What are the implications of the new Omicron variant for organizations? For answers, we spoke with Dr. Michael Osterholm, a leading US epidemiologist who directs the Center for Infectious Disease Research and Policy at the University of Minnesota. Here's our conversation, edited for space and clarity:
What are the implications of the Omicron variant for workplaces? Should organizations be doing anything different at this point?
At this point, the organization should really be continuing to do what they were doing for Delta: making certain that they have as high levels of vaccination as possible, that those levels are current (meaning that if they are eligible for a booster, to get that), also paying attention to ventilation, and screening for individuals who are not vaccinated who are coming back into the workplace.
A number of organizations have January or February target dates for bringing employees back into the workplace. If you were in their shoes, would you be hitting the pause button now?
There are two sets of questions we have yet to answer. One is transmissibility. While that is a question still, I can also tell you that the information of the last 72 hours suggests that this is being spread readily around the world. This appears to be surely a more transmissible variant than we've seen with any of the previous ones. The other unanswered question is what is the likelihood of disease severity, and for different categories of people (vaccinated, not vaccinated, people who have previously been infected, not infected, those with underlying comorbidities, those not.)
Until we can answer those questions, it is going to be a challenge, in terms of making plans for January or February. If we have a highly transmissible virus, with a preponderance of milder illnesses, then that's one situation. That's like working in an influenza world where we don't shut down. If we see a similar incidence of severe disease as we see with the current Delta, then you've got a whole different ballgame on your hands. I wish we had more data, but I think it's just too early to say yet.
What about the scenario where Omicron is very transmissible, but has mild symptoms, which some people say could be helpful if it dominated over variants such as Delta which can cause serious illness?
It's just too early to say, because that also could be a situation. However, to date the individuals who have had milder illness have largely been younger, healthy adults who were fully vaccinated. So the question becomes what will the picture be across all ages, all underlying comorbidity risk groups? And that's what we just don't have the data on yet.
The company holiday party in Norway where people were infected by Omicron seems like a pretty chilling scenario....
We're still looking carefully at that one with regard to vaccination status and the underlying comorbidity issue and then what the outcomes are. What that one does is just further support the point I made earlier about the transmissibility of this virus. That was a remarkable super spreading event.
I'm hearing that a lot of US companies are going forward with their holiday parties...
We're seeing that all over. And this is even as Delta is very rapidly escalating in terms of its importance. Some could argue that even if Omicron had never shown up, people would need to reconsider January or February start dates, just because of what Delta's doing.
I worry, for example, in the Northeast right now about what this is doing to Boston. Earlier this week, Boston did not have one ICU bed open because of Covid. I think New York City is poised on the very edge of what could be a very significant Delta surge. Some of these places are going to be dealing with this issue in January and February, even if Omicron never showed up.
That’s because of the spread of Delta among vaccinated populations as well?
Yes. A good example is that you have Vermont with the highest vaccination rate in the country. And yet this past week, they had the highest number of hospitalizations for Covid that they've had in the entirety of the pandemic. It just points out that even if you have a small sliver of your population not protected, this virus will find you. In Vermont, you have these high rates of vaccination—77%—and yet the majority of their very critically ill patients are unvaccinated.
What are you telling people about end-of-year family holiday plans?
It’s not any different than what I would have said before Omicron. If you have a vaccinated population getting together, and people are current—particularly with boosters—I think you go ahead and do it. In some cases where you have multi-generational situations and younger kids are not yet able to be fully vaccinated, then it's making sure that they're tested at least two days in a row before they get together. And you can surely go ahead and do those this year—we have the tools we didn't have last year at this time, in terms of vaccines.
If you were in an organization that had people traveling for business, would you be reassessing that right now?
We'll look at this with Omicron. But right now I have every reason to believe that if you're fully vaccinated—particularly for those who can be boostered and have their booster—you can do that relatively safely. I would still do everything I can to minimize my risk exposure, like wear an N95 respirator in any kind of public spaces. But I think you surely can go ahead and do it. I think the vaccine status is the key piece.
The one thing I would add to that is that of course assumes that you will take into account your own personal risk picture for serious illness. These vaccines are remarkable tools, but they're not perfect. And, for example, in the data we have for solid-organ recipients, we know that the current vaccines are only about 50% effective in reducing serious illness, hospitalizations, and deaths. There's a group that surely would reconsider its risk of exposure even if they're fully vaccinated.
What future do you see now?
I don't know what the future is going to be other than the fact that I know we're going to be dealing with this for a long time to come. This is not going to be over with like an influenza pandemic that's a two-year event, is done, and becomes seasonal flu; so be it, it's over. This is not that.