The United States has just surpassed 50 million reported cases of COVID-19 and more than 800,000 (conservatively estimated) deaths from the disease. While these numbers are a stark reminder of where we have been, the current idea of where we are going is unclear and potentially disturbing.
We faced a spike in delta cases, and then last week in our country, as in the rest of the world, the omicron, a much more transmissible variant, exploded. As if that weren’t enough, we are entering flu season.
We have a lot to worry about. The simultaneous waves of delta, omicron and influenza, “tridemia”, can easily overwhelm our healthcare systems and cause untold suffering and death. We must do our best to avoid this.
In September, we left the category of the summer delta. Then, by November, the number of delta cases started to increase again (Thanksgiving gave this a significant boost). But by last week, Omicron had become the dominant version of the coronavirus in the United States, accounting for 73% of new infections, federal health officials said Monday.
Omicron, first identified in mid-November by a prominent South African surveillance team, is now present in more than 50 countries. Nearly every state in the United States has reported omicron illness. While it is too early to tell whether omicron causes less serious disease than delta, we know that it is two to three times more transmitted.
Given that the doubling time of the omicron is about 2.5 days, it seems inevitable that most of those who are not vaccinated and do not take precautions will become infected. Omicron is likely to also affect the vaccinated population, but probably with less severe consequences.
Most of us remember what it was like last year in the early winter months. It could have been worse this winter. Modeling experts at the University of Texas predict that omicrons will peak in early February, when there will be almost twice as many hospitalizations as a year ago. This estimate may change as we learn more about the severity of the omicron.
And while the pattern was that the new options replace the old ones, this may not be the case with the omicron and delta. Trevor Bedford, a computer virologist at the Fred Hutchinson Cancer Research Center in Seattle, argues that omicron and delta are so different that they cannot compete – we could have two bursts at the same time with limited cross-protection.
In our conversation about COVID-19, we are losing the flu. Last year we had surprisingly few cases – the lowest in decades. We’ve already had major outbreaks on college campuses this year. We had medium flu season last week. This is nothing to ignore. From 2010 to 2020, influenza caused millions of illnesses, hundreds of thousands of hospitalizations, and 30,000 deaths annually in the United States. Influenza has a more serious impact on child mortality compared to COVID.
The good news is that this year we have tools to protect ourselves and our communities that we didn’t have a year ago. The most important thing is vaccines. If you are not vaccinated against COVID, get vaccinated. If you are vaccinated, get a booster shot. And be sure to get a flu shot; not too late.
If you do become infected, you may be a candidate for monoclonal antibody treatment, which can reduce your risk of hospitalization by about 70%. And while it’s too late for this early winter, there is hope for a COVID-19 cure, paxloid. If what we know about this drug is correct, then taking it shortly after the onset of an infection can reduce the likelihood of hospitalization by up to 90%.
The United States is home to about 4% of the world’s population, but we are responsible for 15% of the world’s deaths. It’s sad that we didn’t perform better. But with the new year just around the corner, this is the perfect time to do what is needed to quell the looming tridemia and make 2022 the year we free ourselves from the COVID-19 jaw.
Dr. John Schwarzberg is Distinguished Clinical Professor at the School of Public Health, University of California, Berkeley. Dr. Michael S. Asher is an infectious disease specialist and former director of the Viral and Rickettsial Diseases Laboratory of the California Department of Public Health.