Public health experts warned it could happen for months, but for many, that hasn’t made the news of the latest COVID variant any easier. The emergence of omicron has raised a slew of questions about how this variant will behave and what it means for the future of the pandemic for people across the globe, along with pure logistical questions about public health protocols, our holiday plans and daily lives.
What do we know so far? Omicron, which the World Health Organization designated as a variant of concern Nov. 26, appears to have more than 30 mutations on its spike protein, the virus’ signature feature that helps it infect human hosts. For comparison, the delta variant, which still makes up the vast majority of known new infections in the U.S. and around the world, had fewer than a dozen such mutations. The WHO said this variant potentially carries an “increased risk of reinfection” and has been found in a handful of countries. On Wednesday, health officials in California said they had identified one fully vaccinated person who was sick with the variant and had returned to the U.S. from South Africa on Nov. 22. That person developed mild symptoms, tested positive and self-quarantined. Their close contacts have tested negative, according to the Centers for Disease Control and Prevention. This case was inevitable, many public health experts have said in recent days, including Dr. Anthony Fauci, chief medical advisor to the White House, who told the PBS NewsHour’s anchor and managing editor Judy Woodruff on Monday that he “really would be surprised if we didn’t ultimately have it here in this country.”
Key questions need to be answered about the new variant, including whether it is more transmissible, produces more severe disease, and responds to vaccines and medicines. Amanda McClelland, who is an expert in international public health management with the global health initiative Resolve to Save Lives, says she expects answers will come into focus over the next 10 days as scientists closely map omicron’s evolution.
The type and combination of mutations found on omicron concerns epidemiologists like Dr. Katelyn Jetelina, an assistant professor at the University of Texas Health Science Center at Houston and author of the blog, Your Local Epidemiologist.
But the main message that experts like Jetelina and Fauci want the public to hear is more optimistic. “We can’t lose all hope right now,” Jetelina said.
What should people do right now?
We are far from powerless against the virus, experts have reminded us in recent days. The tools that have reduced new infections, hospitalizations and death across the pandemic remain our best protection, epidemiologists, virologists and public health experts told the PBS NewsHour. Viruses mutate in order to infect more hosts and survive, and early reports out of South Africa suggest that this variant may have sickened vaccinated people. But Dr. Saad Omer, an epidemiologist who directs the Yale Institute for Global Health, said, “Even if we find out there’s lower efficacy, we’re unlikely to find out that there’s no efficacy.”
Vaccines are safe, highly effective and one of the most important ways to protect people from severe COVID outcomes. If you are unvaccinated, get your shot, they said. If you’re fully vaccinated and eligible, get boosted.
On Monday, the CDC said that any person aged 18 and older who received their primary series at least six months ago should roll up their sleeve for a booster dose — a revision of their earlier guidance that recommended boosters only for certain groups. Emerging evidence has suggested the protection vaccines offer wanes over time. This summer, a growing number of (typically mild) breakthrough infections among fully vaccinated people demonstrated that despite their power, coronavirus vaccines have their limitations — as is the case with any vaccine. Couple that dwindling protection with colder temperatures, winter holidays and people spending more time indoors with others, and public health officials were already expecting to see more cases, even without the presence of omicron.
Though powerful in preventing hospitalization and death, immunization alone is not enough to slow the spread of the virus and its variants, so falling back on other public health measures can help. People should wear masks in public indoor places or other settings with people with different households and ventilate those spaces, experts say. If you have symptoms, such as sneezing, a runny nose or cough, get tested. If you are infected, isolate yourself from others to prevent the virus from spreading further.
“We have some tools at our disposal that work fantastic,” Jetelina said. “We need to continue to use them.”
Planning for holidays with a new variant
Omicron caught the world’s attention the day after Thanksgiving in the U.S., when many Americans were getting back into the swing of what seemed like a more normal holiday season and in some cases returning to larger gatherings of family and friends.
In fact, the picture wasn’t so rosy to begin with — the delta variant has for months caused infections to rise across the U.S. and much of the world. In Europe, where many countries have high vaccination rates, confirmed cases have been soaring, and several nations ramped up restrictions in recent weeks to control further spread — developments that experts saw as warning signs for the U.S.
