Omicron is currently surging through the U.S., infecting huge numbers of people and causing record-high hospitalization rates.
Its high transmissibility means that even people who are vaccinated and wear masks in public places are contracting the variant. But now the U.S. is better equipped to deal with COVID than it was when the first wave hit in early 2020. Vaccines have left many people at least partially protected against coming down with a severe case. New antiviral drugs are on the horizon, and the government has committed to sending millions of tests to homes and schools.
Now, two years after COVID first reached U.S. shores, a new variant that evades current vaccines, and the prospect of more to come in the future, some public health experts believe that it’s time to change the way we think about COVID, moving away from the idea that we will vanquish the virus completely and instead learn to live with it as an endemic disease like the flu.
“For a lot of people there has been this hope that there will be a day where victory will be declared. They will say, ‘Today was the end of COVID, and tomorrow we will live in a COVID-free world again,’” says Dr. Wafaa El-Sadr, professor of epidemiology and medicine at Columbia University. “I think that is really unrealistic, and not feasible.”
You will probably get Omicron
Early studies have shown that Omicron’s R rate, or the average number of secondary infections an infected person will produce, is around 3.7, according to the U.K.’s Health Security Agency. This is around 2.7 to 3.7 times higher than the Delta variant, according to a preprint study conducted by the University of Copenhagen, Statistics Denmark, and Statens Serum Institut (SSI), which cites Omicron’s ability to circumvent vaccines as the key to how easily it spreads.
In practice, this means that even people who got two vaccines, a booster shot, and take other precautions are still contracting the virus.
U.S chief medical officer Dr. Anthony Fauci said on Tuesday that the likelihood of anyone escaping Omicron is slim.
“Omicron, with its extraordinary, unprecedented degree of efficiency of transmissibility, will ultimately find just about everybody,” said Fauci.
That same day, the World Health Organization predicted that by mid-March, at least half of the population of Europe will be infected with COVID.
The fact that Omicron is able to evade vaccines has already gone a long way to reduce any potential shame around contracting COVID, according to Amitabh Chandra, a professor of health policy at the Harvard Kennedy School.
The sky-high transmission rate is eroding the division between the idea of reckless people who get COVID because they took no precautions, and others who have been cautious but have still come down with a case.
“If a lot of people are getting COVID despite being very careful, then I think the stigma of getting COVID-19 will fall substantially,” Chandra said. “The politics of the disease has changed.”
But we have more tools to reduce infection severity
When it seems like catching the Omicron variant is inevitable, the question is no longer how to avoid it, but rather mitigating how bad it will be when it finally comes.
Although studies have shown that Omicron infects vaccinated people, those people are more likely to experience less severe illness. And along with vaccines, new antiviral pills that can be used to treat people after they contract COVID are slowly hitting the U.S. market.
Around 63% of the U.S. population is fully vaccinated and around 90% of the country’s vulnerable and elderly people are fully vaccinated. A substantial portion of the population has also already lived through COVID-19, giving them at least some immune response against the disease.
To Chandra, that means that the cost of a restrictive measure like lockdown, particularly for low-income people, to try to prevent the spread of the disease outweighs the number of lives it will save, and that we should rethink how to combat the disease.
“When the vaccination for the elderly is 90% and the death rate is much smaller and the potential for economic carnage of the poor is enormous, we’ve got to change our answer,” Chandra told Fortune.
Why it’s still important to still take precautions right now
Although Omicron appears to be less severe among vaccinated people, the high transmissibility rates mean that it’s spreading more rapidly than any other variant. And when more people get sick, even a lower percentage of severe cases leads to overwhelmed hospitals.
Around 600 U.S. counties are currently at full capacity with no hospital beds available, according to the COVID-19 Hospital Capacity Circuit Breaker Dashboard, a tool created by Dr. Jeremy Faust that collects real-time data of hospital occupancy, and another 476 counties are expected to reach capacity within the next seven days.
Many hospitals are also struggling with a critical shortage of nurses, doctors, and other medical staff who have either quit or have been infected with COVID and are isolating.
Additionally, the supply of antiviral drugs that many hoped would quell the rush of Omicron across the country has been severely limited by manufacturing delays and supply-chain issues, rendering them largely ineffective at the moment.
To make sure people don’t contribute to burdening overtaxed health care systems, governments around the world are still advising people to have limited social gatherings and work from home if possible.
So what does the future look like?
Both El-Sadr and Chandra agree that with the prevalence of vaccines, boosters, and the hopeful arrival of new antiviral pills, the time for lockdowns is over.
Advocating a lockdown in January 2022 “in the presence of all of this scientific advancement and in the presence of a virus that is substantially less virulent than the earlier strains, seems irresponsible to me,” says Chandra.
The argument over how to proceed during the next few months is happening in Europe, where they are considering treating COVID as an endemic illness and moving beyond pandemic-style restrictions after Spain’s prime minister, Pedro Sánchez, called on the European Union this week to debate the possibility of treating COVID-19 like the flu. Switzerland joined the fight today, suggesting COVID may be shifting to an endemic phase.
Former Microsoft CEO Bill Gates said in Twitter Q&A on Tuesday that after the Omicron surge, there will be fewer cases, and COVID could be “treated more like seasonal flu.”
Chandra emphasizes, however, that taking a pragmatic approach to Omicron, considering how easily it spreads, is not akin to giving up, and adds that more vaccines, more vaccine mandates, and better availability of antigen testing is the way forward.
“I agree with people who say we don’t want to give up,” he says. “But that doesn’t mean the only way to not give up is to have a lockdown.”
