It may sound like a dream, but it’s possible that this “Omi-tsunami” wave, which has been surging in California and other parts of the US since early December 2021, will be the end of the COVID-19 pandemic. This is the optimistic view, and notwithstanding pandemic fatigue driving our strong desire for COVID to be over, I believe it’s important not to pin our hopes on this being the final wave. Unfortunately, we have to reckon with the fact that this virus is wily and unpredictable, which means that future variants and mutations are still possible, and likely.
But, before you sink into a deep depression, there is a lot to be sanguine about, including:
- For fully boosted individuals (who are eligible), the current mRNA vaccines prevent almost all hospitalization and death due to Omicron.
- Pfizer’s Paxlovid is close to the holy grail in terms of a highly effective therapeutic treatment for Omicron when taken orally within several days of onset – millions of doses will be available in the US by April 2022.
- In the next two months, we should know more about Omicron specific vaccines.
- By June at the latest we will know when vaccines for infants and toddlers will be rolled out.
- By mid-summer we are likely to better understand whether individuals who have had Omicron will have enduring protection.
- Scientists soon expect to have a better understanding of the causes of long COVID.
- Our tools for fighting COVID will continue to improve.
We know that Omicron spreads with lightning speed, you can catch it even if you have some immunity, and you can spread it even if you’re asymptomatic. Data available in the last few days indicate that Omicron has almost totally displaced Delta in the US. We also know it has much lower virulence than earlier variants, both because it is a milder virus and because we have existing immunity (both after COVID infection and due to vaccination). Omicron infection is significantly less severe than Delta in children under the age of 5 (who are by definition unvaccinated). Omicron is also causing much less severe disease overall than previous variants. But, don’t be misled — even though Omicron appears less severe, it is not an exaggeration to say that Omicron is everywhere. “According to a January 19, 2022 Lancet article, the unprecedented level of infection suggests that more than 50% of the world will have been infected with omicron between the end of November, 2021 and the end of March, 2022.”
Due to the massive numbers of infected individuals, many hospitals in the US have been overwhelmed in the last two weeks (largely with unvaccinated or under-vaccinated individuals). Further, while children who contract Omicron typically have mild cases, kids under 5 (again, by definition, they are unvaccinated) and unvaccinated children over 5 are being admitted to intensive care units throughout the country. In a January 21 tweet, an emergency medicine doctor at South Carolina Children’s Hospitals reported that 55 of 56 children admitted were unvaccinated, 30 were too young to receive the vaccine, 8 were in intensive care and 2 children (under age 5) were on life support. So, for those parents who have been thinking, “Why not get it over with and try to contract Omicron?” my strongest advice is don’t do it. Would you knowingly do the same with influenza or measles?
After this wave, it seems quite likely that most people will have some level of immunity thanks to vaccines, COVID infections, or both. We will also be in a good position to get vaccines fast if we need them for new variants while also leveraging treatments like Pfizer’s wildly successful Paxlovid when people get sick. Unless a new variant dramatically changes the situation, I believe by March 2022, we could have a respite of up to 3 or more months (e.g., think back to June 2021 before the Delta wave hit) and some have posited that we may move out of the COVID pandemic phase and into the endemic phase. Even if we transition to the endemic phase, COVID will continue to exist and people will be infected by it. While Omicron seems to some to be more like the flu, we don’t know how it might morph and mutate and it could still be severe and deadly for some, as it is now.
On the positive side, with the tools we have now along with those on the horizon, it is probable that the virus won’t disrupt society in the US, Western Europe, Middle East and parts of Asia/Australia the way it has for the last two years. That’s because we have the immune systems, vaccines and mitigation measures developed over the last 23 months at our disposal. I do worry, however, about less developed nations which don’t have the same resources, funds or infrastructure that we do. COVID can and will fester and mutate in those places, and this is a significant risk to all of us. In other words, we must face and address systemic inequities throughout the world if we really want to end the pandemic everywhere.
When Will the Omicron Wave End?
It isn’t totally clear when the Omicron wave will end in the United States (or in San Francisco), but we can look to other places for clues. We have seen in South Africa that it took about a month to peak and about a month to recede. If this pattern holds for us, we could be done towards the middle or end of February. As of the date of this piece (1.23.22), the preliminary data from the SFDPH indicate that the number of daily cases appears to be sharply dropping. Keep in mind, though, we can anticipate a large number of cases on the other side of the peak, which would suggest 36-46% of the United States population infected with Omicron by mid-February.A variety of factors, including vaccination and booster rates as well as individual behavior (like wearing masks) will affect–for better or worse–how quickly the wave ends and what the tail of it looks like.
Get Vaccinated and Boosted To Avoid Long COVID (and Other Thoughts).
We know that vaccines are one of our most effective tools against severe COVID illness and death (particularly in adults), and it is so satisfying to see powerful examples of this in real time. One such case: before United Airlines implemented a vaccine requirement, more than one employee died each week from COVID. But since the requirement went into effect, there have been zero hospitalizations or deaths. Even though 3,000 employees are currently positive for COVID, none have needed to be hospitalized.
Additionally, a new small Israeli study indicates that 2-dose vaccination protects against long COVID. The study has not yet been peer-reviewed, but the information is still exciting and promising. Not only may vaccination help individuals–including approximately 2% of infected children–avoid long haul conditions, it also basically prevents MISC in children and may alleviate the burden of long COVID on our larger communities and health systems going forward (since some studies report as many as 30-50% of adults struggle with long-haul symptoms post-infection).
If you or your eligible children haven’t yet been vaccinated, now is a great time to start, effectively protecting yourselves against not only infection but also any lasting consequences of infection, which I would argue have still to be fully elucidated. For example, the large increase in the “excess death rate” (i.e. the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods) during the last two years suggests that there is much more fall-out from COVID than what is being attributed directly to this virus.
And, again, it’s also not time “just to get COVID because everyone’s going to get it.” Instead, hunker down for the next few weeks as I believe we are in the final stretch of this marathon (at least there are strong indicators that’s so) and continue to make the efforts you have to prevent becoming infected: wear an upgraded mask, spray your nose and throat at least twice a day with Briotech or Xlear (both of which we offer at our offices), stay outside for activities with your kids and friends, don’t dine inside at restaurants just yet, get enough sleep, eat the rainbow, and take your immune supports. (See this link for our age-based COVID fortification protocols.)
Then, dare to imagine a spring/summer with low community case counts, less (or no!) need for masks for most of us, gathering without distancing, taking public transportation to a ballgame, hugging and hanging out indoors with your friends and family, enjoying a movie in a theater, etc., etc. We’re almost there!
In the meantime, please let us know how we can further support you – as always, we are happy to help you navigate any issues around vaccination, testing, COVID safety or immune fortification, or any NON-pandemic related concerns.