As people learn of a new COVID-19 variant, many are concerned. As an infectious disease physician, I get a lot of questions. I received a text message Tuesday from a misinformed friend that reads, “So omicron is pretty bad if it spreads 5 times more easily and the vaccines don’t work as well against it?”
I replied: “That’s not remotely true.”
We don’t have enough information yet to make those claims. However, her text message displays a tendency a lot of us have after nearly two years of living through a pandemic. Some of us tend to panic. As we’ve seen in the past few days, policymakers also share this tendency.
There is still a lot of uncertainty regarding the omicron COVID-19 variant. There are many more questions than answers. Scientists don’t immediately download all there is to know about a new phenomenon instantaneously, but we dig in and work hard to answer questions. It takes time.
In scientific and medical communication, it can sometimes be difficult to communicate the uncertainty that is inherent in studying something new. What can happen, as appears to be the case with omicron, is that some policymakers take some action in an attempt to “act quickly” — even in the absence of compelling medical or scientific evidence to do so.
In the case of omicron, a variant that was first identified in southern African countries, this led to a rash of travel bans targeting countries in which diligent surveillance and transparent communication first alerted the world to this potential threat. This action, despite well-established drawbacks and a myriad of negative consequences, was what policymakers turned to.
This is not early 2020, we have learned a tremendous amount about COVID-19, have developed highly efficacious vaccines, monoclonal antibodies and antivirals. We know how transmission occurs, which activities are risky, as well as how to mitigate that risk with masks and moving activities outdoors. Policymakers need to respond to new scientific discoveries in a measured, precision-guided manner and leverage all these new tools to respond.
Several years ago, I worked on a project regarding what characteristics a pathogen would need to posses to cause a pandemic. I concluded certain virological and epidemiological features were almost essential such as spread during the incubation period when no symptoms are present. I also included human factors drawing on mistakes that I had found magnified the societal disruption of an infectious disease emergency. At that time, I was thinking of SARS in which the Chinese government delayed notification of cases delaying the rest of the world’s preparations.
With SARS-CoV2, human factors have been pervasive when it comes to magnifying the impact of the pandemic. Policymakers err on both sides continuously — too much and too little. I wonder if this stems from the short-range privileging that happens with politics and policymakers, where the next election may be the time horizon and long-term principled thinking is not what keeps one in power. Perhaps they don’t want to be blamed and the downside of doing too much is more excusable than doing too little — indeed this is often the subtext when an action is taken “out of an abundance of caution.”
I believe omicron is already in the U.S. — the first identification is imminent — and while its ultimate threat level remains unclear, one thing is certain: The precautions and preparations in place for the delta variant — indeed all variants and the original strain of the virus — apply to omicron. Vaccines, which are extremely likely to prevent against severe disease, and testing are the two pillars of preparing for any variant of COVID-19. The goal remains not to prevent every case, but to prevent severe illness and protect hospitals from being over capacity. We need to continue to focus on these goals.