The omicron wave currently washing over the world may have just hit its peak. According to the scientists at the Institute for Health Metrics and Evaluation at the University of Washington (IHME), which runs computer models of the pandemic, the number of daily reported cases in the United States was expected to hit a maximum of 1.2 million by January 19, and then decline. If the pattern of South Africa holds up in the U.S., that decline will be steep.
It is possible, but far from certain, that the Omicron onslaught marks the beginning of the end of the COVID-19 pandemic. The optimistic scenario goes something like this: Once Omicron is through ravaging the world, enough people will have acquired natural immunity that, together with those who have been vaccinated, the virus is suppressed to more or less permanently low levels in the population. When—if—that happy day arrives, the world will begin making the transition from continual crisis to something more manageable—a slow-boiling concern that keeps scientists and public-health officials occupied but leaves the rest of humanity free to go about the daily business of life.
The pessimistic scenario, which unfortunately is equally valid, starts with that familiar bugaboo: the random threat of some new, unforeseen mutation of the COVID-19 virus rising up and dashing our hopes. In this view, Omicron subsides only to be replaced by yet another troublesome new variant that causes more illness and death and extends the pandemic.
It’s too early to know which scenario best describes the near future, and will probably be knowable only in retrospect. But one thing is reasonably certain: SARS-CoV-2, the virus that causes COVID-19, is not going away. Scientists are in near-universal agreement that the virus will be a fixture for generations to come.
Even if the pandemic is winding down, it’s not clear what our future with SARS-CoV-2 will look like. Will the virus morph into something benign like the common cold? Or will it pester us like influenza, requiring yearly shots and constant vigilance for the next pandemic? Or will it break with convention entirely and follow some new, horrific path? Scientists are calling on the Biden administration to take steps to cope with the long-term implications of living with SARS-CoV-2.
Vaccinations in a shopping center in Zimbabwe.
Meanwhile, the pandemic isn’t over yet. With billions of people left to infect, Omicron still has plenty of maneuvering room for mischief. It has overtaken the Delta variant in 110 countries, says the World Health Organization (WHO). That includes the U.S., where case counts have soared to more than three times the previous peak seen in January 2021. It is so highly contagious, infecting the vaccinated and the unvaccinated alike, that in the next two or three months, IHME scientists say, it could infect three billion people—more than a third of the world’s population.
“I am hopeful that in the big, big picture things are getting better,” says Jonathan Eisen, an evolutionary biologist at U.C. Davis. “But when one actually looks at the details, that hope needs to be tempered by the facts on the ground. And those facts are seriously troubling.”
With billions of people left to infect, Omicron still has plenty of maneuvering room for mischief. O.R. Tambo International Airport in Johannesburg after countries banned flights from South Africa.
THE MOST TROUBLING FACT ABOUT THE PRESENT moment is the speed and magnitude of the Omicron outbreak, which stands to inflict a great deal more suffering and death.
The good news is that Omicron causes less severe illness than the original virus in 2020, or the Delta variant last year. Based on data scientists have been compiling regularly from national health agencies—particularly, in this case, from South Africa, the United Kingdom, Denmark and Norway—the team at the University of Washington has estimated that “over 90 percent and perhaps even as high as 95 percent” of people who are infected will have no symptoms. Many may never even know they had the virus. And the fatality rate, based on the reports from those countries, “is probably 90-96 percent lower for Omicron than for Delta,” the variant that caused such pain and death last year.
In the pessimistic view, Omicron subsides only to be replaced by yet another troublesome new variant that extends the pandemic by another year or two. A line forms for COVID-19 tests in New York City.
The sheer numbers of people being infected all at once, however, is straining hospitals and public health systems—even a less-severe virus that is so highly contagious will put a lot of people in the hospital. Omicron is also proving to be a significant threat to vulnerable populations, such as people who are old or have compromised immune systems. Unvaccinated people may be as much as 13 times as likely to die as those who are fully vaccinated, according to data from the Centers for Disease Control. Vaccination rates in some of the world’s poorest countries are a sixth of what they are in the United States. And the effects of “long COVID,” in which symptoms last for months or years, are poorly understood.
As to what happens immediately after the current Omicron wave subsides, scientists are divided. Ali Mokdad, an epidemiologist at IHME, sounds an optimistic note. “After Omicron—sometime around March, April—this will be behind us,” he says. “Short of a new variant popping up, we’ll feel that we are in a very good position. Not normal—we’re not going to be normal until we are sure no new variants are surfacing. But we will be in a much better position—our hospitals will not be overwhelmed, our medical staff will get a break, people will travel, things will change.”
Eisen, though, says there aren’t hard numbers to support the view that Omicron will increase people’s immunity enough to stem the rise of new variants. “I see it all over the place,” he says. “It is based largely on hope and not data.”
Volunteers repaint hearts on the National Covid Memorial in London.
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