What Are the Facts on Omicron

The Picture Is Getting Clearer

Omicron poses a serious threat, but we’re not back to square one.
Omicron has quickly supplanted Delta to become the dominant variant in
the United States after spreading widely in South Africa, the United
Kingdom, and other parts of the world.

The past couple of weeks, Covid cases have set records in the U.S. —
reaching almost triple the number of infections of last January’s peak.
Although it appears that we may have hit a peak nationally, there’s still A
LOT of virus in the air, and in many places the deluge hasn’t yet crested.

The Omicron “wave” is more like a flash flood or tsunami. In my more

than 30 years of experience in infectious diseases, I’ve never seen a virus
THIS transmissible — but the good news is that it appears to be much less
severe — on an individual basis — than previous variants, and vaccines
continue to protect extremely well against hospitalization and death. The
virus has adapted, so we must also adapt our response … to Omicron, and
to whatever comes next, also.

As both cases and hospitalizations have risen in the U.S. throughout the
past few weeks, I’ve addressed some of the most common questions
concerning the variant, what it means for the U.S. health system, and
ways we can mitigate spread of the virus.

What’s different about Omicron

Omicron caused a lot of concern when it emerged because of the large
number of mutations it contains, which have changed the way it behaves.
The variant spreads faster and is better able to escape immunity — at
least to infection if not severe disease — than previous variants.
For example, studies of household contacts find a higher risk of
transmission — maybe as much as double — when a case is caused by
Omicron compared with one caused by Delta, a striking finding.

Is Omicron milder
Although Omicron is one of the most infectious viruses ever, the good
news is that it appears to be significantly less dangerous than previous
variants on an individual basis. Having said that, it’s important to be very
clear that the speed of transmission and sheer number of infections pose
an acute and serious threat to our healthcare system.

Based on what we know now, people who get infected with Omicron —
especially vaccinated individuals — are far less likely to experience
serious symptoms or require hospitalization. Data suggest that Omicron
may be roughly as severe as influenza from a population perspective, and
much less so for those who are up-to-date on vaccination.

It may be that the virus is encountering more population immunity than

earlier in the pandemic — in many places, 90% or more people have
already either been infected with Covid or vaccinated against the virus.

Unfortunately, because Omicron is so contagious, it is still a very serious

threat to our healthcare system. Even though a smaller proportion of
people infected with Omicron require hospitalization, the sheer number
of people being infected with the variant is enough to inundate hospitals
throughout the U.S. with a flood of patients.

And at the same time cases are at record levels, our health care system
capacity is less because health workers are tired from years of emergency
or aren’t able to work at all because they have Covid themselves. (And
hey, how about cutting CDC a break from time to time. They saw this
coming and quickly and appropriately adjusted recommendations for
health care worker isolation and quarantine, shared the evidence for this,
and disseminated it widely to health care providers.)

Do vaccines still work against Omicron

Vaccines continue to provide excellent protection against severe disease
from Covid, and that hasn’t changed much with Omicron.

Early data from lab studies showed a reduction in antibody neutralization

of the virus compared to earlier variants, and those data have been
backed up by new real-world evidence. Unfortunately, reinfection is more
likely with Omicron than with Delta.

Although Omicron is causing more infections in vaccinated people,

unvaccinated people face the most risk from Omicron. A new CDC study
published Friday found that unvaccinated adults had a five times higher
risk of infection in December compared with adults who were up-to-date
on vaccination. And data from New York show that most of those
hospitalized from Covid are unvaccinated. Despite Omicron’s increased
immune evasion, vaccine protection against both hospitalization and
death remain remarkably high, and a booster dose strengthens your
protection.

It’s important to get up-to-date on your vaccination. Other effective, low-

burden mitigation tools, particularly masks, are also necessary, at least
until the Omicron tsunami passes.

Will getting Omicron protect me against future variants

We don’t know if infection with Omicron will protect against some, all, or
no future or past variants of SARS-CoV-2. With many infectious diseases,
less severe illness is associated with less development of immunity, so it’s
not clear that the Omicron flash flood will substantially strengthen our
wall of immunity much, though it’s possible that it will.
In a very small study from South Africa, antibodies from people recently
infected with Omicron could neutralize the Delta variant in the lab.
However, what this will mean in the real world, and especially for long-
lasting protection is unclear.

Even though we don’t know for sure if Omicron infections will cause
effective or long-lasting immunity, we do know that increased vaccination
and infection are strengthening our defenses against Covid.

I’m more optimistic about our ability to tame the pandemic than at any
point since its emergence — unless, of course, a worse variant emerges,
with the infectivity of Omicron and as deadly as Delta. That’s possible, but
doesn’t change our ability to move forward if we vaccinate, mask,
strengthen public health, and increase vaccine production capacity.

What else can I do to avoid getting infected with Omicron or spreading it

There are simple steps each of us can take, in addition to vaccination, to
reduce our individual risks
▪️Consider upgrading to more protective masks such as an N95, KN95,
KF94, or equivalent.
▪️Improve ventilation by opening doors and windows, filtering air, or
spending more time outside.
▪️Before gathering indoors with friends and family you don’t live with,
consider getting tested.
▪️If you’re exposed to Covid, quarantine and test.
▪️If you test positive or have Covid, stay home and isolate to protect those
around you.
▪️Take extra precautions before visiting vulnerable, elderly, or
immunocompromised contacts.
We can’t prevent every infection, but we can make a big difference
Omicron poses a serious threat, but we’re not back to square one. We’ve
got vaccines, masks, tests, treatment, and ventilation. Get vaccinated and
boosted, mask up indoors (and up your mask game to an N95 or similar if
you’re immunosuppressed or elderly), get tested if you are exposed to
the virus or feel sick, and balance the potential risks and benefits of
activities until the floodwaters recede in the next month or so. Do what
matters most to you, as safely as possible.

Let’s learn from the lesson of Omicron — this virus moves fast. Mutations
are, in effect, innovations by the virus. Omicron may not be the last
surprise this virus throws at us. If anyone insists they know what’s coming
next with Covid, they simply don’t know what they’re talking about. To
blunt the spread of disease and death, we need to learn quickly, adapt
our response, communicate well, and act on what we know.