Omicron Update: Nov 27

There is a lot of anxiety. I have a lot of anxiety. The public is being asked to understand the second most complex system in the human body while navigating a sea of misinformation while coping with significant pandemic exhaustion and mental health problems. All while receiving little-to-no communication.

So, I thought I would give you a quick update on where we’re at. This what we’ve learned in the past 36 hours since my last update:

1. WHO declared B.1.1.529 a Variant of Concern (VOC) and named it Omicron.

• WHO skipped Nu (because it’s too easily confounded with “new”) and Xi because it’s a common surname. This has already become political in the U.S…..

• VOC is a more severe classification than “Variant of Interest” but less severe than “Variant of High Consequence”. After working with South African health officials, WHO had enough evidence to say Omicron is more transmissible and had enough key changes on the spike protein that were concerning.

2. We have received one update from the CDC, which was a few lines long. They basically said there are no cases in the U.S. and to keep public health mitigation measures in place. The deafening silence from the CDC is the most disheartening thing to me.

3. Several more Omicron cases have been confirmed worldwide. BNO newsroom is keeping a great count:

But even this is a little “outdated” because this situation is changing by the minute. To add more cases and context to this list:

• Israel: Now has 4 confirmed cases: 1 from travel and 3 from community transmission. The confirmation of community transmission is what prompted their shut down.

• Belgium: 1 case has been identified. An unvaccinated young woman developed flu-like symptoms 11 days after travelling to Egypt via Turkey. She hadn’t traveled to South Africa. Because of this, Belgium is retroactively tracking 47 potential cases. They’re looking at past PCR positives to ensure Omicron wasn’t spreading under the radar.

• Netherlands: You may notice the 61 in the table above. There were two flights from South Africa that landed in Amsterdam late last night. Upon arrival, all 600 passengers were tested on the tarmac and 61 tests came back positive. A 10% prevalence rate on a flight is unbelievably high. Like defies imagination (as Bergstrom said). Especially given all passengers were negative before take off. With these positive cases we need to know a few things:

  • Were these people connected in some way before the flight (like in a tour or same hotel room)?

  • What was the vaccination rate (type, timing, boosted)?

  • What are the symptoms?

  • And, of course, were these caused by Omicron?

  We should have an update soon.

4. We still have no scientific updates on Omicron’s impact on immunity escape or transmissibility. If you’re hearing anything right now (even if it’s the British PM) it’s purely speculation. Hypotheses are important to discuss, but not the solid evidence we need. Getting answers takes time because good science takes time. I give it a week or two until the evidence starts rolling in.

5. We’re seeing a lot of cases but not a lot of severe disease. Yesterday, Dr. Rudo Mathivha, head of the ICU at an Omicron epicenter hospital said that among their patients:

“About 65% are not vaccinated and most of the rest are only half-vaccinated”.

This is incredibly encouraging news. This may be a sign that our vaccines continue to protect against severe disease and death. I cannot stress enough, though, that this is preliminary evidence. We need to know a few more things:

1. Is this because of a small sample size? Maybe Omicron just hasn’t spread enough in South Africa to see hospitalizations rise.

2. Is this because of lag time? Population-level hospitalization trends lag cases trends by 3-4 weeks.

3. Is this because of the population? Populations will respond differently to infections. What may be happening in South Africa may not be representative of what will happen elsewhere.

Bottom Line: We still have more questions than answers. But we will get them soon. Do not take Omicron lightly, but don’t abandon hope either. Our immune systems are incredible.

None of this changes what you can to do right now: Ventilate spaces. Use masks. Test if you have symptoms. Isolate if positive. Get vaccinated. Get boosted. (Yes, get vaccinated. I’ll explain more about this tomorrow.)

No idea if this helps, but thought I could bring you along for the ride.

Love, YLE

---

“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH PhD— an epidemiologist, biostatistician, professor, researcher, wife, and mom of two little girls. During the day she has a research lab and teaches graduate-level courses, but at night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health science so that people will be well-equipped to make evidence-based decisions, rather than decisions based in fear. This newsletter is free thanks to the generous support of fellow YLE community members. To support the effort, please subscribe here: