Viewpoint: Omicron demands a nuanced frame of mind — and a clear plan

Panic or indifference might be understandable reactions to a pending wave of the COVID-19 variant of omicron in the United States. But neither is helpful, according to Ashish Jha, MD.

The frame of mind needed to navigate this wave over the next two months lies somewhere in the middle, he argues. 

"We will see cases rise rapidly in the next few weeks, likely peaking sometime in mid-January," Dr. Jha, dean of Brown University's School of Public Health in Providence, R.I., wrote in an op-ed for The Atlantic published Dec. 19. "With any luck, cases will then fall as quickly as they rose, getting to very low numbers by the end of February. All of this suggests that the work ahead is to manage the next six to eight weeks." 

Three goals lie at the heart of Dr. Jha's response strategy: preventing deaths, protecting hospitals from overwhelming caseloads, and keeping schools and businesses open. Four actions to support these goals, as presented by Dr. Jha, are listed below.

1. Increase COVID-19 vaccinations. It's clear that protection for adults against the delta and omicron variants of COVID-19 requires three doses of mRNA vaccines or at least two doses of Johnson & Johnson's vaccine. "This is not novel; lots of vaccines require three or even four doses," Dr. Jha wrote. "Unfortunately, this idea has not yet settled into the minds of most Americans." As of Dec. 20, about 30 percent of the fully vaccinated population in the U.S. has received a booster dose, according to the CDC

2. Increase use of rapid COVID-19 tests. The growing demand for rapid, at-home tests for infection detection might involve government intervention. "The government must use all of its powers to get more tests into the marketplace and into homes," according to Dr. Jha. "The Biden administration is making important strides here. It needs to keep going. Booster uptake and widespread availability of testing will help reduce the strain on hospitals."

3. Establish a clear strategy for schools. Dr. Jha says the strategy in which schools send entire classrooms home for two weeks after one infection is detected in a classroom  "will be unsustainable amid the wave of infections that will follow the school holidays." He supports a test-to-stay strategy, in which students exposed to infected classmates continue to attend for in-person learning as long as they test negative with regular rapid tests.

4. Make modest sacrifices. The upcoming weeks will require tradeoffs to prevent unnecessary spread of infections, such as avoiding large parties and other unmasked indoor gatherings, Dr. Jha wrote. "During this omicron wave, we can't do everything we'd want to do if the pandemic were over. But we can do so much, and far more safely than at the beginning of the pandemic." While large indoor holiday gatherings with eating and drinking should probably be canceled, he says Americans should feel comfortable seeing friends and family — "as long as everyone eligible is vaccinated and boosted, and uses rapid testing as an additional layer of protection."

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