Today, Explained - (Some) omicron answers

Episode Date: December 15, 2021

Thanks to South Africa, the world now has some data on omicron’s severity, transmissibility, and whether or not the vaccines will protect us from it. Today’s show was produced by Miles Bryan with help from Hady Mawajdeh, edited by Matt Collette, engineered by Efim Shapiro, fact-checked by Laura Bullard and hosted by Sean Rameswaram. Transcript at vox.com/todayexplained Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

Get groceries delivered across the GTA from Real Canadian Superstore with PC Express. Shop online for super prices and super savings. Try it today and get up to $75 in PC Optimum Points. Visit Superstore.ca to get started. It's Today Explained. I'm Sean Ramos from We Found Out About Omicron on Thanksgiving weekend. So on November 29th, our first day back, we went to Umair Irfan, who reports on science at Vox for answers. Understandably, he didn't have a lot of the time, but he still helped us understand how governments were responding. Now that we have a few more answers, Umair is back.

Umair, we've known about Omicron for a few weeks now. What more do we know about how it works? There was a study that just came out this week from the largest health insurance company in South Africa that looked at about 210,000 COVID-19 results. And they found that the overall risk of hospitalization was about 29% lower with Omicron compared to infections with the variant that infected South Africa last summer. And that's controlling for the vaccination status. And so that seems to hint that this is a less severe version of the virus. Okay, that's good news. But we also saw that this seems to be a much more transmissible variant of the virus. So more people seem to be getting it, including people who have been previously infected and people who have been vaccinated. Okay, that's bad news. Tell me more about this study.

Well, they looked at, you know, people in South Africa. South Africa has had multiple waves with multiple different variants throughout this pandemic. South Africa also has roughly about 40% of its adults vaccinated at this point. So it's still a minority and there's still a lot of unvaccinated people. But between the waves of infection and the vaccinations, some of the researchers I talked to say that about 70% of South Africans have been exposed to the virus in some fashion. And so the fact that this variant seems to be spreading nonetheless seems to show that previous exposures and previous protection doesn't hold up as well. Omicron is causing an increase in COVID-19 reinfections in South Africa. Previous infection used to protect against Delta and now with Omicron, it doesn't seem

to be the case. What they've seen in their hospitals is that you're seeing fewer people needing things like oxygen and ventilation and intubation after they've been admitted. And it seems that even though more people are getting infected, fewer of them are getting severely ill. But in South Africa, they're also seeing a huge growth in cases. You know, they're seeing, you know, doubling or tripling week over week. In a new high, nearly 20,000 cases were recorded in the last 24 hours.

36 new COVID related deaths were confirmed. So even if a smaller number of people are getting severely ill, the fact that more people are getting ill means that they could still face a big stress on their health care system. South Africa's President Cyril Ramaphosa urged citizens to get vaccinated against COVID-19 on Monday, a day after he tested positive. And of course, the caveat here is that, you know, we're only a few weeks into the after our discovery of this variant and to this outbreak. So a lot of these results are still preliminary. There's usually a lag between when we first start detecting cases and when we start seeing a rise in hospitalizations and deaths. So the other shoe may still get dropped.

So this particular study solely focuses on South Africa, is that right? Right. You know, South Africa was one of the first places that discovered the Omicron variant. And so some of the best information we have is from there. And South Africa has actually done a fairly good job about tracking COVID-19 throughout the pandemic. And so the data that they have is actually fairly robust. And a lot of researchers around the world are paying close attention there. I've read that South Africa has a much younger population comparatively, at least with the West. Is that something that could skew the data here? That's a potential factor here. But from some of the folks that I've talked to, including some health officials on the

ground, they say that they're seeing Omicron infections in all age groups, in all demographics, and they're seeing a lower rate of severe cases among all demographics as well. What about the symptoms here? Does coming down with Omicron feel qualitatively different than, say, Delta or OG Rona? It is a milder virus, so it does seem to lead to milder symptoms. I'm here in isolation in Johannesburg, South Africa, after contracting the Omicron variant of COVID. A lot of folks have reported things like a scratchy throat, a sore throat, earache,

congested nose, a dry cough, muscle aches and pain, lower back pain. Kind of just feeling very, very run down. And so the symptoms overall don't seem to be all that worrying. But, you know, because this disease can spread asymptomatically, it's important to get tested. And we may not know the full spread or the extent of this variant because so many people may be infected and not realize it.

