Omicron could be milder — or a disaster. Don’t wait to find out.
The warnings are coming fast and furious. “Tidal wave,” said British Prime Minister Boris Johnson. “Omicron is spreading at a rate we have not seen with any previous variant,” said Tedros Adhanom Ghebreyesus, the World Health Organization’s director general. “I’m a lot more alarmed,” said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. A new wave of highly-transmissible coronavirus is engulfing the world and will explode soon in the United States. It is vital to grasp what this means and how to respond.
Cases will rise fast. Omicron appears to transmit more rapidly than the delta variant, and it will almost certainly bring more breakthrough infections in people who are already vaccinated. Cornell University shut down its Ithaca campus after a COVID-19 outbreak marked by a significant share of omicron cases, including in the fully vaccinated. (Though this omicron outbreak did not bring severe disease.) In South Africa, omicron rapidly overtook the delta variant, and omicron cases appear to be doubling every two days in Britain.
Such rapid transmission demands the country double down on proven mitigation measures: face masks, distancing and improved ventilation. Rapid spread also poses a potential threat to hospitals already burdened by delta and battered by nearly two years of pandemic. “The sheer number of cases could once again overwhelm unprepared health systems,” Tedros warned. Hospitals must prepare for another onslaught. And, critically, more people must get booster shots.
A hint of why omicron is spreading so fast comes from a study researchers at the LKS Faculty of Medicine at the University of Hong Kong just released. They found that omicron infects and multiplies 70 times faster than delta in the human bronchus, the airways that conduct air into the lungs, but omicron infection is somewhat weaker inside the lung. The study, though not yet peer reviewed and based on laboratory work, suggests that high amounts of the virus in the bronchus could help explain omicron’s rapid transmission.
But researchers still do not know if more cases will lead to more severe disease. Early evidence suggests omicron hospitalizations are not rising as quickly as they did with delta.
If it turns out omicron is milder and spreads wildly, that could be a blessing, as the new variant displaces delta. But it is still too early to know; in a worstcase scenario, if omicron causes severe COVID, the coming wave could be devastating.
Vaccines proved highly effective against delta. Preliminary results show that, with boosters, people still have healthy protection against omicron and against severe disease. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Wednesday that “our booster vaccine regimens work against omicron,” and that a new variant-specific vaccine is unnecessary.
Yet people who have been initially vaccinated but not boosted might be quite vulnerable to omicron infection. Though it is unclear whether they would face mild or severe symptoms, there is no reason to take a chance; getting a booster shot is safe, easy and free, and the many question marks surrounding omicron suggest the new variant should not be underestimated. Government officials, businesses and others should not let up in their efforts to get more shots into more arms.
The country should hope omicron is a timid kitty — but act as if it is a tiger.
Researchers still do not know if more cases will lead to more severe disease. Early evidence suggests omicron hospitalizations are not rising as quickly as they did with delta. If it turns out omicron is milder and spreads wildly, that could be a blessing, as the new variant displaces delta.