Dec 17, 2021
A growing chorus of voices is sounding the alarm about the Covid-19 pandemic's likely trajectory in the United States, where hospitals--already overwhelmed by a post-Thanksgiving spike in Delta cases--are bracing for a massive surge in infections driven to a growing extent by the even more contagious Omicron variant, which is running rampant ahead of major holiday gatherings.
"Whether out of complacency or exhaustion, we ignore this at our own peril."
"We're really just about to experience a viral blizzard," Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, toldCNN's Erin Burnett on Thursday.
"In the next three to eight weeks," he said, "we're going to see millions of Americans are going to be infected with this virus, and that will be overlaid on top of Delta, and we're not yet sure exactly how that's going to work out."
The U.S. Centers for Disease Control and Prevention (CDC) briefed state health leaders earlier this week, presenting "two scenarios, based on models, for how the variant might drive infections in the next few weeks and months," The Guardian reported Thursday. "Omicron and Delta cases could peak as soon as January or a smaller surge of Omicron could happen in the spring."
According to Celine Gounder, infectious disease specialist and epidemiologist at New York University andBellevue Hospital, it remains to be seen whether Delta or Omicron will be dominant in the coming weeks, or if the two strains will coexist. Regardless, she said, "we anticipate an increase in hospitalizations, an increase in deaths, and an increase in the burden on the healthcare system over the next couple of months."
CDC data shows that the Omicron variant accounted for almost 3% of Covid-19 cases in the U.S. as of Saturday--up from just 0.4% the week before.
Scientists have attributed the rapid spread of the recently detected variant to its high transmissibility.
A new study by researchers from the University of Hong Kong's LKS Faculty of Medicine, which has not yet been published and is currently under peer review, found that the Omicron variant "infects and multiplies 70 times faster" than the Delta variant and the original coronavirus strain in the human bronchi.
They also learned that Omicron infection in the lungs is "significantly lower than the original SARS-CoV-2, which may be an indicator of lower disease severity."
However, The Guardian noted, "it is still too early to tell if Omicron is more or less deadly than previous variants."
"The virulence really depends on the age of the person we're talking about, as well as other demographics, but age is probably the most important one," said Gounder. "With the early data coming out of South Africa, much of that was in young, relatively healthy, college-student-aged people."
The Guardian added that available evidence "does indicate the variant is more transmissible and immune-evasive, making infection more likely among those who are vaccinated or have recovered from earlier bouts with the virus."
Even if the Omicron variant turns out to be less virulent than previous strains, its rapid spread--Covid-19 cases are doubling roughly every two days in the United Kingdom--could be more than enough to inundate the United States' hospitals and cause the nation's pandemic death toll, already above 800,000, to keep climbing.
As journalist David Wallace-Wells explained in a New York magazine essay published on Wednesday:
The largest study to date on early South African data... found that, overall, those with Omicron were experiencing 29% less severe disease than those who got sick in the country's first pandemic wave. Other, independent assessments have yielded lower--which is to say, more encouraging--estimates: Perhaps Omicron's severity is lower by two-thirds, perhaps even less.
But a strain that is one-third as deadly and three times as catching lands you pretty quickly in the same spot, death-wise. And a strain that is 70% as deadly but five times as catching lands you somewhere a lot worse. That is the logic of some U.K. modeling suggesting that a best case for the country was a level of hospitalization half as high as last winter's brutal surge, and a worst-case for one twice as high.
Keep in mind, that earlier surge--by far the country's deadliest phase of the pandemic--came before mass vaccination. To approach its death toll despite a very well-protected elderly population would require an explosive couple of months.
And since American vaccination rates are considerably lower than those in the U.K., with booster uptake lower as well, extrapolating the same model to the American population yields an even bleaker set of projections.
"Beyond the question of virulence," he stressed, "the new variant's speed throws all of our inadequate prep and policy into similar disarray. Even in a best-case scenario, the country is almost certainly going to be overwhelmed, very soon, by new cases."
"Even if Omicron cases turn out to be milder (which is no guarantee), the sheer number of expected cases can overwhelm an already fragile system."
Healthcare professionals are already issuing warnings about the devastating consequences likely to accompany the impending "massive spike" in Covid-19 infections.
"Working in the ER today made me really concerned about what we'll see in the coming weeks," Dr. Craig Spencer, a physician in New York City and director of Global Health in Emergency Medicine at Columbia University, said Wednesday in a detailed Twitter thread.
"For starters, we are facing a massive nursing shortage," he said. "Nurses are overextended, taking care of more patients than is generally considered safe. Anyone working in the ER knows that nothing happens without nurses. And a good nurse can be the difference between life and death."
"On top of that," Spencer continued, "healthcare workers are burnt out. Crushed. Exhausted after two years of the pandemic."
He pointed to a recent survey that shows nearly 20% of healthcare workers have quit since the start of the ongoing public health crisis, adding that "those that stay are struggling with psychological scars or grasping to find the empathy that used to come so easily."
"The point is that even if Omicron cases turn out to be milder (which is no guarantee)," he said, "the sheer number of expected cases can overwhelm an already fragile system. Previously we asked you to flatten the curve. But the next curve could truly flatten us."
According to Spencer, "In South Africa, 20% of healthcare providers got sidelined with Covid after Omicron started spreading there. If we experience even a fraction of that loss amongst our already struggling and short-staffed frontline providers, we're in huge trouble."
Speaking with CNN on Thursday, Osterholm echoed Spencer's warning.
"What you have here right now is a potential perfect storm," Osterholm said. "I've been very concerned about the fact that we could easily see a quarter or a third of our healthcare workers quickly becoming cases themselves."
Spencer, meanwhile, said that "whether out of complacency or exhaustion, we ignore this at our own peril. As an ER doc, I promise you'd rather face the next few months fully vaccinated."
According toCNN, "Recent lab studies of blood taken from vaccinated people and exposed to Omicron showed the variant can evade some protection offered by two doses of Moderna's Covid-19 vaccine, but a booster dose restores much of that immunity, researchers reported Wednesday. The Pfizer/BioNTech vaccine has shown similar results."
"The daily rate of vaccinations is up around 22% from a month prior, according to CDC data, with more than half being booster doses," the news outlet noted. "At the current pace, it will take more than two months for at least half of adults to get a Covid-19 booster."
U.S. President Joe Biden on Thursday urged Americans to get vaccinated, including a third shot, as quickly as possible.
"For the unvaccinated, we are looking at a winter of severe illness and death," he said. "But there's good news: If you're vaccinated and you have your booster shot, you're protected from severe illness and death."
"As an ER doc, I promise you'd rather face the next few months fully vaccinated."
As The Guardian noted, "Biden's national plan for addressing Omicron specifically excludes restrictions like stay-at-home orders and the majority of states have seen their local health powers significantly curtailed during the pandemic, making it more difficult to enact emergency measures to slow the spread of the virus."
Gounder, for her part, stressed the importance of improving ventilation and air filtration and wearing high-quality masks, such as KN-95s and KF-94s.
In addition, she said, public health officials should scale up testing and wastewater surveillance across the country. "Omicron has an even shorter incubation period of two to three days," Gounder explained. "If you want to have a reasonable chance of catching most of those infections and being able to do something about it, you really need to be testing every day."
While the White House scoffed at the idea of delivering free tests to every household in the U.S. through the postal service, Colorado and Massachusetts have both launched free, rapid at-home testing programs, and Gounder encouraged other states to follow their lead by using American Rescue Plan funds to purchase tests for residents.
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