Omicron Is Spreading. Resistance Is Futile

[davidp]

Omicron Is Spreading. Resistance Is Futile
By Daniel Halperin, 1/24/22, Wall St. Journal

As the Omicron wave crests, there’s bad news and good news. The
bad news is that the main strategies for slowing its spread—
repeated testing, masks and vaccine boosters—are largely futile
for that purpose. The good news is that while protecting the
vulnerable remains vital, slowing the spread of the virus needn’t
be the priority. The biggest danger from Omicron is probably acute
hospital staffing shortages, in part because of asymptomatic
employees who stay home from work after testing positive.

Although Covid testing can be useful, it also has important
limitations. The “gold standard” PCR tests are frequently too
sensitive; research has shown that in many cases people who test
positive are no longer contagious. The increasingly used rapid
antigen tests have the opposite problem, often failing to detect
infections during the earlier part of the 5-day isolation period
of presumed contagiousness.

This coronavirus, especially the Omicron variant, is so fast-moving
that mass testing and contact tracing, and probably even isolation
& quarantine, can’t slow it down significantly. The U.K. & other
countries, unlike the U.S., already had widespread rapid-testing
capacity during their recent surges, yet they experienced the
same meteoric rise in cases. As with other interventions such as
booster shots, testing is most useful for those at high risk of
serious complications, who might benefit from early treatment.

As for masking, the CDC recently acknowledged that cloth masks
do relatively little to prevent spread. Some experts on corona-
viruses, including epidemiologist Michael Osterholm, for nearly
two years have questioned the efficacy of masks. A recent rigorous
review by his University of Minnesota research group concludes:
“We are well past the emergency phase of this pandemic, and it
should be well-known by now that wearing cloth face coverings or
surgical masks, universal or otherwise, has a very minor role to
play.... It's time to stop overselling their efficacy & unrealistic
expectations about their ability to end the pandemic.”

The first large randomized community-level study, published last
month in Science, found that while generic surgical masks provided
a modest (about 10%) reduction in the risk of infection from Delta,
cloth masks didn’t significantly reduce risk. Masks may be even
less protective against an extremely contagious variant like Omicron.

That has led to calls for mandatory N95-type masks, which are
more effective but harder to use. Some schools have even mandated
them for kids. Yet two years is a long time for anyone’s face to
be covered for many hours a day, and it’s an interminably long
time for youngsters, possibly leading to lasting psycho-social &
other harms. Like Delta and earlier variants, Omicron doesn’t
seriously threaten the vast majority of kids; preliminary evidence
suggests much less risk for youth than from Delta. An increasing
number of public-health experts, including infectious-disease
specialist Monica Gandhi, have called for ending school mask
mandates soon.

And while vaccines & boosters continue to offer strong protection
against serious illness & death—& are therefore vitally important
to those at high risk—they’re less effective at preventing infection,
especially with the Omicron variant. While a new CDC study finds
that boosters substantially reduce risk of infection as well as
hospitalization from Omicron, countries like the U.K. and Israel
that had widespread booster coverage before Omicron struck have
also seen unprecedented surges in cases.

In any case, even if you get a booster now, the current surge
probably will have subsided by the time immunity kicks in. It’s
possible that future variants will arise against which currently
administered boosters would still be useful, although by then
immunity may have waned significantly. The European Medicines
Agency recently cautioned that repeated boosters may weaken the
immune system over time.

Which brings us to the good news: Because the new variant is
relatively mild and so many people already have some immunity
from vaccines, prior infection or both, Omicron’s explosive spread
is much less threatening than previous waves. A recent Southern

California study looked at over 50,000 patients infected with the
new variant. Not one required mechanical ventilation and only one
died, compared with 14 deaths and 11 ventilations out of some
17,000 infected by the Delta variant during the same period.
Consistent with evidence from other countries, hospitalizations
were considerably lower and average hospital stays much shorter
among Omicron than Delta patients.

Although reported numbers of “Covid hospitalizations” are up
nationally, these figures include patients admitted for other
reasons who incidentally test positive. Based on data from several
states & the U.K., it appears that roughly half these admissions
likely aren’t caused mainly by the virus. HHS Dept data indicate
the total number of patients in U.S hospitals has hardly budged
over the past six months.

Because the new variant primarily targets the upper airways
instead of the lungs, doctors report that few patients are
requiring ventilation or even supplemental oxygen. Christopher
Murray of the Institute for Health Metrics & Evaluation estimates
in the Lancet that the number of Omicron deaths “seems to be
similar in most countries to the level of a bad influenza season
in northern hemisphere countries.” In 2017-18, the flu caused some
52,000 deaths in the U.S., probably peaking at over 1,500 a day.

Public-health authorities are beginning to come to terms with the
passing of the Covid emergency. Six experts who advised the Biden
transition, including Osterholm, earlier this month called for a
pivot toward accepting Covid as an endemic disease, following the
example of several European countries. As Fauci has acknowledged,
“just about everybody” will eventually become infected. Some
scientists have even suggested that Omicron may end up providing
a kind of global “superimmunity” against serious illness from
future variants.

It’s past time to shift focus from trying to stamp out all new
infections to protecting the most vulnerable from severe disease
directly thru vaccination and other evidence-based measures &
alleviating hospital staffing shortages. Ending mask mandates,
de-emphasizing isolation and encouraging vaccination ought to be
a compromise most of us can live with.

Mr. Halperin is an adjunct professor at the Gillings School of
Global Public Health at UNC Chapel Hill & author of “Facing
Covid Without Panic.”

https://www.wsj.com/articles/omicron-is-spreading-resistance-is-futile-masking-mandate-n95-vaccine-requirement-boosters-covid-11643064353