We Asked a Former Acting CDC Director About the Omicron Variant. Here's What He Said
It is important to take the emergence of this new strain seriously until we know more about it. What we don't know about Omicron right now far exceeds what we do know, but what we've learned so far is cause for concern. Omicron has more than 50 mutations. Many of them are in the spike protein region of the virus, which is the area targeted by our current vaccines and some of our treatments. That raises the question as to whether it will be able to evade our immune systems and the protections provided by either our current vaccines or prior COVID-19 infection. Over the next week or two, we should begin to have a clearer picture of whether that is in fact the case, as well as whether it causes more severe disease and is more transmissible than other strains.
We shouldn't be surprised that cases of the Omicron variant have been discovered in the U.S. With Omicron already documented in more than 30 countries, it was only a matter of time before it arrived here. Viruses don't respect borders. There will be more Omicron cases to come. The scientists in South Africa who discovered the variant should be applauded for their speed and transparency in sharing this information with the world and allowing other scientists to quickly begin sequencing viral isolates—meaning samples from infected individuals—and studying its impact.
Regardless of whether the Omicron variant causes a surge in COVID-19, we continue to lack control over the Delta variant, the current dominant strain. Delta is still killing nearly 1,000 people in America every single day. We cannot allow complacency to set in so that this loss of life becomes acceptable, especially when so many of these deaths are preventable. Our current vaccines work incredibly well against Delta, yet millions of people remain unvaccinated. Anyone eligible for any COVID-19 vaccine—whether it's a primary series, a third shot for people who are immunocompromised, or a booster shot for adults—should get those shots now as we head into the December holidays and the winter months. And whether it's Delta, Omicron, or any other variant, the public health playbook—masks in indoor public settings, testing, handwashing, ventilation—still provides extremely effective tools to manage this pandemic, but only if we choose to use them.
Should we anticipate more variants after Omicron? Will this just be a part of our daily life living with COVID-19 strains?
No one is entirely safe from COVID-19 until everyone is safe from COVID-19. Until COVID-19 transmission is under control everywhere—and unless and until vaccines are available and easily accessible for everyone around the globe—we can expect COVID-19 to continue to freely circulate, which will lead to additional new variants. A new strain that can elude our immune protection puts everybody at risk—even people who have been vaccinated or those who have had prior infection. Omicron may or may not turn out to be that kind of strain, but even if it isn't, a future strain that does so is entirely possible. While new variants could easily emerge in the United States, both Omicron and Delta originated outside our borders, and both swiftly found their way here. Walls and travel restrictions may slow the entry of a new virus for a short time, but they cannot prevent it.
The world must treat this moment as a serious wakeup call when it comes to global vaccine equity. In the US, we are fortunate to have the means to provide vaccines and boosters to our entire eligible population. Other nations simply do not have the resources to do so, yet wealthy nations continue to hoard vaccines: the latest numbers show that approximately three-quarters of vaccines administered worldwide have been in high- and upper-middle income countries. Nearly half of the world's population remains unvaccinated. In Africa, population 1.4 billion, nearly 90% of the continent's population has yet to receive a single shot. As long as these types of inequities continue, new variants will have far too much time and space to spread and flourish. There is a moral, economic, and health imperative for the United States to redouble our own efforts and galvanize efforts by other nations to help vaccinate the world. It is a matter of equity that the world must not continue to ignore.
When can school-age children in the U.S. expect to be eligible for boosters?
Only those 18 and older are currently eligible for boosters. The CDC recently expanded its booster guidance, recommending that every adult eligible for a booster receives one. In light of the ongoing toll of Delta, and the unknowns around Omicron, I think that guidance makes sense.
Pfizer recently announced that it will ask the FDA to authorize booster shots for its vaccine for 16- and 17-year olds. If the FDA, CDC, and their respective advisory committees think that's the way to go, families and healthcare providers should heed that advice. And if the science shows that the degree of protection starts to fall for vaccinated children over time, boosters for a broader swath of our younger population might become a reality. But we're not there yet. When it comes to children ages 5 and up, ensuring they receive their primary series of shots is where we must focus our energies and resources. As a pediatrician, I have seen how important it is for families to get their questions answered by a trusted healthcare provider. And when parents get to a "yes" on getting their kids vaccinated, we need to make it as easy as possible for them to do so. Every employer should offer paid leave benefits so parents and caregivers do not have to choose between getting their children vaccinated and earning a paycheck.
Health experts appear divided on the issue of travel. With the holiday season in full swing, would you recommend against traveling with the Omicron variant now circulating? How should families approach gathering for holidays with small children, both vaccinated and unvaccinated?
I felt extremely grateful to share Thanksgiving with my family and friends this year. We did so in a safe way by following CDC guidance. Thanks to the safety and effectiveness of our current vaccines and increased availability of home testing, Thanksgiving in 2021 was a lot more joyous for our family than it was in 2020, and we had the peace of mind that comes with doing things the right way. Too often, however, when it comes to returning to our normal lives, people are still viewing public health guidance as an enemy rather than an ally. When that guidance is discarded or ignored, especially during the holidays when a lot of people gather together, we all suffer the consequences.
At this point, I don't see a reason to change my travel plans for the December holidays, but I recognize that each person has a different level of both actual risk as well as risk comfort. If it turns out that Omicron is more contagious than Delta, causes more severe infection, and poses a significant risk even to people who have been fully vaccinated, gathering for the holidays would be a lot riskier than it is now and likely would be discouraged. If, on the other hand, Omicron does not cause more severe infection and current vaccines continue to offer protection, gathering can be done pretty safely if we adhere to public health guidance. We should know the answers to those questions soon.
A few days ago, President Biden announced stronger testing protocols for international travelers coming to the United States and extended the federal mask requirement for planes, trains, and other forms of public transportation. Irrespective of Omicron, those steps make a lot of sense given Delta's continued spread. I encourage families to follow CDC's guidance around holiday travel and any updates to that guidance that may be issued in the coming weeks as we learn more about Omicron. As a general principle, we should all be mindful of traveling to any location domestically or internationally where case rates are high and vaccination rates are low.
The Omicron variant could hurt the economy as we enter the holiday season and the start of 2022. How important is getting the pandemic under control for our economic recovery?
This pandemic has hit every community in America physically, emotionally, and economically. However, the pain has not been felt evenly across our nation and the recovery has been inequitable. The same populations that have been at disproportionate risk of suffering from COVID-19—people of color and those who are paid low wages—are the same ones who continue to struggle the most economically. At various points during the pandemic, Congress has provided critical economic assistance to families that has prevented a dire economic situation from becoming truly catastrophic for many; in fact, thanks in large part to this increased support, the U.S. poverty rate actually declined in 2020. But providing temporary support that only gets us past an immediate public health threat is insufficient if we are to finally address the fundamental barriers to economic prosperity and health that still exist in America.
The Build Back Better Act recently passed by the House of Representatives would be an important step forward in our efforts to provide everyone in America with the opportunity to live the healthiest life possible. Among other steps, the bill would provide health insurance to millions of people living in states that have declined to expand their Medicaid programs; extend higher Child Tax Credit payments for a year and make those with no or low wages permanently eligible for the full amount; make major investments in affordable housing and child nutrition programs, and significantly increase access to child care services and paid leave benefits. These measures will truly help all Americans experience economic security and healthier lives during the pandemic and beyond.