Before we get into the new, sexy cousin, Omicron, we should talk a little about Delta. Delta, all by itself, continues to kick America’s ass. Almost every state (43) is currently seeing rising Covid case numbers. CDC has established a metric of 10 cases per 100,000 population as evidence of control of this outbreak. Our country is currently at 37/100,000, with only 3 states below the recommended level for control. Covid hospitalizations are also increasing. Right now there are more than 55,000 people hospitalized with this virus, a 15% increase in just two weeks. Michigan hospitals and ICUs have been swamped for over a month. Even the most extreme Covid outcome, death, has seen a recent increase nationally of 12%. Two years into this pandemic and we still lose about 50 people every hour, 24 hours a day, 7 days a week. A million Americans are dead from Covid. The virus inexorably takes its toll. The upper Midwest and the Northeast are facing truly bleak holiday numbers even before families and friends begin to gather in enclosed, crowded places. Happy Holidays!

All of the above is happening in a country with free access to extremely effective vaccines. Also, all of this is before the incredibly infectious Omicron strain begins to push Delta aside and take over the job of infecting our population. Is there nothing this country cannot screw up anymore? This is all our fault.

Omicron – The basic question on everyone’s mind is, “How is this Omicron going to affect us?” The answer is, of course, complicated and unclear though the future is becoming a little more clear every day. However, there are still a lot of unknowns.

The most salient fact about this viral strain is that Omicron is highly infectious. Some researchers are saying 3X more infectious than Delta. Some are saying 10X more infectious. For the public, who cares if Omicron is 3X or 10X more infectious? The point is that Omicron spreads faster and more easily than any Covid viral strain than we have seen and that Omicron’s infectiousness will have to be factored into our public health responses to control the spread. As you, as an individual, consider Omicron, you’ll have to factor in how easily this strain spreads and adjust your actions and decisions accordingly.

Although there hasn’t been too much emphasis on this strain’s virulence so far in the news coverage, I am convinced that Omicron is not going to cause as much damage to the body as previous Covid strains. My 2 major reasons for that optimistic projection are 1) that early data seems to indicate milder symptoms in populations infected in South Africa and Europe and 2) that most pathogen mutations that result in greater infectiousness do not enhance virulence. Omicron seems to cause mild flu-like symptoms that resolve in 5-7 days. There are 2 caveats, though, to my hopeful outlook. Omicron could hit some subpopulations (children?) harder than previous strains or long-term sequelae from acute infection could be more serious. Let’s hope not, but we have to wait for more data. As always, older people and people with impaired immune response are at increased risk.

The biggest worry about Omicron is that early data seems to indicate that the strain evades much of the protection from initial infection offered by our vaccines – at least the antibody levels that represent our first line of defense. However, there is every reason to believe that fully-vaccinated people will avoid serious illness from Omicron infection and those with recent boosters will probably avoid infection altogether.

So, to summarize Omicron at this early stage:

Right now, there are thousands of Americans infected with the Omicron strain of Covid and soon Omicron will be the dominant Covid strain in the US. Omicron spreads quicker and easier than any Covid virus that we have known, though most people infected may only experience relatively mild symptoms. The unvaccinated will almost undoubtedly become infected with this virus and vaccinated people without boosters are also at much greater risk of infection than with the Delta strain. Let me be clear, if the early data are true, I think that almost all of the unvaccinated proportion of our population (39%) will become infected with this Covid strain over the next 5-7 months. Those numbers will be huge and if even a small percentage of those need to be hospitalized, we will be in big trouble.

The pubic health response to this threat is simple and straightforward. Get people vaccinated. Get people boostered (Yes, that’s a made-up word). Re-emphasize distancing and masking. Since there’s a chance that Omicron may be spread more by contact than previous Covid stains, recommend frequent hand washing again, at least until we know more. We need to go back to basics and hope to avoid shutting down because I don’t think any of that will be acceptable to the majority of Americans.

I’m sorry. Once again, no good news. Much of this could have been avoided, but it hasn’t been and we all now why. Hunker down and let’s see what Omicron brings.

Be smart. Be informed. Get the shot. Get boostered. Maintain your distance. Wear the mask. Be careful. Seek out joy from any source.

p.s. – 2 people that I may have written off too soon early in their careers are Keanu Reeves and Snoop Dog. They kinda grow on you or, and this is very hard, I was just wrong earlier.

p.s.s – John Candy, Phillip Seymour Hoffman, James Gandolfini, John Prine, Nora Ephron, Bruno Kirby, and John Cazale. My life would be better if these people were still alive. So would yours.