And how about the vaccines? Do they work more effectively against Omicron, less effectively? What do we know? So Pfizer and BioNTech, they developed the mRNA vaccine. They found that when you get a booster, you dramatically increase the level of projected protection by about 25-fold, which means that people who get boosted after their two-dose mRNA should really do quite well. A new study on the

Moderna vaccine found that it, too, needed a booster to be effective against Omicron. There was also another study done on the AstraZeneca-Oxford vaccine that was preliminary, but it found that that vaccine offered diminished protection. And there are some ongoing studies on the Johnson & Johnson vaccine. Those seem to be offering less protection against some of the other variants. South Africa famously actually stopped the distribution of the AstraZeneca vaccine because they found it was much less effective against one of the variants that was circulating there. So the Pfizer vaccine is one of the more commonly used vaccines in South Africa right now, which is why they were very keen on testing that one. Okay, so what we know right now is that Omicron is less severe, but it is significantly more infectious, and it's also good at evading our vaccines.

It's spreading exponentially in South Africa and is now about something like 3% of all cases in the United States, but that number is obviously going to grow. What will that growth look like? Well, first, I want to push back on what we actually know. These are the earliest bits of evidence, and they're not certain, and we can still find information in the coming weeks that will contradict this. And so I want to have that caveat there that this is just an early indication. Okay, good caveat. And then as far as what we can expect here in the US, like there's a lot that could happen, but you could probably group them in one or two different ways. One is that we'll have more cases that are less severe. And because they're so much less

severe, we'll have fewer people in the hospital. And overall, the health burden of this will be much less. So in one scenario, we'll have the lower severity of this variant being the more significant factor. That sounds like a good scenario. What's the other one? Well, the other one is where the transmissibility becomes the more significant factor. So we still have less severe cases, but because it's so much more transmissible, we have so many more people getting infected that even though there's a smaller percentage overall of severe cases, that absolute number is so large that it does still overwhelm the healthcare system. We still have more people going into the hospital, and that not only impacts people getting COVID-19,

but that impacts everybody else who needs to use the hospital as we see constraints for other resources. And so if the hospital beds are all full with people with COVID patients, you know, that's going to be harder to get treated for things like heart attacks or respiratory distress or any other kinds of issues that you may have in that intervening time. And so it has a big ripple effect. And I'm guessing the way around scenario two, which sounds much worse than scenario one, is making sure people get boosted, get their second shots, get their first shots, wear masks, and take safety precautions? The way around both scenarios is to use that exact playbook, the same playbook that we've been using the entire pandemic. But the problem is people

are getting pretty tired of that playbook, huh? We've been at this for two years. A lot of people are a bit tired of wearing masks, about social distancing, and not being able to go to work or take all these precautions. And the will is just not there. And that's kind of the challenge. Because individually, our risk from this virus may be lower. But collectively, across a society, the risk is still there. So that's really the hard message to sell to people that, you know, you may yourself may not be the one getting severely ill, but if too many people get sick from this, then this is going to have major health impacts again. How to keep COVID cases down when people are sort of over being careful

