Omicron completely changed the pandemic – it’s time to change the way we respond to it

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Omicron has completely changed what we thought we knew about COVID-19 – given how quickly it grows in the body, shows symptoms, and infects others – meaning the tools we have at our disposal to try to contain it are no longer as effective.

The highly contagious variant is now spreading at a rate unlike anything we’ve ever seen before, completely crushing our testing capacity and infecting more Canadians than at any time during the pandemic, because hospitalizations reach record highs.

“It’s kind of the difference between a garden hose and a fire hose,” said Michael Osterholm, epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“As bad as Delta was, it was more of a garden hose. It’s a fire hose in terms of the transmission.”

Omicron has fundamentally changed the virus on almost every level – from the speed at which it spreads, to the time it takes to infect, to the severity of the symptoms it causes.

“Thank goodness we are where we are,” said Dr. Bonnie Henry, BC provincial health worker, in a telephone interview. “If this had been the initial virus that spread before people were vaccinated, especially the elderly, I mean it would have been the plague.”

Henry said that one of the biggest challenges with Omicron is that the incubation period has become much shorter – meaning that while it took five to seven days for symptoms to appear with the previous variants, it won’t. now it takes two or three days for people to get sick.

“So that leads to rapidly explosive epidemics which are relatively less severe, but when you have that number of people infected you are still going to have a strain on your health care system,” she said.

“It’s not about stopping this, we can’t stop Omicron… but what we can do is slow it down and try to keep it away from those who are most at risk and try. mitigate the impact on hospitals. ”

WATCH | Hospital numbers are falling while Omicron causes an increase in hospitalizations:

Omicron cuts hospital numbers as hospitalizations increase

The Omicron variant has dealt hospitals a double blow – increasing patient numbers and plummeting staff levels due to illness and isolation requirements. 2:44

Will strict public health measures work against Omicron?

Canada is responding to the devastating wave caused by Omicron by reimposing tough public health measures – ranging from curfews to the closure of bars, restaurants and gymnasiums, and even delay going back to school.

But Osterholm, who is also a member of US President Joe Biden’s COVID-19 advisory board, co-wrote a point of view in JAMA magazine this week, who argued that it was not possible to eliminate Omicron, saying we need to completely rethink our public health response to this problem.

“We are not going to contain it. This word should not be used,” he said. “But there is certainly a lot we can do to slow it down.”

Omicron brought us back to “flatten the curve,” said Bill Hanage, an epidemiologist at Harvard TH Chan School of Public Health.

“Most people think the previous measures would delay, but not stop, Omicron. It is always worth doing because you are helping more vulnerable people,” he said.

“The can particularly effective interventions, such as closing large gatherings, restaurants, etc. during a defined period, when hospitals are most in demand. ”

WATCH | Canadian Hospitals Prepare for Increase in COVID-19 Admissions and Staff Shortages:

Staff shortages and increase in admissions linked to COVID-19 add to pressure from Canadian hospitals

Hospitals across Canada brace for a surge in admissions as Omicron-related staff shortages add further pressure to the variant wave. 4:22

But Dr Amesh Adalja, an infectious disease physician and senior researcher at the Johns Hopkins Center for Health Security in Baltimore, wonders if tough public health measures will have the same level of impact on Omicron.

“They didn’t make sense at the start of the pandemic and they don’t make sense this late in the pandemic to me, because of all the cascading negative impacts they have and the fact that they are very direct, ”he said. noted.

“I don’t know how you can treat the vaccinated and the unvaccinated the same with these kinds of policies when the virus doesn’t treat them the same.”

As COVID-19 becomes a less serious respiratory virus for the vaccinated, Adalja said, it is still a major threat to the unvaccinated who continue to be at a much higher risk of serious illness.

Steven Hoffman, director of the Global Strategy Lab and professor of global health law at York University in Toronto, believes the impact on hospitals could be devastating in the weeks to come if public health measures fail to slow the spread of Omicron.

“The thing that really worries me is what happens if someone gets hit by a car during the month of January when all the intensive care units are full of COVID patients– 19? ” he said.

“Once you run out of intensive care beds and doctors and other healthcare professionals have to start making decisions about who gets a bed and who doesn’t, the whole system collapses. ”

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People line up outside a mass immunization clinic prioritizing teachers and school staff at the International Center in Mississauga, Ont., Jan.7, 2022. (Evan Mitsui / CBC)

Osterholm believes that while many more people will be infected with Omicron in the coming weeks, strict public health measures and increased vaccinations will impact its ability to spread and lead to hospitalizations.

“In addition to helping ease the immediate burden on the healthcare system, we can also get more people vaccinated, especially with this third dose,” he said.

“It is becoming very clear that it can have a big impact on the severity of the disease with Omicron. Very important.”

The reason strict public health measures are being reinstated around the world is that trying to spread the number of Omicron cases at any one time is an important step to avoid overloading the health care system, Osterholm said.

“Whether you have 1,000 infected people coming to the hospital today or 1,000 infected people coming to the hospital in the next 10 to 15 weeks, it can make all the difference in the world,” he said. -he declares.

Will Omicron prolong the pandemic?

So if Omicron is not possible to eliminate and is already spreading like wildfire, threatening to overwhelm our healthcare system, what does this mean for the end of the pandemic? And how will the coming weeks and months unfold?

“In North America, I think we’ll probably have another two to four weeks of major activity, and then I think it will start to decline dramatically,” Osterholm said. “But the next few weeks should be very difficult.”

Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa, expects COVID-19 levels to continue to rise dramatically before peaking in the coming weeks.

“A rapid rise will be followed by a rapid fall. We have seen it in South Africa. So while it will be a high peak, fortunately it will be a short wave,” he said. declared.

“So does that mean we don’t have to do anything? No, of course, no. What we have to do, of course, is slow down the transmission to a.) Preserve the health care system and b. ) protect the unvaccinated and give them time to be vaccinated. ”

Dr Bonnie Henry gives a COVID-19 briefing in Vancouver on January 4, 2022. (Ben Nelms / CBC)

Henry believes that while we are on track for COVID-19 to become endemic, like other respiratory viruses, and the worst of the pandemic will end in the months to come, it will be a bumpy road to get there.

“I said this a few weeks ago, when I knew people were going to be really down – I was really down, I went home and cried for an hour – but we can’t waste our time. energy by wishing it was different. That’s what it is and we know what to do, “she said.

“I really believe we’re going to be in a much better environment and through the critical phase of the pandemic and up to, ‘OK, how do we live with this virus in the future? “phase will probably come spring or summer.”

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