As coronavirus transmission rates plummet across California, indicating that the surge spawned by Omicron is flattening out, many wonder if the latest variant will be the final surge in the COVID-19 pandemic.
There remains considerable debate around this issue. Some experts are loath to make predictions, given that earlier predictions of the pandemic’s conclusion have not proven true.
But one thing is clear: Scientists generally say it’s too early to declare an “endgame” for COVID-19.
“There are different scenarios for how the pandemic might unfold and how the acute phase might end. But it is dangerous to assume that Omicron will be the last variant or that we are at the end of the game,” said Tedros Adhanom Ghebreyesus, director general of the World Health Organization, on Monday. “On the contrary, overall, the conditions are ideal for more variants to emerge.
“It is true that we will be living with COVID for the foreseeable future and we will need to learn how to manage it through a supported and integrated system for acute respiratory disease” to help prepare for future pandemics, he added. . “But learning to live with COVID doesn’t mean we give this virus free rein. This cannot mean that we accept almost 50,000 deaths per week from a preventable and treatable disease. »
Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, is among those saying we need to prepare for more surprises after the Omicron wave ends.
In a blog post on Saturday, Topol warned against thinking that the drop in Omicron cases means the 2-year pandemic will soon be over.
If that happens, great, he wrote.
But “it seems quite unlikely — with so much of the world’s population, especially in low- and middle-income countries, [having] not vaccinated yet,” Topol wrote. “Omicron’s future trajectory is unclear, and we cannot rule out a second Omicron push at this point in locations around the world.”
It would be foolish to predict that high Omicron infection rates around the world would lead to COVID-19 becoming a disease we can all be less concerned about, Topol added.
It is possible that high infection rates result in a new variant that may be more resistant to existing immunity and vaccines. And that’s why it’s so important to make progress on a vaccine that can work on all coronaviruses; oral and nasal vaccines that can help block transmission by boosting immunity in our mucous membranes; and to accelerate mass production of anti-COVID-19 pills that are likely variant-proof, Topol wrote.
“If there’s one thing we’ve learned about predicting the trajectory of SARS-CoV-2, it’s that it’s unpredictable. So we shouldn’t be planning a pink image,” Topol wrote.
Others, however, suggest the end of the pandemic is near.
Between the end of November and the end of March, more than 50% of the world’s population will be infected with Omicron, wrote Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, in a commentary for The Lancet magazine.
New variants will emerge, and some may be harsher than Omicron, he wrote. Immunity will wane over time, and countries should expect winters to be a time of increased viral transmission, he added.
But the health impacts of future transmission of the coronavirus “will be less due to extensive previous exposure to the virus, vaccines regularly adapted to new antigens or variants, the advent of antivirals and the knowledge that people vulnerable can protect themselves in future waves when needed by using high quality masks and physical distancing,” he wrote. “COVID-19 will become another recurring disease that health systems and societies will have to manage.”
“The era of extraordinary measures taken by government and corporations to control the transmission of SARS-CoV-2 will be over,” Murray predicted. “After the Omicron wave, COVID-19 will return but not the pandemic.”
Dr. Ashish Jha, Dean of the School of Public Health at Brown University, tweeted that the United States should be prepared for a new summer surge in the South as the weather warms and people come indoors, and for a new surge next winter in the North as temperatures drop .
“Will there be another variant? I guess so,” Jha wrote.
Jha suggested that public health restrictions, including mask mandates, be relaxed as case numbers drop and hospital capacity improves.
“During future surges, we may have to ask people to step down or mask up again,” Jha said. “Preserving people’s will to do things is essential.
Between surges, Jha said, preparations should continue. He echoed Topol’s call for vaccines that can cover all coronaviruses or create better immunity in people’s mucous membranes. He also advocated for a commitment from the US government to buy and stockpile billions of rapid tests so that there is sufficient supply for the next surge and the manufacturing of huge quantities of anti-COVID-19 pills.
The issue of positivity
On a shorter timescale, Dr. Robert Wachter, chairman of the department of medicine at UC San Francisco, recently tweeted the criteria he would use to determine when to return to to activities such as indoor restaurant dining.
Wachter said he would be looking for a test positivity rate of 1% and a coronavirus case rate of 10 or fewer cases per day per 100,000 population.
LA County hit those metrics before Omicron’s surge took off in mid-December. But county metrics are much worse now. According to a Times analysis of state data, LA County is reporting a rate of 307 daily coronavirus cases per 100,000 population. By comparison, the rate for San Diego County is 309; Orange County, 214; and San Francisco, 172.
And the rate of positive tests in many parts of California is well over 1%: the figure is 13.5% in LA County, 27.5% in San Diego County, 26.5% in the county of Orange and 17.5% in San Francisco.
Here are the daily coronavirus case rates, per 100,000 people, for other Southern California counties and by region elsewhere, according to a Times analysis:
- Riverside County: 283
- San Bernardino County: 256
- Ventura County: 243
- Santa Barbara County: 224
- Southern California: 281
- San Joaquin Valley: 238
- San Francisco Bay Area: 196
- Greater Sacramento: 182
- Rural Northern California: 132
Some experts and public health officials say there are also good reasons to avoid getting infected, including the potential risk of long-lasting COVID, in which symptoms of the disease persist for months or longer, or transmit the virus to someone who is elderly or has a weakened immune system. system.
It will be months before more is known about a connection between Omicron and the long COVID, Topol said in a recent online chat hosted by Wachter.
There are plausible reasons why the incidence of long COVIDs might be worse with Omicron than previous variants; others might explain why Omicron might be less likely to cause the syndrome, Topol said. But without adequate data, “we should expect the worst of the long COVID.”
The Associated Press contributed to this report.