As Delta Spikes in Parts of U.S., Omicron Wave Builds Momentum

This time, we have the vaccines. This time, we have booster shots. This time, we have new treatments and methods that have been tested in previous waves. This time everybody knows the non-pharmaceutical mitigation methods—hand hygiene, social distancing, masking.

All of that should matter, say medical experts. Still, the health care system in the United States faces yet another unprecedented challenge. Omicron looks to become the dominant variant, according to many experts, and too much of the U.S population lacks the proper protection, which is more and more seen as having 3 doses of a COVID-19 vaccine. Also, while mortality rates might not be as high as in previous COVID-19 surges, hospital systems could be burdened not only by COVID-19 patients, but all the non-COVID infected patients who need help.

No matter how this plays out, infection preventionists (IPs) figure to be in the thick of any surge once again.

Rebecca Leach, MPH, BSN, RN, CIC, a member of Infection Control Today^®’s (ICT^®’s) Editorial Advisory Board (EAB), says that “at this point, the preparation that infection preventionists need to make are around resiliency and support for clinical staff who are exhausted and already stretched beyond limits.”

Heather Saunders, MPH, RN, CIC, is director of infection control at Johns Hopkins Office of Population Health, and another member of ICT^®’s EAB. Saunders says that “while mortality rates might not be as high as in previous COVID-19 surges, hospital systems could be burdened not only by COVID-19 patients, but all the non-COVID infected patients who need care.” She adds that “while influenza (flu) activity in the United States remains low, many regions of the country are beginning to detect small, steady increases in cases. It’s possible that we’re looking at a relatively typical flu season, or at least more cases than last year. And if so, increases in influenza cases coupled with a highly transmissible COVID-19 variant does not bode well for hospital capacity.”

And the Delta variant isn’t done with us yet. Yesterday, 1260 people died in the US from COVID-19, according to the Johns Hopkins Coronavirus Resource Center. There were 117,363 COVID-19 infections yesterday.

Even as Omicron rolls over Europe, even in countries where most of the population is vaccinated, experts stress that there’s still much that we don’t know about the variant. Early data suggest that it’s not as lethal as the Delta variant.

But as Kevin Kavanagh, MD, another ICT^® EAB member, noted in a recent article, while only a small percentage of the Omicron variant of COVID-19 cases may require hospitalization so far, high infectivity may turn this small percentage into a large number of patients, which will further stress health care systems.

What’s going on in the United Kingdom, where about 70% of the population is vaccinated, alarms experts. Investigators there found that Omicron is 3.2 times more likely to cause household infection than Delta. A person who catches Omicron can infect 2 to 4 other people.

So, Omicron appears to be growing exponentially. Eric Topol, MD, the founder and director of the Scripps Research Translational Institute, wrote on Substack yesterday that “the rapid growth of Omicron is especially alarming, with a doubling rate between 2-3 days in multiple countries where it has been tracked (South Africa, UK, Germany, Denmark, Norway, Belgium US). This exponential rise could take us to levels of even 1 million cases per day in the United States, which previously would have been considered an unthinkable projection.”

As has happened with earlier iterations of COVID-19, what happens in Europe doesn’t stay in Europe; it immigrates to the US. Jeffrey Barrett, PhD, is the director of the Genomics Initiative at the Wellcome Sanger Institute, which tracks variants in the U.K. “By next week, we will see clear evidence of an Omicron wave in European countries, and I suspect the U.S. is at most a week behind that,” Barret tells NPR.

Matt Ferrari, the director of the Center for Infectious Disease Dynamics and a professor of biology at Penn State University, tells NPR that “everybody in my industry is hopeful that we’re being alarmist, but more than at any other point in the course of the whole pandemic, we know how bad it could be.”

Just how much protection COVID-19 vaccines provide against Omicron also continues to be investigated. A report issued by the Statens Serum Institute in Denmark yesterday shows that three fourths of Omicron cases occur in people who’ve been fully vaccinated; while 9% of those who’ve gotten a booster shot have been infected by Omicron.

About 80% of the population in Denmark has been vaccinated.

In the US, almost 61% of the population is fully vaccinated, while only 1 in 4 adults have received a booster shot, according to the Centers for Diseases Control and Prevention. Omicron has been spotted in about 25 states in the US, but gathering data on COVID-19 cases can take time. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, tells Axios that “frankly we don’t have enough reliable, robust data at this point to give a clear direction as to what this will look like in the weeks to months ahead.”

Experts do know that vaccinations, boosters, and prior infections do offer some protection against Omicron. One of the many known unknowns about Omicron includes how or if it might exacerbate long COVID-19.

Meanwhile, IPs need to rest and recharge if they can, says Lisa Waldowski, DNP, RN, CIC, a regional director in infection prevention and control at Kaiser Permanente. “Time to stretch and refresh mentally and physically with our COVID-19 prevention efforts (complete vaccination status, mask-up, socially distance, and perform frequent hand hygiene) as we continue to along this pandemic marathon.”