Still think omicron is “mild”?
Low severity of disease ≠ mild impact
While the virulence of omicron is seemingly less severe on an individual scale and especially in those who are vaccinated, the impact of omicron on the healthcare system, schools, businesses, economy etc. has been far from mild. Notably, higher vaccination coverage during the omicron surge likely led to less severe disease for many. Yet, according to an MMWR report from the CDC, we still saw some of the highest daily case counts, hospitalizations, and emergency visits during the omicron wave. Over a 3-week period, there were more cases of omicron compared to delta and 17% higher deaths.
The narrative that the media espoused was that omicron is a milder variant, but mild compared to what? Compared to COVID when we didn’t have vaccines available? Additionally, as the recent NY Times piece “the pandemic of the forgotten” pointed out, this narrative doesn’t take into account vulnerable populations such as the 7 million immunocompromised Americans. We do not know how well the vaccines work in this population and many of these Americans continue to live in fear for their lives while the rest of us learn to “live with the virus.” Similarly, we are neglecting to address the racial inequities and socioeconomic inequities in vaccination.
Impact on the economy, healthcare system and schools
According to the Census Bureau survey, 8.8 million people did not work between the end of December and the beginning of January as they had to care for themselves or someone else with COVID symptoms. In a survey of small business leaders, 71% of responders said their revenue was negatively affected due to the increase in COVID-19 cases and 37% had to close their business or scale back.
With regard to schools, omicron caused disruptions in learning whether children were attending in person instruction or doing virtual learning. Many schools had to close temporarily and if they remained open, there were staffing shortages and child absences due to illness or quarantine, making it difficult to maintain a consistent learning environment.
Of course, the healthcare system has been overwhelmed in a multitude of ways with 80% of hospitals are under “high or extreme stress,” record hospitalizations, extreme burnout amongst healthcare staff and staffing shortages.
Will the next variant be less severe?
The second narrative being pushed by the media is that the next variant will be even less severe. There is no certainty that this will be the case. Even if it is the case, less severe cases of COVID can still cause long COVID. Data also shows that even a less severe case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis. The rates of conditions such as heart failure and stroke are much higher in people who have recovered from COVID-19 than in those who never had COVID-19.
What comes next?
Well that depends on our level of preparedness. With less than two-thirds of Americans fully vaccinated and only one-fourth of Americans having received a booster shot, we still have a long way to go in our vaccination efforts. Recent data shows that a third dose of the mRNA vaccines was highly effective at preventing Covid-19 associated emergency room and urgent care visits by 94% during the Delta wave and 82% during the omicron wave. The risk of hospitalization was also decreased by 94% for Delta and 90% for omicron after a third shot.
Additionally, as I’ve mentioned before, masking is a low cost, effective tool and sadly, it is being politicized. While I don’t think we will need to mask forever, we have still not vaccinated a large enough percentage of the population, only 24% of children ages 5-11 are vaccinated and children under 5 cannot be vaccinated so masking is still essential.
I also just want to remind everyone that the goal was never to eradicate COVID (although that would be nice), the goal was to mitigate its effects on our health, hospital systems, schools and our economy. Vaccination is effective in preventing deaths, reducing hospitalizations and reducing the severity of disease. The next time someone describes omicron as mild, it needs to be taken into context that vaccination has allowed it to be viewed as mild, yet the impact on our society has not been mild whatsoever. We need to focus on increasing vaccination efforts AND promoting masking until we have successfully vaccinated a majority of our population and taken care of our most vulnerable.
Iuliano AD, Brunkard JM, Boehmer TK, et al. Trends in Disease Severity and Health Care Utilization During the Early Omicron Variant Period Compared with Previous SARS-CoV-2 High Transmission Periods — United States, December 2020–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:146–152. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e4external icon.
https://www.census.gov/data/tables/2021/demo/hhp/hhp41.html
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