US appears vulnerable as it braces for Omicron challenge

Health experts have warned the US faces a huge challenge to contain the fast-spreading Omicron variant of Covid-19 due to relatively low vaccination rates, inadequate testing and inconsistent rules about mitigation measures such as mask wearing.

The emergence of the new strain comes as healthcare systems in some US states struggle to cope with a wave of infections caused by the Delta variant, which has pushed the total number of Covid deaths to 800,000.

This sombre milestone, equivalent to one in every 411 Americans, coincides with the first anniversary of the vaccine rollout in the country, which has since stalled with only 61 per cent of citizens fully vaccinated.

"We are very exposed and in real danger," said Ali Mokdad, professor of global health at University of Washington.

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“We have a new variant that is very infectious and is already in the US. We are entering the holiday season, people are travelling and we have a red-blue [political] mentality, so mask wearing is low and vaccination has plateaued.”

Mokdad said unless the US got a better handle on its Covid-19 response the healthcare system could be overwhelmed and the number of deaths next year could exceed the 415,000 fatalities reported so far in 2021.

On Tuesday the Centers for Disease Control and Prevention warned that Omicron was "more transmissible" than other variants and reiterated its advice for people to get vaccinated and booster shots to increase their immunity. Omicron accounted for 3 per cent of new cases nationwide and 13 per cent of cases in New York and New Jersey, according to the agency's testing.

But experts said despite recent efforts to strengthen its national testing infrastructure, the US still lagged behind many other rich nations in genomic surveillance capacity, hindering its ability to track the spread of new strains such as Omicron.

Sequencing

The US has only sequenced about 2.3 per cent of Covid cases in the past month, falling behind 20 other countries, including Israel, which has sequenced about 30 per cent of cases, and the UK, with about 13 per cent, according to Gisaid, a global science initiative based in Munich. Sampling of at least 5 per cent of positive cases is needed to allow for the detection of emerging strains of Covid-19, experts say.

Only seven states have sequenced more than 5 per cent of Covid cases in the past month, including Vermont, Massachusetts and California, where the first US case of the Omicron variant was identified on December 1st.

Eric Topol, director of the Scripps Research Translational Institute, said weak genomic and rapid testing infrastructure had left the country vulnerable to fast-spreading variants such as Omicron.

The US is now registering more than 119,000 new infections a day, a 61 per cent increase over the past month and approximately half of the January 2021 peak of daily cases. Deaths have not risen nearly as quickly, with fatalities up just 10 per cent from a month ago to 1,260 a day.

Topol warned that the new variant could push up the number of new cases to many times its current level. When combined with the low vaccination rate compared to many other rich nations, any surge in cases would increase pressure on the US’s already overstretched healthcare system, he said.

In Vermont, Rhode Island and New Mexico, approximately half of all hospitals are experiencing staff shortages, according to the department of health and human services. In 11 states, Covid-19 patients represent anywhere from a third to half of ICU capacity.

Vaccination appeal

The heads of nine big hospital networks in Minnesota ran a full-page ad on Sunday urging locals to get vaccinated as hospitalisations overburden providers.

"Here in Minnesota, all our beds are full and it's the same with every hospital you talk to: they have fewer staff and are in total crisis," said Mary Turner, president of the Minnesota Nurses Association and an intensive care nurse. She added that many nurses were exhausted.

“But this has been caused by Delta, which is really deadly. If people end up in my ICU they are usually ventilated and prone [lying on their abdomen]. They aren’t surviving . . . I just can’t imagine what will happen if Omicron is worse.”

States’ responses to the threat from Omicron have been uneven, contributing to a highly politicised atmosphere and helping foster misinformation that has fuelled vaccine hesitancy.

Even as states such as California and New York have tightened rules once again, other Republican-led areas have refused to re-implement restrictions and challenged the Biden administration’s efforts to introduce vaccine, testing and mask-wearing mandates, arguing these policies are federal over-reach and limit personal freedoms.

But experts are hopeful initial data from South Africa suggesting Omicron may cause less severe disease than Delta are proven to be true and will ease the burden on the US health system.

The response to Omicron will also be aided by enhanced immunity from previous infections and vaccinations, as well as new treatments, such as antiviral pills and monoclonal antibodies.

“The US is not helpless against Omicron. It is December 2021, not January of 2020. We have amassed a lot of knowledge about Covid’s transmission and risk factors for severe disease,” said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

“[But] the fact that 40 per cent of the population is not vaccinated does mean that Omicron will have the potential to infect and sicken them, some of them seriously.” – Copyright The Financial Times Limited 2021