Health Care

Looming threat of omicron wave triggers early pandemic déjà vu

When the U.S. made COVID-19 vaccines available for all adults in the spring, Americans, including government officials, hailed the development as a turning point in the pandemic. 

President Biden himself echoed the optimism that the U.S. may be turning a corner.  

“Today we’re closer than ever to declaring our independence from a deadly virus. That’s not to say the battle against COVID-19 is over. We’ve got a lot more work to do,” he said in July. 

“It no longer paralyzes our nation, and it is within our power to make sure it never does again,” he added.

But fast-forward to December, and pandemic history appears to be repeating itself. 

In the course of just a few weeks this month, the omicron variant and a steep rise in U.S. cases have triggered COVID-19 restrictions reminiscent of the early part of the outbreak. 

Professional sports leagues have begun postponing games, some schools have started transitioning to remote learning and city officials have acknowledged they were reconsidering implementing prior coronavirus protocols such as mask mandates.

The current situation in the U.S. has also promoted concern from health experts. 

“You know, I’m extraordinarily worried,” Lawrence Gostin, faculty director of the O’Neill Institute for National and Global Health Law and professor of global health law at Georgetown University Law Center and a contributor to The Hill, said in an interview. 

“I’ve always thought that there would be surges and waves but the overall arc would be toward containing the virus and getting back to normal. And now that omicron is here, I’m not sure about that,” Gostin said. “And I think for the foreseeable future, we’re going to have a fairly rough ride with the variant.”

The omicron variant, first detected in South Africa, has spread across the United States since the first case was reported earlier this month.

Scientists are racing to learn more about the new variant, which some health officials say is anticipated to be the dominant strain in the United States in a matter of weeks. 

A study, still under peer review, from researchers from the University of Hong Kong’s LKS Faculty of Medicine suggests that while the omicron variant can infect 70 times more quickly in humans than previous strains, “the Omicron infection in the lung is significantly lower than the original SARS-CoV-2, which may be an indicator of lower disease severity.”

Pfizer, BioNTech and Israeli researchers have said that Pfizer’s booster appears to provide good protection against the omicron variant. 

Gostin said that “there’s no question” the boosters would be helpful in combating the variant. However, it’s a question of how protective the boosters would be against infections and hospitalizations and how long that protection would last.

“Because a lot of the studies of the boosters have been, you know, in the first few weeks after the booster is given and whether that third shot immunity will wane is an open question,” Gostin said. “But our experience is that it will wane … and we don’t know how long, so we’re just really heading into a concerning unknown here.”

Jesse Goodman, formerly the chief scientist at the Food and Drug Administration and a current professor at Georgetown University’s School of Medicine, cautioned that there is still a lot that officials do not know about the variant. However, he said it has become clear that the variant is highly transmissible.
 
“This is sort of an unfolding story, and the virus throughout this entire pandemic has never quite met expectations,” Goodman said. 
 
“So I think everything has to be taken with a grain of salt,” he added.

These developments have Americans scratching their heads over whether the U.S. might see a return to the early days of the COVID-19 pandemic. 

Already, some families have canceled holiday gatherings, students have transitioned to remote learning, entertainment venues have shut down and city officials are grappling with how to approach mitigation of the new outbreak. 

Prince George’s County, Md., public schools announced Friday that they would temporarily return to virtual learning amid a surge of coronavirus cases. 

“The increased positivity rates have significantly challenged the ability to … [teach in person], causing anxiety among many school communities and disruption to the school day,” Prince George’s County CEO Monica Goldson said. 

Holiday shows have also been canceled amid a surge of the virus. 

In New York City, “The Christmas Spectacular Starring the Radio City Rockettes” has canceled all of its upcoming performances due to coronavirus cases among the crew. 

Jay Varma, a top public health adviser to Mayor Bill de Blasio (D), said earlier this week that “we’ve never seen this before in #NYC” amid daily cases doubling in just three days. 

De Blasio also unveiled a six-pronged approach to combating the spread of the new variant, including investing in K-95 masks and distributing rapid home tests. 

Washington, D.C., Mayor Muriel Bowser (D) announced this week that she was considering reinstating an indoor mask mandate just a few weeks after the requirement was lifted in the nation’s capital. 

On Friday, the District reported its second day of record-breaking new coronavirus cases. 

“I think that we should absolutely try to mitigate the spread as much as we can through indoor masking mandates, vaccination mandates, social distancing and ventilation. But in my view, I think there’s such enormous pandemic fatigue that people are not going to tolerate in America, you know, closures of schools or lockdowns,” Gostin said. 

The global health law professor added that the lack of knowledge about the new variant means that Americans should act preemptively, assuming that the threat is serious. 

“We really don’t know if it’s less serious. There’s no good data to suggest that it’s less serious, so I think we should act as if it has the same progression to serious disease and hospitalizations as … other former variants did, including delta,” Gostin said. “If it turns out to be significantly less serious, we’ll still see our hospitals filling up to capacity because of the sheer numbers, even if it’s just a smaller rate.”

Goodman concurred, saying that it is better for officials and businesses
to remain vigilant against the virus as scientists race to learn more about it. 
 
“I hope we’re overreacting, but I think it’s the right reaction,” the former FDA chief scientist said when asked if officials might be overreacting to the virus. “Again, I think until we know more it’s better to be overprotected when it’s in ways that aren’t necessarily harmful.”

But some areas of the U.S. have already started to feel the effects. 

States in the Midwest have seen a rise in COVID-19 hospitalizations over the past few weeks, with hospital systems’ intensive care units reaching capacity. 

Wisconsin last week reported that 96 percent of the ICU beds in the Badger State were occupied. And the state’s governor, Tony Evers (D), called for 100 FEMA workers to assist health care workers. Sixty National Guardsmen have been called up to serve as nursing assistants. 

Michigan has also been battered by a wave of COVID-19 infections and on Monday was one of 14 states that reported that their overall inpatient bed capacity had reached 80 percent. 

Indiana’s largest hospital system also requested help from the National Guard last week for most of its locations due to COVID-19 hospitalizations. 

Gostin said that officials should hesitate before considering reimplementing lockdowns or other harsh measures. He noted that the country should instead focus on getting as many Americans fully boosted as possible and making Pfizer’s antiviral drug, Paxlovid, available. 

“Access to testing and to effective monoclonal treatments, while improved over several months, is still quite problematic — and the [U.S. government] and others should be doing all they can to improve access and distribution, including matching supply to needs,” Goodman added in a follow-up email.

Experts are concerned, however, that the supplies of Paxlovid — which still awaits emergency use approval from the Food and Drug Administration — will not be able to keep up with demand amid high numbers of COVID-19 cases.

In addition, vaccine hesitancy remains among a good portion of the American public, and the Biden administration has battled several legal challenges its vaccine mandates for businesses, federal employees and health care workers.

“Right now, we do need to get a very, you know, much higher percentage of our population vaccinated and boosted because, ultimately, living with the virus — yes — we are going to need to live with the virus,” Gostin acknowledged. “But when we live with the virus, we have to live with it so that it’s not making us sick. That’s the really important part.”

— Updated at 9:37 p.m.