Omicron: Prepare for the Worst and Hope for the Best

It has been just over two weeks since South African authorities reported a new variant of COVID-19 to the World Health Organization. The variant we now know as Omicron was designated as a variant of concern and has spread rapidly around the world causing widespread disruption, leading governments to reimpose travel restrictions and mandate travelers to quarantine. As medical experts work around the clock to understand Omicron’s potential impact, it is already clear that this variant is much more transmissible than previous variants. 


The Economist reports that in South Africa, Omicron has displaced Delta as the dominant strain. Authorities in the country found that an individual infected with Omicron may infect 3-3.5 other people, whereas an individual with the Delta variant may infect 0.8 other people. There is no lockdown in South Africa, which might explain the rapid spread, but this might also be due to its increased infectiousness and ability to evade immunity – which is a worrying sign.


The New York Times summarized what is currently known about Omicron and Jennifer Nuzzo, from Johns Hopkins University, stated that “what is hard to assess right now is how this will play out if or when older and more vulnerable people become infected.” The bulk of our understanding of the Omicron variant is based on studying infections within a relatively youthful population in South Africa and in laboratory tests. Early findings do suggest that there is potential for widespread community transmission, though illness may be less severe. Researchers are still determining what Omicron’s impacts and severity might be on elderly and vulnerable populations, especially here in the United States, where the winter season tends to see people spending more time indoors, thereby raising the risk of contagion. Health authorities and policy makers are right to be cautious as so much about Omicron remains unknown. The best advice they can offer would be to prepare for the worst, while hoping for the best.


Vaccinations from first shots to boosters must remain a priority despite concerns being raised over whether current vaccines will provide protection against Omicron.  Dr. Eric Topol of Scripps Research stated, “I do think vaccines will hold up, not so much for getting infections but for severe illness…Our immune systems are designed to protect us from getting sick, not from getting any infection whatsoever.” While this might be good news, breakthrough infections in vulnerable vaccinated individuals can still prove deadly.  Additionally, those who have been previously infected and already vaccinated can show waning immunity after a few months, making booster doses of the vaccine more important than ever. Dr. Robert R. Redfield, Jr., the former Director of the CDC, recently said that we should move away from the term “fully vaccinated” and anticipate additional vaccinations every six months or so.


Health authorities must also continue to promote COVID-19 testing, including both PCR and rapid at-home tests, as these have shown to be highly effective in detecting infection and mitigating community spread. Once infections have been identified, contact tracing can also play an important role in identifying risk and managing onward transmission. Individuals should be encouraged to continue to follow local COVID-19 regulations and protocols, including social distancing, wearing a mask, and limiting large indoor gatherings. 


Until more comprehensive data and analysis can tell us how this new variant is affecting American communities, local authorities and individuals must treat Omicron as a significant threat and take steps to protect themselves until we know otherwise.

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