is the 40th episode of the “COVID: What Comes Next” podcast, begun in October 2020 and available exclusively from The Providence Journal and the USA TODAY NETWORK. It is hosted by G. Wayne Miller, health reporter for The Providence Journal.