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Opinion Why we need a new approach for the omicron phase of the pandemic

A family leaves a coronavirus testing and vaccination site at a public school in Los Angeles on Jan. 5. (Robyn Beck/AFP/Getty Images)

In the past 10 days, almost a dozen people I know have tested positive for the coronavirus. Two of them had a rough time with it and said it was comparable to a full-blown case of flu. The others had a day of chills or nothing at all. When asked about symptoms, one of them, having been isolated, responded, “Boredom.”

I realize that this is anecdotal, but the data so far confirms this pattern. In the words of one Wall Street Journal headline, “New York’s Omicron Surge Points to a Wave of Mild Cases.” If the pattern holds up, it is crucial that we approach this phase of the pandemic differently rather than fighting the same way we did against the last variant.

The United Kingdom Health Security Agency released an important analysis on Dec. 31; the findings are tentative, based on data available a few days prior. Even so, the analysis estimated that one’s risk of being hospitalized with omicron is half as high as with the delta variant, and the risk of needing emergency care is only one-third as high.

More significant is the distinction between the vaccinated and the unvaccinated. The U.K. analysis, which looked at the AstraZeneca, Moderna and Pfizer vaccines, estimated that people with two doses of the vaccine plus a booster shot are 88 percent less likely to be hospitalized than those without vaccinations.

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Even if you get the virus, if you are double-vaccinated and boosted, you are still an estimated 81 percent less likely to be hospitalized than if you are unvaccinated. If you get the virus and have had two doses of the vaccine, no booster, you are estimated to be 65 percent less likely to need to be hospitalized. In the United States at least, hospitalization numbers are misleading. For instance, the New York Times reported this week that at two major New York hospitals, around 50 to 65 percent of “covid hospitalizations” were people coming to the hospital for other reasons and then, once there, testing positive for covid.

Leana S. Wen: Omicron is not a reason to keep schools closed

U.S. health officials have also noted the growing evidence that omicron is less severe than delta. In South Africa, which first reported omicron, even though relatively few have been vaccinated, people were less likely — 80 percent lower, according to one preprint study posted in December 2021 — to be hospitalized for omicron than for other variants. In addition, the Biden administration has ordered 20 million treatment courses of the Pfizer covid pill, though we need more.

The early data — and it is early — suggests two conclusions. First, omicron is far less lethal than the previous variants of the virus. Second, the vaccines, especially with a booster, are highly effective at preventing serious illness and death. That means we are in a fundamentally different situation than we were in March 2020, when the coronavirus was sweeping around the world. We do not need lockdowns, school closures or onerous travel restrictions. Instead, we need to make an even sharper distinction between the vaccinated and those who are not, coupled with sensible measures to slow the spread of the virus so that the health-care system is not overburdened.

The Centers for Disease Control and Prevention has shortened the recommended isolation period from 10 to five days. Could it be even shorter if you are vaccinated and not showing any symptoms? At this point, for those fully vaccinated, getting omicron appears to be comparable to catching the flu. We don’t force people with the flu to isolate for five days.

We must have different rules across the board for those who are vaccinated. We know from the science and the statistics that they will impose many fewer burdens on the health-care system. Why should the willfully unvaccinated be able to force the rest of society to pay the price for their refusal to take a simple medical precaution?

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Beyond vaccines, the key is mass testing and good masks. The epidemiologist Michael Mina has long argued that the focus on PCR (polymerase chain reaction) tests — as opposed to rapid tests — has been misguided, that from a public health standpoint, what matters is not whether you have the virus but whether you are spreading it to others. Rapid antigen tests determine that pretty effectively. But compared with Europe, tests in the United States cost more and are not as easily accessible. Similarly, we should make masks that are cheap, high-quality and widely available.

Germany’s leading virologist said omicron could become the first “post-pandemic” coronavirus variant, which would likely make this disease an endemic one, not so lethal, and one that we will live with like the flu. We can’t be sure of this because with so many unvaccinated people — about 26 percent of Americans still have not received one dose — the virus still has plenty of space to replicate and thus mutate. But it does appear that at least for now, for the vaccinated majority, the post-pandemic future has arrived — if we are willing to accept it.

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