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November 30, 2021

Omicron updates: WHO warns of 'very high' risk as CDC urges boosters

Daily Briefing

    The World Health Organization (WHO) on Monday warned the global risk from the omicron coronavirus variant is "very high"—news that comes as CDC encouraged all eligible American adults to get booster shots of Covid-19 vaccines.

    Omicron: The 3 biggest unanswered questions

    WHO says risk from omicron is 'very high'

    According to WHO, there are "considerable uncertainties" surrounding omicron, but early evidence shows the variant has mutations that could help it evade immune system response and increase its transmissibility.

    "Depending on these characteristics, there could be future surges of Covid-19, which could have severe consequences, depending on a number of factors, including where surges may take place," WHO said. "The overall global risk … is assessed as very high."

    Theodora Hatziioannou, a virologist at Rockefeller University, said omicron's mutations suggest it may have evolved in the body of someone with a compromised immune system. The virus could have stayed in the person for months, evolving the ability to evade antibodies. "This virus has seen a lot of antibodies," Hatziioannou said.

    Still, some experts say it's too early to know how effective Covid-19 vaccines will be against omicron. William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, said vaccines will most likely protect against the variant but more studies are needed to determine just how effective they'll be.

    Omicron is "certainly enough to take seriously, but it's not apocalyptic," Hanage said. "It's not a magic virus."

    CDC urges all American adults to get booster shots

    Meanwhile, CDC Director Rochelle Walensky on Monday urged all American adults to get booster shots of Covid-19 vaccines, a change from the agency's previous recommendation that young, healthy adults "may" get a booster shot.

    "The recent emergence of the omicron variant further emphasizes the importance of vaccination, boosters, and prevention efforts needed to protect against Covid-19," Walensky said.

    Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that when a vaccinated person receives a booster shot, "you increase the level of neutralizing antibodies extraordinarily high—many fold higher than even the peak following the first two doses."

    He added that "it is quite conceivable if not likely" that booster shots will protect against omicron.

    However, Paul Offit, a professor of pediatrics at the Children's Hospital of Philadelphia, alongside Marion Gruber and Phillip Krause, two former FDA officials, authored an op-ed saying the United States should focus on reaching the unvaccinated rather than booster shots.

    "To the contrary, the possible need for a booster shot targeting a potentially vaccine-resistant variant is a reason to hold off on a booster targeting the original variant," the authors wrote.

    Celine Gounder, an epidemiologist and infectious disease specialist, said boosters should be part of the response against omicron, but focusing mostly on booster shots could leave much of the developing world unvaccinated, which creates an environment for more variants to emerge.

    "You have one approach that has a likely short-term benefit versus another approach that has a very likely long-term benefit, and how do you weigh one versus the other?" Gounder said. (Keaten et al., Associated Press, 11/29; Zimmer, New York Times, 11/26; Rafford, Politico, 11/29; Shear/Stolberg, New York Times, 11/30; Lim/Gardner, Politico, 11/29; Abutaleb et al., Washington Post, 11/28; Loftus, Wall Street Journal, 11/29; Collis, Politico, 11/29; Walker, Wall Street Journal, 11/30; Schnell, The Hill, 11/29)


    Advisory Board's take

    The policies Biden and states could use to control the omicron variant

    Heather BellBy Heather Bell, Senior Consultant

    The Biden administration has several policy levers it can pull to help control the spread of omicron in the United States, if it is ultimately detected here. But after nearly 21 months of the pandemic, the public—and the health care workforce—are growing strained, which is likely to factor into how the White House responds. White House Covid-19 response coordinator Jeff Zients has already said the United States is unlikely to impose another lockdown to stem the spread of the coronavirus, and instead will rely on other tools. For example, President Biden has already imposed travel restrictions for non-U.S. citizens from eight countries in southern Africa, and its possible we could see that list expanded based on the level of infection in other countries. In addition, we're likely to see the Biden administration continue to dole out Covid-19 relief funds, extend the public health emergency, authorize and approve Covid-19 vaccines and treatments, and encourage U.S. citizens to get vaccines and booster shots.

    But at this stage in the pandemic, it's the state actions that are likely to have the biggest impact. And as we've seen throughout the pandemic, the level of public health response (for instance, masking and social distancing policies) will vary depending on the state. Public health measures are not the only lever at states' disposal. At least three states—Colorado, Idaho, and New Mexico—have hospitals operating under crisis standards of care as a result of Covid-19 surges, and Massachusetts recently urged hospitals to scale back elective procedures, citing staffing shortages related to the pandemic.

    Why policy alone may fall short

    The main takeaway here, is there are numerous policy options the Biden administration and states can use to control the spread of omicron variant if it begins to spread in the United States. But in order to be effective, the public must be ready to comply—and increasingly people are suffering from pandemic fatigue and that is a phenomenon that policy alone can not fix.

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