Going into the holidays, getting fully vaccinated (or boosted) should be people’s top priority, reiterated Dr. Eric Topol, head of the Scripps Research Translational Institute. As a fallback, therapeutics, including pill-form medications, offer protection against potentially life-threatening outcomes, especially if administered early.
Free, reliable and widely available rapid tests are critical to catching cases, both to take advantage of cutting-edge medications, as well as to protect loved ones if you’re going to be traveling or in close quarters. Fortunately, this variant can also be detected in available PCR tests, Fauci said Monday, which means cases driven by omicron won’t evade our monitoring.
Topol noted, other developed nations have provided those tests to households directly and have managed to keep caseloads (and deaths) far lower than the U.S., where more than 776,000 people are known to have died from the virus during the pandemic.
For nearly two years, untimely deaths have devastated families, precautions and restrictions have kept loved ones apart, and lives and livelihoods have been upended in ways that will likely take decades to mend.
It is important to remember that the U.S. is better positioned to respond to the virus than it was a year ago, said Dr. Gigi Gronvall, a senior scholar for Johns Hopkins University’s Center for Health Security. Vaccines, which this time last December were on the brink of being offered to only the nation’s most vulnerable populations, are now widely available to people ages 5 and older. And the federal government typically is on top of the latest data and science, she said, unlike a year ago when the Trump administration was arguing “with government officials about whether or not this virus is harmful.”
“We’re all tired of being in this pandemic and want to be on the other side of it,” Gronvall said. “But things are — in so many ways — better than they were a year ago.”
At the same time, leaders cannot dismiss the social and emotional toll of the pandemic, Omer said.
He and his colleagues have studied pandemic fatigue — and what is at stake if it is ignored — since the early days of COVID. From that field of research, best practices for policymakers include the need to appeal to people rather than to blame, shame or scare them into heeding public health measures; using “clear, precise and predictable language” in outlining those measures and why they are necessary; and understanding that, while some tactics may protect people’s physical health, they also harm their overall well-being and prove unsustainable.
Before authorized vaccines were available, lockdown measures stifled spread and protected health care systems from being overwhelmed, but those mitigation efforts came at a high cost. During a news conference on Monday, President Joe Biden said he did not see any need for such orders at this time if people got vaccinated and wore masks. Even faced with the unknown risks of an emerging variant, Omer said lockdown measures open “windows of opportunity” to act early based on evidence, but “are not sustainable in perpetuity.”
What the world needs to do
The pandemic’s latest variant is a real-life reminder of global vaccine inequity and what happens when low- and middle-income countries are not fully integrated into vaccination campaigns. About half of the world’s population has received at least one vaccine dose. But in low-income countries, that level of protection against the virus drops to 6 percent.
So far, the U.S. leads the world in donating COVID-19 vaccines to the global community, but those donations are a fraction of what the country has pledged to offer, Omer said.
“We’ve heard a lot of platitudes about vaccine equity, but we haven’t seen a lot of actions,” McClelland said.
In South Africa, about a quarter of the population has been fully vaccinated. There, scientists first identified the variant earlier in November and alerted the global community. But, despite evidence suggesting the variant could be traced to earlier origins in Europe, travel bans swiftly descended upon travelers from South Africa and neighboring countries, raising concerns that countries will be disincentivized from transparency and collaboration.
Meaningful action also requires more than throwing doses at countries and expecting them to pick up the slack, McClelland said. For example, she said, one small nation with a population of 2 million people has received seven different vaccines — each with their own logistical considerations for handling, distribution and side effects. Those hurdles, combined with the need for staffing as well as clear public health messaging (in part to counter misinformation as seen in the United States), complicate vaccine rollouts, McClelland said.
“We need to think about vaccines as a full end-to-end process,” she said. “It’s not just about vaccines arriving.”
This week, the World Health Assembly is gathering in Geneva to forge a new treaty with the goal of preventing future pandemics, and McClelland said countries must commit to more equitable distribution and manufacturing of vaccines to reach that goal.
“It really is a now-or-never moment,” she said.