While most of us were enjoying our first Thanksgiving in two years with loved ones, a new COVID variant exploded onto the scene. In a matter of hours after South Africa announced its existence, on Nov. 24, B.1.1.529 earned the name Omicron by the World Health Organization as a new variant of concern, and the European Union, the United States, Israel, and Singapore announced bans on travelers from southern Africa. New York also preemptively declared a state of emergency, although no cases have yet been detected there or in the United States generally.
Nearly 24 months into the coronavirus pandemic and a year after vaccines became available, the United States is making the same mistakes around Omicron as last year, by embracing crude and ineffective feel-good solutions over harder but more impactful actions. Travel bans and lockdowns will not work, while at the same time the things that will work, like vaccinations and masks, are not being fully utilized. We seem unable to learn from our mistakes — can we change things this time?
At first blush, Omicron looks as scary as its name sounds. Initial data out of South Africa, where it was first identified, show that, armed with 30 new mutations in its spike protein, Omicron is able to outcompete Delta, the latest and most contagious variant. (The mutated virus was able to infect a passenger in a Hong Kong quarantine hotel and it has infected 13 people who arrived in the Netherlands on flights from South Africa.)
Given this initial information, doesn’t an immediate travel ban into the United States make sense?
No. Travel bans will fail because the virus almost certainly escaped before the ban could be implemented. Travel bans cost billions of dollars to countries’ economies, disrupt supply chains and family relationships, and in the end have only minor effects on transmission.
While Omicron is probably highly contagious, it is still not known if it can escape vaccine protection. But before we panic, researchers need to learn if current vaccines help to lower the rate of infection from Omicron, and we must measure the virus’s ability to cause serious illness.
While bans are a bad idea, there are other steps the Biden administration and state officials should take immediately — but it is not clear they are doing so.
Nationally, the Biden administration needs to make pre-departure and upon-arrival rapid testing mandatory for all international flights, with quarantines strictly imposed on positive cases. This would slow the spread of Omicron and give scientists more time to understand the severity of this new threat and prepare countermeasures, including the development and deployment of vaccines that specifically target the mutated virus.
The United States should also work closely with other affluent countries to promote wider and immediate vaccine availability in developing countries. In South Africa, 18 percent of the general population is infected with HIV and only 35 percent are vaccinated against COVID, leaving a large immunocompromised population susceptible to incubating and transmitting new variants. It is no coincidence that two of the most serious COVID variants have emerged from southern Africa, while Delta originated in India, another country where only 32 percent are vaccinated and variants have a greater chance of being propagated.
Rather than punishing countries for sharing knowledge of new variant threats by slamming the doors shut (thus creating disincentives for countries to report new variants in the future), wealthy countries, led by the United States, should be working to invest in a global surveillance network for the rapid detection and sharing of new pandemic outbreak information.
In Massachusetts, officials need to admit that COVID has not been vanquished despite our record-high rate of vaccination. Delta is still with us, and our state has the second-highest rise in cases over the last two weeks in the United States.
Governor Charlie Baker, Mayor Michelle Wu of Boston, and other local leaders need to work together to encourage everyone to get a booster — an mRNA vaccine, regardless of the initial shot a person received. The booster should not be seen as a bonus but as a necessary layer for maximum protection against new infections.
It is still not known if Omicron can escape the current vaccines that were designed for the original virus, but there’s reason to believe that they may still be partially effective. Only 28 percent of the 3.6 million eligible Massachusetts residents who were initially vaccinated six months ago have received a booster. With vaccines readily available now, we need to increase booster coverage to 90 percent of those eligible in the next few weeks. And if you are in the remaining 10 percent of people in Massachusetts who have not had any shots, you need to sign up today.
All licensed health practitioners should be fully vaccinated before the end of the year to maintain employment. COVID cases and hospitalizations are rising again in long-term care facilities due to waning immunity in both elderly patients and among only partially vaccinated health workers.
Regrettably, the state needs to reinstate a mask mandate in indoor public spaces, regardless of vaccination status and local conditions. COVID isn’t over — and universal masking is still the best preventive action against respiratory viruses, but it will work only if we all do it.
Rapid COVID tests that have been widely recommended before gathering indoors in small groups of unmasked friends and family should also be used by everyone. With the Christmas holidays coming up and the weather turning colder, rapid antigen tests are the best way to ensure that people can get together safely, and this will also slow the spread of Delta and Omicron.
We now know more about what to do to control Omicron and stay safe — vaccinate everyone including boosters, universally mask, and test before gathering indoors. While Omicron is a serious threat, it could also be the wake-up call that pushes us to finally do what we should have done months ago to free ourselves from the worst global disease outbreak of the last 100 years.
Shan Soe-Lin is managing director of the Boston-based Pharos Global Health Advisors and a lecturer in global health at the Jackson Institute for Global Affairs at Yale University. Robert Hecht is president of Pharos Global Health Advisors and a clinical professor of epidemiology at the Yale School of Public Health.