Even as President Biden outlined new plans on Tuesday to fight the highly contagious Omicron variant, public health experts warned the measures would not be enough to prevent a stark rise in infections and hospitalizations in the coming weeks.
The government’s strategy includes doubling vaccination campaigns and supporting hospitals as they deal with a large influx of patients. Federal officials will deploy resources, including military doctors, to support health care systems and distribute rapid tests to Americans.
But Mr Biden explicitly ruled out lockdowns and other harsh measures taken when the pandemic first unfolded in early 2020. In interviews on Tuesday, some scientists argued that the rapid spread of the variant requires more vigorous containment measures.
Some expressed frustration and alarm at what they described as a timid public health response, lamenting the apparent lack of will on the part of politicians and society in general for more aggressive steps.
The crisis is brewing just as Americans prepare to travel to holiday gatherings, students return home for vacation, and young and old alike gather for New Years celebrations or embark on a journey that could further spread the virus.
Federal health officials on Monday asked health care providers to advise their patients to perform rapid home tests for Covid before holiday gatherings, and ask their guests to do the same. But while the tests are sold over the counter, prices start at $14 for a two-pack, and many stores are sold out.
And in stark contrast to advice given last year, Mr. Biden encouraged people to gather and celebrate the holidays, as long as they were vaccinated and taking standard precautions.
At the same time, he warned that the variant was spreading at an unprecedented rate, saying there would be Omicron infections among those vaccinated, apparently resigned to the fact that even those given boosters could become infected with the highly contagious variant.
“I still can’t quite get over how fast this is going,” said Joseph Fauver, a genomic epidemiologist at the University of Nebraska Medical Center. “I think it’s going to get really bad. I don’t know how else to say it.”
It is not yet clear whether the variant causes milder disease than previous variants. But some scientists worry that the idea has gained wide dissemination and the pandemic-weary public has slackened its vigilance.
“This is an incredibly contagious pathogen and we don’t yet know its impact on severity and death,” said Galit Alter, an immunologist and virologist at the Ragon Institute of Massachusetts General Hospital, MIT and Harvard.
“We need to restore the importance and accuracy of the first wave,” she added. “We’re back in ‘flatten the curve’ mode.”
Saskia Popescu, an infection prevention epidemiologist in Arizona, said Mr. Biden’s steps should be accompanied by increased vigilance at the community level.
Indoor gatherings should be restricted in high-transmission areas, and masks should be worn even at large events held outdoors, she said. Restaurants must have adequate outdoor seating and ventilation and must check customers’ vaccination status to eat inside.
“Now is the time to strengthen safety measures, and I think people are hesitant because everyone has burnout, but the truth is we need them now more than ever,” she said.
Omicron is spreading so quickly that the United States can’t afford to wait to see how things play out in other countries, as has happened in previous waves, said Dr. Jacob Lemieux of the Massachusetts Consortium on Pathogen Readiness.
Nor can Americans “bet the farm” on the variant that causes less severe illness, he said. The vaccines and booster injections encouraged by Mr Biden should help reduce the incidence of serious illnesses, but the vaccinations are most effective two weeks after administration; in the meantime, those who haven’t gone for their shots are highly susceptible.
The rapid spread of the variant is likely to put a strain on already overburdened hospitals and endanger vulnerable Americans, including older adults and those with weakened immune systems.
“We need to make sure they stay protected,” said Dr. Megan Ranney, an emergency physician and the academic dean of Brown University’s School of Public Health. “Reducing the spread of the community in general helps them.”
How do you do that? Proposals range from mandating vaccinations and Covid negative tests to board domestic flights to renewing the preventive behaviors recommended since the start of the pandemic, such as washing hands regularly, wearing masks in enclosed public areas, avoid crowds and keep windows open for ventilation.
“We’ve been through this many, many times,” said Alessandro Vespignani, director of the Network Science Institute at Northeastern University in Boston. “Right now we know there is a portfolio of interventions that can be layered on top of each other.”
Experts have recommended the distribution of free, high-quality masks in addition to quick tests and a robust public education campaign to ensure people know how and when to use those tests.
Hundreds of public health experts, aerosol scientists, health professionals and lawyers signed a letter Monday urging the federal government to encourage the wearing of masks indoors regardless of vaccination status, stating that the precaution can be implemented quickly and is highly effective. .
The Biden administration plans to provide 500 million free rapid tests to Americans — a good start, experts say. But the tests are not expected to be available until January, after many experts fear the Omicron peak will be well underway, and the number will likely be insufficient as tests are intended to be used frequently.
Also, people will have to use a website to request the free tests. Right now, stores in cities like New York no longer carry rapid tests, so many Americans can’t easily get a diagnosis before a meeting or a flight.
“People are having to work too hard right now to do the things it takes to prevent infection and transmission,” said Bertha Hidalgo, an epidemiologist at the University of Alabama at the Birmingham School of Public Health.
Ideally, she said, the tests would be made more widely available in places people already routinely visit, such as schools and workplaces.
The coronavirus pandemic: important things to know
Despite Biden’s advice on Tuesday, Americans planning family gatherings with grandparents or other potentially vulnerable individuals, or planning New Year’s Eve parties with friends, should reconsider, some experts said.
“If you have a holiday gathering right now, there’s a good chance that one in 10 people in that room is infected and doesn’t know it yet,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“If you really want to protect yourself during the peak, you need to limit contact with people in public institutions and in your own home.”
The Biden administration’s decision not to close entertainment venues, shops or restaurants, and keep schools open with new testing procedures, highlights the grim choice facing many governments as Omicron proliferates, said Dr. Salim Abdool Karim, an associate member of the Ragon Institute and director of the Center for the AIDS Program for Research in South Africa.
“We can let people decide for themselves and companies decide for themselves about risk, or we can take structured action and say, ‘These things shouldn’t be done,'” he said. Given the rapid spread of the virus, the choices must be made quickly: “Time is not on your side,” warned Dr Abdool Karim.
In the United States, many hospitals are already struggling under the Delta wave amid a staff exodus. Hospitals and nurses have begun directly begging the public to take the pandemic seriously.
Welcoming Mr. Biden’s proposals, Rick Pollack, the president of the American Hospital Association, said on Tuesday that health professionals “have been pushed to the brink.” He reiterated an appeal to all Americans to get vaccinated and strengthened as soon as possible.
In Rhode Island, there is little evidence that current measures are sufficient to contain the latest wave. In some hospitals, emergency room wait times have been extended to more than 12 hours, and doctors treat patients in parking lots, said Dr. ranney.
“There are no nurses,” she said. “There are no beds. There is no way to get an IV in people in the waiting room. There is nothing you can do about it.”
The government’s plan to mobilize the National Guard to help prop up overstretched hospitals and increase the number of hospital beds is much needed, she added.
Standards of care may need to be reassessed, experts said. Staff shortages could mean that infected healthcare workers continue to work if possible, despite the risk to patients.
Annoyed health professionals have pleaded with the public to take every possible step to protect themselves — and to prevent the health care system from crumbling.
“For God’s sake, get the vaccine and booster,” said Mary Turner, an intensive care nurse who is president of the Minnesota Nurses Association. “The nurses are at a breaking point.”
“A year and a half ago I compared what we were going into as a war, and we were soldiers going into battle,” said Ms. Turner. “And I’m telling you, we’re losing the war.”