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BetMGM operates pursuant to an operating agreement with iGaming Ontario. Today, I'm back to announce our action plan to battle COVID-19 this winter. Dylan Scott, your senior correspondent covering healthcare here at Vox. Omicron is coming for the United States. It's already here. What's President Biden's plan to deal with it? So, earlier this month, President Biden laid out his winter COVID plan. And it doesn't include shutdowns or lockdowns, but widespread vaccinations and boosters and testing and a lot more. And the plan to get us through the next few months when

experts were already expecting before Omicron ever came on the scene, at least a small surge in COVID cases, just because the virus seems to be settling into a bit of a seasonal pattern, not unlike the flu. And now with Omicron coming on the scene and looking much more transmissible, I think the possibilities of a big winter surge are only rising. Now as we move into the winter and face the challenges of this new variant, this is a moment we can put the devices behind us, I hope. This is a moment we can do what we haven't been able to do enough of through this whole pandemic,

get the nation to come together. So the White House has laid out their playbook for trying to blunt the impact of the virus over the winter. And really it's got like three big components. One is vaccinations, including booster shots for as many people as possible. And then, you know, newly vaccinating as many kids and, you know, as many new adults as we can reach. Two is trying to make tests affordable for people. And the way they're proposing to do that is to let people submit the costs of buying a test to their insurance company for reimbursement.

And then three, they are proposing to create what they're calling strike teams that can be deployed to assist hospitals and local health departments that are facing acute emergencies because of surges in COVID cases and hospitalizations in their immediate vicinity. So it's a pretty comprehensive plan.

They try to touch on as many parts of the pandemic response as you'd expect. But, you know, the challenge is going to be, you know, how much of a difference can the federal government really make when a lot of states are resistant to any new COVID interventions? And frankly, a lot of the public is getting sick of living in this pandemic reality and anxious to move on to a new kind of normal where the virus isn't constantly impeding on their lives. Before we talk about the challenges more, let's talk about this winter plan.

Sounds cool, but like boosters. Let's start with boosters. Boosters have already been around for a while. What's new about Biden's plan for boosters? There's a couple of things. One, before the Biden White House even laid out this winter plan, the CDC had revised its guidance for boosters to say that all adults over age 18 should get a booster shot six months or later after they got their first two doses. More than 32 million Americans have already had a booster shot, and now those numbers are expected to shoot

up as Americans look to boost their immunity heading into the holidays. So now everybody in the country is now recommended to get a booster shot. And that reflected an optimism among experts that even though the boosters have not been, you know, re-engineered for Omicron specifically, there's still a belief that a booster of the old vaccine will still provide more protection against especially severe illness from Omicron. When you get boosted, it brings it back up to the level of pretty good protection, which is a very strong argument for people getting their boosters. So they're trying in a couple of small ways beyond the CDC guidance to increase booster uptake. One thing they're doing is partnering with the AARP

for an education plan to just inform seniors about the availability of boosters and why they're important. They're planning to use Medicare as well to do some outreach to people. But we've got a long way to go. Only about 30% of the eligible adults have gotten their booster shots at this point.

And then we've also got another 30% of the population that's totally unvaccinated. All right, so an uphill battle on boosters, but it's happening at least slowly at this point. What about testing? We did a recent episode on how the U.S. really fell behind on testing, especially compared to our peers in Europe. How does Biden want to finally fix that? Health insurers must cover the cost of at-home testing so that if you're one of the 150 million Americans with private health insurance, next month your plan will cover at-home tests.

The way they put it is they want to make at-home testing free for everybody. Yeah, that sounds great, right? But they're doing it in a slightly roundabout way. So rather than just buying 500 million testing kits and sending them to every person in the United States, what they're proposing is, okay, you or I could go to CVS or Walgreens and purchase a testing kit ourselves, but then we can take the receipt from that purchase and send it to our health insurer, and then our health insurer is supposed to reimburse us for the cost of purchasing a test over the counter. That's nice.

This is not a plan that a lot of public health experts are really enthusiastic about, to be honest with you. Making everyone file insurance reimbursements to get free tests does not sound like making this a lot easier or compelling for people to go do. No, it's not the smoothest way to do it. That's for sure. Okay, let's talk about part three of this three-part plan, this strike team. What is that?

