Will this COVID-19 wave result in herd immunity? Are you much less more likely to get sick once more for those who had omicron? Why this ‘milder’ variant is a double-edged sword
“I think we’ll all get it. It’s only a matter of time.”
How many times have you heard that from a friend or family member in the past few weeks? The Centers for Disease Control and Prevention has relaxed its isolation guidelines. Is it any wonder that some people seem to lose their guard and dine in crowded restaurants while a highly contagious strain makes its way through schools, social services and homes?
Epidemiologists are weighing the significance of the recent omicron wave and the public’s response to it, and wondering how, if at all, it could change the course of the pandemic. You breathe a sigh of relief that the Omicron variant seems less severe, but more than that, the world is once again playing Russian roulette with a virus finding new ways to survive.
Aaron Glatt, chairman of the medical school at Mount Sinai South Nassau, is positive. “We’re seeing many, many more people getting infected, but thank God Omicron is a less severe disease. We’re seeing fewer hospital admissions, fewer ICU admissions, fewer intubations and fewer deaths.” That’s the percentage of new cases, now a daily average of 761,122, a 185% increase over two weeks.
““Thank God Omicron is a less serious disease.””
Omicron may prove less severe than Delta, but its rapid rate of infection still results in high numbers of very sick Americans. The high rate of contagion has also resulted in a 40 percent increase in deaths over the past two weeks to an average of 1,736 deaths a day. The hospitalization rate has risen 84% in the past two weeks to a daily average of 140,641, according to the New York Times daily tracker.
Another concern: “While children still have the lowest rate of hospitalizations of any group, pediatric hospitalizations are highest compared to any previous point in the pandemic,” Rochelle Walensky, director of the CDC, said in a statement. “Unfortunately, we are seeing hospitalization rates increasing for children ages zero to four, children who are not currently eligible for a COVID-19 vaccine.”
What if you tested positive for Omicron, the highly transmissible variant of COVID-19, the disease caused by SARS-CoV-2? What now? Can you go about your work knowing that you have the COVID-19 antibodies and are less likely to test positive for the coronavirus again any time soon? Should you be as scared of Omicron as, say, Delta? Unfortunately, some people take unnecessary risks.
“Have you heard of omicron parties where people meet up with others infected with omicron to catch the ‘milder’ infection?” Gregory Poland, who studies the immunogenetics of the vaccine response at the Mayo Clinic. “We experience what we experience because of the behavior of viruses and humans. Human behavior is the only thing we can control and we have given up on that.”
The next COVID-19 variant could be worse
Health advisors are apparently advising against throwing caution to the winds and going outside and socially mingling with others without masks and with little social distancing – and not just because of the impact that taking time off work can have on the economy had. “Ideally, the lower the proliferation potential of Omicron, the less likely it is that new strains will emerge,” Glatt told MarketWatch.
Among the most recently discovered variants was IHU in France, thought to have come from Cameroon. It has not been flagged as a variant of interest, variant of concern, or consequence variant by the World Health Organization. But it is an ominous sign that the world is far from at the end of the pandemic. “We gave up the opportunity to fix this a long time ago,” Poland told MarketWatch.
First, some potentially good news. Research led by Alex Sigal, a researcher at the Africa Health Research Institute and associate professor at the University of KwaZulu-Natal in South Africa, found that Omicron infection “boosts neutralizing immunity against the Delta variant.” The study was a small project involving just over a dozen patients. It was published last month and has not yet been peer-reviewed.
““We gave up the opportunity to eradicate this a long time ago.””
The increase in neutralization of Delta variants in people infected with Omicron may result in a reduced ability of Delta to reinfect them, the research says. “Along with new data suggesting that Omicron is less pathogenic than Delta at this point in the pandemic, such a finding could have positive implications for reducing the COVID-19 burden of serious diseases.”
“Should omicron prove to be less pathogenic, it could show that the course of the pandemic has shifted,” Sigal said in a statement. “Omicron will take over, at least for now, and we may have less disruption in our lives.” That’s a big if, though, and maybe an even bigger maybe, infectious disease doctors contend. It doesn’t rule out that more variants will find their way around the world.
Now the bad news. The spread of the virus opens up the possibility of more variants, and in this viral mole game, the next one can be worse than the last. Unvaccinated, immunocompromised, elderly, and other vulnerable populations have a greater chance of doing so. Due to its transferability, we were very fortunate that Omicron wasn’t deadlier.
Paul Sax, clinical director of the Department of Infectious Diseases at Brigham and Women’s Hospital, wrote on Twitter TWTR, -1.06% that the vaccine had helped tremendously: “It’s amazing to imagine what would have happened if omicron had been applied to a completely immunologically naïve population would have encountered and how other variants are efficiently replicated in the lungs.”
The distant prospect of herd immunity
The Omicron wave could provide a wall of immunity for the more vulnerable people. “It certainly has the potential to infect a lot of people and that could be a positive thing, at least they have immunity to COVID-19 or the Omicron strain,” Glatt said. “Theoretically, that could bring us closer to herd immunity and bypass the unvaccinated.”
This is just a theory and difficult to prove. Herd immunity — the idea that once a high proportion of a population has contracted a disease or been vaccinated against it, the chances of others in the population becoming infected is dramatically reduced — remains tantalizingly unattainable, even if it covers 62% of the US population are fully vaccinated.
Here’s one way to boost a society’s immunity when herd immunity isn’t reached: Takeshi Arashiro, an infectious disease researcher at Japan’s National Institute of Infectious Diseases in Tokyo, and his fellow researchers published a study — which has yet to be peer-reviewed – This suggests that countries that have experienced infections from other variants may have been spared the worst Omicron wave of 2022.
““It’s not clear how long you’re protected from getting sick again.””
There’s a catch. A key tenet of achieving herd immunity is separating those at lower risk of dying from the higher risk group — those over 70 and with pre-existing conditions. If the lower-risk group becomes infected with the virus, immunity spreads in the so-called herd, lowering the risk for those in the higher-risk group. The real world is notoriously unpredictable and not a neat laboratory environment.
Ultimately, asymptomatic spread is another “Achilles heel” and complicates any herd immunity strategy that separates infected people from the more vulnerable. In reality, the latter group cannot remain housebound and out of contact with anyone not considered vulnerable for months – possibly years – or for as long as it takes to reach critical levels of herd immunity.
And according to the Mayo Clinic, it would take 70% of the population, or over 200 million people, to recover from the virus. “This number of infections could lead to serious complications and millions of deaths, particularly in the elderly and those with pre-existing health conditions,” the Mayo Clinic wrote. “The healthcare system could quickly become overwhelmed.”
Also, as the WHO points out, herd immunity by infection does not take into account the possibility of re-infection with the Omicron or Delta variants and, as mentioned, the emergence of new, unknown variants. “It’s not clear how long you’re protected from getting the disease again after recovering from COVID-19,” the Mayo Clinic says. “Even if you have antibodies, you could get COVID-19 again.”
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