Omicron Mobilization

https://www.nytimes.com/2021/12/21/briefing/omicron-mobilization-spread-us-cases-dominant.html

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President Biden’s Covid-19 response got off to a strong start. In his first few months in office, he and his team eliminated the chaotic, scientifically dubious messages that had come from the Trump administration and rapidly accelerated the pace of vaccinations.

In doing so, Biden compared the fight against Covid to wartime mobilization. “It will be the first priority, the second priority and the third priority — to deal with Covid and bring down the spread and bring down the death rate,” he told me during a phone call shortly before taking office.

But the Biden administration has fallen behind in recent months — on persuading people to get booster shots, on approving lifesaving treatments and on making Covid tests easily available. With the Omicron variant spreading rapidly, Biden faces another need to mobilize the federal government. He is set to give a speech today outlining his plans to do so.

According to White House officials, the plans include: sending military troops to help hospitals cope with Covid surges; deploying ventilators to places that need them; invoking a wartime law to accelerate production of Covid tests; sending free tests to people next month; and opening more vaccination clinics.

Omicron already accounts for about 75 percent of new cases in the U.S., the C.D.C. said yesterday, and experts expect cases to soar over the next month. The vast majority will be mild because the vast majority of Americans have some degree of immune protection (and because childhood Covid is almost always mild). But Omicron may cause such a large increase in cases that it will nonetheless overwhelm hospitals, many of which are already near capacity.

One potential problem is hospital staffing. One-third of all health care workers may contract Covid and need to miss work, Michael Osterholm of the University of Minnesota said on the podcast “In the Bubble.”

“The good news is it could be over quickly,” Andy Slavitt, a former White House adviser and the host of “In the Bubble,” told me, referring to the Omicron surge. “The bad news is that almost everything could face some kind of shortage.”

Here are the three major areas in which the U.S. has fallen behind:

For months, Americans heard a message — from experts, politicians and journalists — that anybody who had received two Covid shots was “fully vaccinated.” That message is no longer fully accurate. If you received your second shot more than six months ago (or a Johnson & Johnson more than two months ago), your immunity has begun to wane. You are more likely to contract Omicron than somebody who has received a booster shot.

People who closely follow Covid news are aware of the power of boosters. But millions of other Americans are not. About 73 percent of Americans have received at least one vaccine shot, and less than 20 percent have received a full initial dose plus a booster, according to the C.D.C.

In a notable development, Donald Trump yesterday said that he had received a booster shot and encouraged his supporters to embrace Covid vaccines. In the past, Trump has been less positive about vaccines, and many conservatives continue to sow vaccine misinformation.

In heavily Democratic areas, the problem is different: a shortage of shots before holiday gatherings. “My local CVS pharmacist said they have been besieged and are no longer taking walk-ins,” Carey Bodenheimer, a California resident, tweeted yesterday.

One idea, if you’re not boosted yet: Search online for a nearby clinic that does not require appointments. That worked for my family.

Public health officials have demanded a lot of flexibility from Americans during this pandemic, as Matthew Yglesias of Substack has pointed out: Keep your children home from school. Work at home. Cancel family events. Save the masks for medical workers — then again, start wearing masks now!

But public health agencies like the F.D.A. and C.D.C. have frequently failed to show much flexibility themselves. Rather than overhauling their approach during a global emergency, they have been slow to take steps that could have saved lives — like encouraging mask use sooner, giving full approval to vaccines sooner or encouraging mix-and-match booster shots sooner.

“What’s been sticking in my craw,” Yglesias wrote, “is the extent to which America’s public health institutions themselves have shown so little flexibility during this crisis even as they see the virtue of flexibility in everyone else’s behavior.”

The latest example is the F.D.A.’s lack of approval for a Pfizer treatment intended for people who have contracted Covid and are at risk of serious illness. The treatment, known as Paxlovid, reduces hospitalization and death by about 90 percent, Pfizer says.

Obviously, if the F.D.A. has an undisclosed reason to believe that the treatment is problematic, the slowness would be justified. But recent history suggests the agency often moves slowly and passively out of bureaucratic habit, not substantive concern.

The simultaneous arrival of Omicron and the holiday season has caused a surge in demand for rapid Covid tests. They are again nearly impossible to find in some places. As my colleague Tara Parker-Pope asks, “How do we get through the holidays and the next two months without rapid tests?”

Biden’s announcements today — to increase production and distribute free tests next month — are intended to address the shortage.

The bottom line: On any individual level, many Americans remain at very small risk of a severe case of Covid. But the unvaccinated face serious risks. Some vaccinated Americans — including the elderly and people receiving cancer treatments — face a meaningful amount of risk. And the country’s medical system is at risk of being swamped.

Any kind of progress by the Biden administration, governors and other officials over the next few weeks is likely to help save lives.