Yeah, so there's actually a couple different types of strike teams. And what these teams would be would basically be like teams of nurses and doctors and public health workers, epidemiologists, those kinds of folks who would be kind of on call and available to deploy to specific localities that are having a really serious and acute surge of COVID cases. So like one of these teams might be deployed to hospitals that are being strained because of COVID and because they don't have enough staff. So the idea is like, okay, you're experiencing a COVID surge right now and you're already understaffed at your local hospitals. We're going to send a bunch of nurses there to help you deal with the glut of patients that might be coming in because of COVID.

Another one of these teams could be deployed specifically to administer the antibodies treatment that has been shown to lead to better outcomes for people who get infected with COVID. And then another one of these teams could just be like a team of epidemiologists who can support a local health department that is just trying to get a handle on like, all right, how widespread is the virus in our local area? You know, where some of the vectors, you know, where some of the trouble areas that we might want to consider, you know, restrictions or new closures or whatever, basically just a whole team of kind of disease investigators who can embed with a local or state health department and just help them get a handle on tracking the virus.

How does this winter plan of President Biden stack up against other countries' plans for handling Delta surges and Omicron and everything else? So I would say that our federal government is being less aggressive than other federal governments. So, you know, in the United Kingdom, for example, they've instituted new mask mandates. You have to get like a pass, you know, that proves vaccination if you're going to go to large events. They've mandated vaccines for their National Health Service.

But the single biggest thing that every one of us can do is to get our jabs and crucially to get that booster as soon as our turn arrives. Got countries like Austria and Germany that have put new restrictions into place for unvaccinated people specifically. France and some other countries have closed nightclubs and restaurants in a hope to stem the spread of Omicron specifically. Denmark's another country that's done that. So at the national level, we are not

doing quite as much as other countries are. I would say, you know, the US's situation is complicated by a couple of things. One, we're just a much bigger country that has this, you know, federalized system of government. And so a lot of, you know, the responsibilities for making these decisions are just by the way we've structured our government are delegated to states and local governments. And we have seen some states, California and New York have reinstituted mask mandates. I today am announcing that we are enacting a statewide indoor mask mandate unless a business has a vaccination mandate. You've seen some local governments introducing vaccine mandates for indoor dining or indoor activities. So at a more localized level,

I think you are seeing parts of the United States be as aggressive as those European countries are. But at the national level, on the one hand, it's harder for the Biden administration to do those kinds of things because they might just not be legally permissible. But also, you know, they're going to do what we can to help people get vaccinated, to help people get tested, to help people get treatment if they end up infected with COVID. But like beyond that, there's not as much that the Biden administration can do. And so I think this plan is sort of a tacit acknowledgement of the limits of their own power. And did it have to be that way?

Did we have to accept that it would just be something we live with and just experience hundreds of thousands of deaths a year? I think we just hit another grim milestone in the United States, 800,000 dead, which is likely an undercount, which is, you know, equivalent to a major American city. And more people have died in 2021 than died in 2020, even with vaccines and boosters. I know we're increasingly desensitized to these numbers,

but was there another way? I'm pretty skeptical that we could have just stamped out COVID in the spring of 2020, no matter who was in charge and no matter what was done. But I think in terms of the world that we actually occupy and the world as it existed in spring of 2020, it was always going to be bad. I don't know that anybody imagined it would be this bad. And I think that's because a lot of us didn't appreciate how deeply divided our country really was. Dylan Scott reports on health at Vox.

Umair Irfan reports on science. You can read each of them at Vox.com. I'm Sean Ramos for him. Our show today was produced by Miles Bryan with help from Hadi Mawagdi. Matthew Collette edited it. Afim Shapiro engineered. Laura Bullard fact-checked. Stay safe.

Don't become a statistic. Happy holidays. It's Today Explained. Thank you.