Scott, let’s start with the basics. What do we know about 0micron, and what don’t we know?
There are three big questions, and we have a decent understanding around two of them.
First, transmissibility – it’s spreading everywhere and it’s hard to see anything that can stop it. It is rapidly surpassing the delta in the US, UK, Denmark and possibly many other countries in the coming weeks.
Second, vaccines – all vaccines, but especially mRNA ones, still seem to reduce the risk of serious illness and death even without a booster (although less than with previous variants). But they fight mightily against a highly contagious variant. which can get into your nose even before your immune system has time to respond. Boosting mRNA (and possibly others) should restore some protection against even mild infection and transmission, but it is not known for how long.
Third, severity – the most debated and misunderstood issue of the three. There is already a cottage industry of hot dishes. My lukewarm opinion has always been that this question would take the longest to answer and require a ton of caveats – we still can’t really answer this conclusively with delta. And delta has shown lower rates of hospitalization and death per case in places with high levels of vaccination or previous infection, although the variant itself is unlikely to be fundamentally less severe.
For omicron, this could also be the case. It appears, however, that South Africa is experiencing a less severe epidemic. And it is proven to replicate less well in the lungs. Both of these things are positive signals, but the reality is that we just don’t know yet and won’t know for at least a few weeks with data from other countries.
South Africa appears to have peaked quickly, is that likely to be the same elsewhere?
We have to be very careful about generalizing the South African experience – the demographic and epidemiological profile is very specific. A rapid rise and fall like this is certainly not out of the question in many places, but remember: the delta is still bouncing around twelve months after it was first identified, and it has spread much faster than previous variants. . There will not be a single timeline for all countries or regions within countries.
Is the timing and nature of the omicron changing the types of policy challenges governments face in addressing them?
For two years we have been in an already exhausting and painful pandemic. The longer it drags on, the more it creates political divisions, compromising the development of coordinated and evidence-based policies. Overall, rich countries may be able to cushion the shock of further disruption with more fiscal stimulus, but the policy environment for doing so continues to deteriorate. Less wealthy countries don’t even have that luxury.
To the right. What about things like vaccination warrants, lockdowns and schools?
Many countries have decided that immunization mandates are the best of a bad set of options to curb the spread. This position is unlikely to change, but it will get more complicated with questions about what constitutes a “fully immunized” and what vaccines qualify under the warrants.
School is a delicate matter. Some are likely to be able to stay safely open, thanks to testing, ventilation, vaccination and small class sizes. But not all, and a general policy to keep all schools open would overlook low-resource schools where many children go home to multigenerational households where grandparents are the caretakers because parents have to work and can’t do it on Zoom.
What did you think of President Biden’s omicron speech on Tuesday?
It’s hard to know exactly who he’s trying to reach at this point, as so many people have been leaning into their respective positions. He’s right to point out the risks to the unvaccinated, but shaming them probably won’t move the needle much and may embolden opposition to the vaccine. Building health care capacity with federal resources, including the military, should help hard-hit areas. But if things go wrong in too many places, it can be more of a band-aid on a gaping wound. And sending 500 million tests to people’s homes is a great idea – twelve months ago. The consistent underperformance of testing remains a big unforced error for the United States’ public health response. Better late than never I guess.
Is there a world in which Omicron is bringing us more quickly to the endemic nuisance stage of the pandemic?
This world exists. I wouldn’t expect to wake up to it in the coming weeks. This best scenario remains possible in the medium term: that is, this variant causes much less hospital strain than previous waves and builds a wall of immunity against serious illnesses high enough to prevent hospitals from overflowing again. .
âIf it bleeds, it leadsâ is a popular saying in journalism. But one of the interesting things about this pandemic is that there is an incredible demand for good news as well, and it can (again) lead to a false sense of security and mission accomplished bias. We must therefore be careful not to smoke too much this sweet hopium â¢.