COVID omicron variant – how worried should you be?

The answer is to be found by addressing three basic scientific concerns

The same questions are on everyone’s mind right now. How afraid should I be about the new COVID-19 variant? Will I be locked down again? Will everything close down that’s being reopened? Will I catch the virus despite being vaccinated? How sick will I get if I do?

The answers are still unknown, which makes everyone even more worried, more afraid, and when we are afraid, as I wrote in my latest book, "COVID; the Politics of Fear and the Power of Science," we jump to the worst-case scenario, we over-personalize the risk, we lose the ability to reason.

Politicians and the media don’t help us. Our leaders want to be perceived as acting ahead of the risk, which is why the travel advisories are being put in place even though this variant has already spread into Europe and likely on into the United States, so travel restrictions now will do little. 

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The WHO, which has an office in South Africa, was, as usual, late in sounding the alarm, finally calling omicron a variant of concern on Friday, when the viral horses were already out of the barn.

How concerned should we be? The answer is to be found by addressing three basic scientific concerns. 

First, how severe is the disease that this variant causes? The answer is somewhat reassuring so far. The numbers are small, but there is as of yet no evidence that it causes more severe disease than the original virus or the delta variant. In fact, historically, as pandemic viruses evolve, they tend to become less deadly, as mutations that allow them to transmit more easily but not kill or severely sicken the host are favored.

In fact, the second basic scientific concern with omicron is whether it spreads more easily than previous iterations of the virus, including delta. Time will tell whether the multitude of mutations it carries gives omicron this survival advantage. But so far, the case numbers are small, and it is too early to conclude anything on this one way or the other. Delta has predominated for months, precisely because it is far more transmissible than any of the other variants out there. Is omicron more transmissible than delta? We don’t know and we should not assume it is.

Federal support to Pfizer and Moderna could speed the development of new boosters to target the omicron variant specifically.

The third scientific concern concerns immune evasion. Are there so many mutations to the spike protein of this variant (more than 30) that the vaccines which target the spike protein won’t work? The answer is likely no, since the vaccine has multiple targets, but it is conceivable that the vaccine won’t protect as well against omicron as it did against the original virus and to a somewhat lesser extent, against the delta variant. 

This knowledge should be a big motivation for getting vaccinated if you haven’t done so and getting the booster if you have been vaccinated more than six months ago (MRNA vaccine), or more than two months ago (Johnson and Johnson). The weaker the protection turns out to be against the new variant, the more you must dial up whatever protection you can get to maximum. We should be reassured by this important tool, and we should use it.

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What should the government be doing beyond making pronouncements and pounding the drum of danger? For one thing, there is every reason to believe that cheap rapid testing helps people screen for contact with any variant including this one. 

It is inexcusable that almost two years into the worst pandemic in a hundred years, we still don’t have free testing in every home, provided by the federal government through a public-private partnership like Operation Warp Speed. Having a free and ready test to assure you don’t have COVID when you develop a cough, congestion or fatigue, goes a long way toward preventing panic.

At the same time, federal support to Pfizer and Moderna could speed the development of new boosters to target the omicron variant specifically, a process that will take several weeks. There are also oral and nasal second-generation COVID vaccines in development that are not only easier to take but may be more successful no matter the variant. 

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And while the monoclonal antibodies may not be as effective against omicron, there is no reason for the emerging anti-viral treatments not to be. In fact, the FDA should speed approval of the oral treatments, especially Pfizer’s Paxlovid, and the government should order much more than the 10 million courses it has already purchased and help speed delivery.

Media hyperbole inflames our fears and political posturing is transparently self-serving and fails to calm us. Only science can reassure, providing context and diagnostic, preventive and treatment tools against the new variant. Our leaders must provide constant timely support for these efforts, not pound the political drum to control us.

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