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January 18, 2022

'Like playing with dynamite': Why you shouldn't try to get omicron on purpose

Daily Briefing

    As Covid-19 cases surpass record levels in the United States due to the omicron variant, health officials are saying most Americans will likely catch the virus, but experts say that doesn't mean people should try to catch it intentionally.

    Radio Advisory: Aaron Carroll on how clinicians can combat medical misinformation

    'Most people are going to get Covid'

    At a Senate Health, Education, Labor, and Pensions committee hearing on Tuesday, acting FDA commissioner Janet Woodcock acknowledged, "I think it's hard to process what's actually happening right now, which is: Most people are going to get Covid." She added, "And what we need to do is make sure the hospitals can still function, transportation, you know, other essential services are not disrupted while that happens. I think after that will be a good time to reassess how we're approaching this pandemic."

    Similarly, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that, given omicron's "extraordinary unprecedented degree of efficiency of transmissibility," the variant "will ultimately find just about everybody."

    "[W]e're not going to eradicate this," Fauci said. "We've only done that with smallpox. We're not going to eliminate it. That only happens with massive vaccination programs, like we did with measles and with vaccines. But ultimately, we will control it. And if you control it in a way it's at such a low level, and people are vaccinated and boosted, sooner or later as we begin to live with it, what [Woodcock] was referring to is that virtually everybody is going to wind up getting exposed and likely get infected. But if you're vaccinated, and if you're boosted, the chances of your getting sick are very, very low."

    Why you shouldn't try to intentionally catch Covid-19

    Because the omicron variant is spreading so quickly, many people have considered intentionally catching the virus as a way to "get it over with," CNN reports.

    The idea has "caught on like wildfire," said Robert Murphy, executive director of the Havey Institute for Global Health at Northwestern University Feinberg School of Medicine.

    "And it's widespread, coming from all types of people, the vaccinated and boosted and the anti-vaxxers," he said, adding, "You'd be crazy to try to get infected with this. It's like playing with dynamite."

    One reason you shouldn't intentionally catch omicron is that, while the variant is less likely to cause severe disease, "that doesn't mean that it can't be a severe illness," said Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia. "It's just less severe. But you don't have a 0% chance of dying. You should never want to get infected."

    "People are talking about omicron like it's a bad cold. It is not a bad cold," Murphy said. "It's a life-threatening disease."

    For most vaccinated people, catching omicron will "feel like a bad cold or the flu," Leana Wen, a visiting professor at George Washington University Milken Institute School of Public Health, wrote in the Washington Post. "Many people will experience up to a week or longer of fatigue, fever, congestion, sore throat, headache, and overall crumminess."

    However, those who catch omicron are also likely to "keep the pandemic going and stress the health care system," Murphy said. Some vaccinated individuals will develop severe Covid-19 and need hospitalization. At present, many hospitals are full, Wen wrote, meaning "you may have to wait hours in the [ED] for treatment and then spend days in the [ED] waiting for a hospital bed."

    "The health care system is not just designed to take care of people with Covid. It's designed to take care of kids with appendicitis and people who have heart attacks and get into car accidents," said Ashish Jha, dean of Brown University's School of Public Health.

    "And all of that is going to be much, much more difficult because we have a large proportion of the population that is not vaccinated, plenty of high-risk people who are not boosted," he added.

    In addition, while sotrovimab, a monoclonal antibody treatment, is effective against omicron, it's in "such short supply that some hospitals are forced to use other monoclonal antibodies that likely do not work against this new variant," Wen wrote.

    There's also the chance of developing long-Covid, Wen wrote, noting that some research has found more than 1 in 10 people with Covid-19 still have symptoms 12 weeks after being diagnosed.

    "We're still trying to understand long-Covid," Offit said. "Because we don't understand it, I wouldn't be so quick to want to get an infection from a natural virus."

    And even if you don't develop a severe case of Covid-19, you can still infect other, more vulnerable people with the coronavirus, Wen wrote. This includes children under the age of five, who are not yet eligible for vaccines, and people who are immunocompromised.

    Bottom line: "Don't mess with Mother Nature," Offit said. "She's been trying to kill us ever since we crawled out of the ocean onto land." (Smith-Schoenwalder, U.S. News & World Report, 1/11; Frieden, MedPage Today, 1/12; Caldwell et al., CNN, 1/12; Blake, Washington Post, 1/11; Wen, Washington Post, 1/12; LaMotte, CNN, 1/11)

    Aaron Carroll on how clinicians can combat medical misinformation

    Listen to the Radio Advisory episode

    Radio Advisory, a podcast for busy health care leaders.

    Medical misinformation has been a significant problem for a long time, but amid the Covid-19 pandemic, the problem has become even more widespread. In this episode, host Rachel Woods sits down with Dr. Aaron Carroll, author, professor, and Indiana University chief health officer—to discuss what all clinicians should do to combat medical misinformation.

    Plus, Advisory Board experts Solomon Banjo and Pam Divack offer their take on clinician’s role in online spaces (with patients and with each other) and translate those same principles for the rest of the industry.

    Listen now

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