All of my final exams came due last night at midnight — they were all fortuitously scheduled for the last day of finals week — so I got to open my mailbox this morning to find an expected mountain of papers to grade. Oh joy. There goes my weekend. Also, my flies arrived late yesterday, so I’ve got to go in to the lab today and get the stocks set up for my spring genetics course. That course, by the way, is going to be taught entirely in person, because my university has been applying some gentle pressure on the faculty to pretend the pandemic is completely over and we can all go back to normal. To be fair, I really want to get back to normal, too, but I’m also realistic enough to know that what I desire isn’t necessarily what I’ll get. The university is not adjusting any of its policies to deal with the threat of the new Omicron variant, and is in fact loosening them. As usual, we’ll wait until a crisis is upon us and only then start changing things, too little and too late, to try and catch up to a disease that’s running ahead of us right now. And my university is relatively progressive compared to the western Minnesota community, and the Minnesota governor!
My next few days are going to be bogged down in work, and then my so-called Christmas “break” I’m going to be tied up in that magic word, preparation, for the next semester, which I’m required to take seriously, unlike the administration. Wouldn’t it be nice if I could submit my grades next week and then take a nap or play with spiders or you know, just relax, until 18 January, when classes resume? Nope, isn’t going to happen. Especially since I have a looming dread that this is going to be an abortion of a semester, that we’ll go in assuming an air of nonchalant normalcy, and at some point we’re going to get screaming panicky emails from the administration telling us the quarantine spaces are all full, the local hospital is full, the pandemic is spiking, change your class management and go into lockdown. I figure I’ve got to prepare for two classes, not just one, an in-person version and a remote version. Thanks, procrastinators on high!
OK, I can’t blame him. I know this stuff, but hey, I’ve been trying to close my eyes and pretend it isn’t as bad as it probably will be. Omicron should open everyone’s eyes to the new normal, that because we refuse to do what needs to be done, we’re going to get new variants every year, and we’re going to have to learn to live with new levels of unpredictability.
America was not prepared for COVID-19 when it arrived. It was not prepared for last winter’s surge. It was not prepared for Delta’s arrival in the summer or its current winter assault. More than 1,000 Americans are still dying of COVID every day, and more have died this year than last. Hospitalizations are rising in 42 states. The University of Nebraska Medical Center in Omaha, which entered the pandemic as arguably the best-prepared hospital in the country, recently went from 70 COVID patients to 110 in four days, leaving its staff “grasping for resolve,” the virologist John Lowe told me. And now comes Omicron.
Will the new and rapidly spreading variant overwhelm the U.S. health-care system? The question is moot because the system is already overwhelmed, in a way that is affecting all patients, COVID or otherwise. “The level of care that we’ve come to expect in our hospitals no longer exists,” Lowe said.
Because we don’t know what is going to happen, we need more discipline, more cohesive action, more cooperative behavior in our communities. That’s not the American way!
The real unknown is what an Omicron cross will do when it follows a Delta hook. Given what scientists have learned in the three weeks since Omicron’s discovery, “some of the absolute worst-case scenarios that were possible when we saw its genome are off the table, but so are some of the most hopeful scenarios,” Dylan Morris, an evolutionary biologist at UCLA, told me. In any case, America is not prepared for Omicron. The variant’s threat is far greater at the societal level than at the personal one, and policy makers have already cut themselves off from the tools needed to protect the populations they serve. Like the variants that preceded it, Omicron requires individuals to think and act for the collective good—which is to say, it poses a heightened version of the same challenge that the U.S. has failed for two straight years, in bipartisan fashion.
We’re not ready for omicron. How about pi, and rho, and sigma, and phi, and…we’re going to run out of Greek letters long before this is over. Oh, wait, “over”? It may not ever be over, at least, not until the recalcitrant and deluded are all dead. I was letting my guard down after I got my third booster, but I’m going to have to look forward to my fourth, and fifth, whatever it takes (at least we run no risk of running out of numbers), and I’m going to have to be less cocky. He says, while preparing to abandon isolation and spend 16 weeks in a classroom.
First, the bad news: In terms of catching the virus, everyone should assume that they are less protected than they were two months ago. As a crude shorthand, assume that Omicron negates one previous immunizing event—either an infection or a vaccine dose. Someone who considered themselves fully vaccinated in September would be just partially vaccinated now (and the official definition may change imminently). But someone who’s been boosted has the same ballpark level of protection against Omicron infection as a vaccinated-but-unboosted person did against Delta. The extra dose not only raises a recipient’s level of antibodies but also broadens their range, giving them better odds of recognizing the shape of even Omicron’s altered spike. In a small British study, a booster effectively doubled the level of protection that two Pfizer doses provided against Omicron infection.
Second, some worse news: Boosting isn’t a foolproof shield against Omicron. In South Africa, the variant managed to infect a cluster of seven people who were all boosted. And according to a CDC report, boosted Americans made up a third of the first known Omicron cases in the U.S. “People who thought that they wouldn’t have to worry about infection this winter if they had their booster do still have to worry about infection with Omicron,” Trevor Bedford, a virologist at Fred Hutchinson Cancer Research Center, told me. “I’ve been going to restaurants and movies, and now with Omicron, that will change.”
I guess I’ll be self-isolating at home from now on, except every day when I go in to work.
Omicron might not actually be intrinsically milder. In South Africa and the United Kingdom, it has mostly infected younger people, whose bouts of COVID-19 tend to be less severe. And in places with lots of prior immunity, it might have caused few hospitalizations or deaths simply because it has mostly infected hosts with some protection, as Natalie Dean, a biostatistician at Emory University, explained in a Twitter thread. That pattern could change once it reaches more vulnerable communities. (The widespread notion that viruses naturally evolve to become less virulent is mistaken, as the virologist Andrew Pekosz of Johns Hopkins University clarified in The New York Times.) Also, deaths and hospitalizations are not the only fates that matter. Supposedly “mild” bouts of COVID-19 have led to cases of long COVID, in which people struggle with debilitating symptoms for months (or even years), while struggling to get care or disability benefits.
And even if Omicron is milder, greater transmissibility will likely trump that reduced virulence. Omicron is spreading so quickly that a small proportion of severe cases could still flood hospitals. To avert that scenario, the variant would need to be substantially milder than Delta—especially because hospitals are already at a breaking point. Two years of trauma have pushed droves of health-care workers, including many of the most experienced and committed, to quit their job. The remaining staff is ever more exhausted and demoralized, and “exceptionally high numbers” can’t work because they got breakthrough Delta infections and had to be separated from vulnerable patients, John Lowe told me. This pattern will only worsen as Omicron spreads, if the large clusters among South African health-care workers are any indication. “In the West, we’ve painted ourselves into a corner because most countries have huge Delta waves and most of them are stretched to the limit of their health-care systems,” Emma Hodcroft, an epidemiologist at the University of Bern, in Switzerland, told me. “What happens if those waves get even bigger with Omicron?”
Ha ha, I know! Nothing! Nothing will change! The people in charge will keep pushing everyone to go back to work, the media will amusingly report without condemnation on all those assholes protesting against basic hygiene, and Republicans will be passing laws against accurate information and public health measures.
And then I die because I can’t get healthcare from a system clogged with people on ventilators who refused to get vaccinated. I’m calling it now.