The world is so eager for the pandemic to end, it’s willfully misinterpreting lower rates of illness among Omicron’s soaring cases as something better than it is.
(Originally published Dec. 29 in “What in the World“) After making us forget about Delta, Omicron seems to have a new side effect: willful and stupid optimism about Omicron. Reports have in the space of a day gone from skepticism about the seemingly lower virulence of omicron to repeating this hopeful falsehood even in the face of disturbing new evidence.
Here’s what’s happening with the pandemic: more and more people than ever are getting infected by Covid, but fewer and fewer are dying from it. Why? Simple: Almost half the world has now been vaccinated against the virus and more than 10% of those folks have received booster shots. The new vaccines are largely ineffective against infection by Covid’s latest strain, Omicron. But they do lower the severity of illness and the likelihood of death among the vaccinated that get the latest strain. Thus, overall infections are rising while overall deaths are falling.
To a clinician, here’s how this looks: more people are coming in with Covid, but fewer of them are seriously ill or dying. Initial perception: Omicron must be less severe.
This is a dangerous, albeit desirable, conclusion. While the death rate is falling, it remains as high or higher than it was in the earliest days of the pandemic in March 2020—when we didn’t have vaccines at all. It’s clear, therefore, that this pandemic has gone from a “pandemic of the vaccinated” back to a pandemic for everyone.
Omicron does appear to be different in many ways. It appears to have a shorter incubation period than previous strains, meaning symptoms develop and patients become infectious sooner after exposure. Similarly, it appears to clear the body sooner, which has prompted the U.S. Centers for Disease Control and Prevention to halve the recommended isolation time for those who test positive, to five days from 10. Some scientists say the CDC may have erred dangerously on the side of optimism, however, to reduce staff shortages in frontline workers, especially hospitals.
What the data don’t yet tell us what the death rate is among the unvaccinated and so how Omicron differs to Delta in “virgin” territory. We do have troubling evidence that Omicron is creating a wave of hospitalizations among one of America’s last great unvaccinated populations—its small children. The WHO is warning that Omicron’s infection rate is so high it is still overwhelming global health systems (including even Australia’s), which has prompted many more responsible governments—including now China, Germany (where Omicron cases soared 45% in a single day) and South Africa—to revive restrictions on movement and gathering.
Our improving survival rate so far seems entirely dependent on being able to keep the number of people freshly immunized rising. And that includes people who’ve achieved immunity by catching Covid, which also seems to prevent severe illness from Omicron—but not against catching Omicron. Also in the “no sh*t, Sherlock” category is a new South African finding that infection by Omicron appears to produce antibodies that protect against earlier strains of the virus.
Mass inoculation is supposed to create herd immunity and bring the mortality rate down along with the number of infections. With Covid, vaccinations have occurred too slowly to achieve herd immunity. So immunity levels drop among early vaccination recipients even as aggregate vaccination levels rise. As a result, deaths aren’t falling with increased vaccination. Instead, our death/vaccination rate is climbing, though the recent surge in boosters amid Omicron’s emergence has created a brief decline. That’s somewhat encouraging, though past experience suggests it won’t last. The death/vaccination rate gave way in early fall to a resurgent pandemic in October as immunity ebbed as the world reopened, enabling Delta to stage a deadly comeback.
Fortunately, the higher immunization rate during that surge meant the number of deaths/cases dropped as that resurgence spread.
So yes, you’re less likely to die of Covid than early on in the pandemic, but only if you’re vaccinated and keep your immunity levels up with repeated booster shots. Evidence of that can be seen in the United Kingdom, which is being erroneously pointed to as evidence that Omicron is a viral kitten and that the best way to handle it isn’t to lock back down, but just to let it wash over the population, like Sweden did with the original virus.
The trouble with that analysis is that the U.K. has arguably one of the highest herd immunities in the world, after Iceland and Chile. That herd immunity comes largely from vaccinations: almost 70% of the country has been jabbed, and very impressively almost half of the nation has received booster shots. Add that to the fact that roughly 15% of the country has already had Covid, and its little surprise that it’s able to handle Omicron in relative stride.
But is it the right approach? The Swedish/UK approach to the pandemic—late and limited restrictions on movement with early relaxation—has been among the world’s costliest. Ask the families of Covid’s victims there if it was worth it.
