Dr. Tom Frieden: Why I’m cautiously optimistic about Covid-19
Despite growing pandemic fatigue and rough weeks ahead as the Omicron tsunami recedes, we’re better defended against Covid than ever. Vaccines and prior infection have steadily strengthened our collective immune defenses. We have now built up a wall of immunity — although we have lost far, far too many people along the way to get here.
In 2020, failure to follow public health recommendations greatly increased the death toll in the United States and elsewhere. In 2021, failure to reach people with vaccination — largely due to partisan opposition and entrenched resistance in the US, and lack of access in many countries — had lethal consequences.
We’ve already lost nearly 900,000 people to Covid in the United States alone and are closing in on the grim milestone of a million American deaths. Most could have been prevented. But now, we can have the upper hand over Covid because our defenses are multilayered and strong, starting with immunity.
We have new drugs that are highly effective at preventing severe Covid. Lab studies suggest they will work just as well against the Omicron variant as Delta. Generally, medical treatments don’t have anywhere near the life-saving impact of vaccines, but they help. These pills could be a life-saver for people at high risk of severe Covid, though we must still overcome supply challenges, pair testing with early treatment and make sure there’s equitable access for everyone who needs them.
Most people understand that masks work and that better masks (such as N95s) work better, and there are now more of them. Masks can stop airborne spread of whatever variant Covid throws at us. We can learn from East Asia by masking if we’re sick or vulnerable, to resist not just Covid but flu and other respiratory diseases.
Although there have been bumps in the road, testing is more widely available, including rapid antigen tests that can be done at home. When Covid is spreading in our community, we can test before gathering indoors with vulnerable people or in large groups, or test if we feel sick; if infected, we can isolate at home until no longer contagious.
Genomic surveillance is another tool that we’ve sharpened. South Africa set a great example by warning the world about Omicron. Many countries have increased their capacity to perform robust genetic sequencing. We can stay ahead of the virus by continuing to be on the lookout.
All of the above are reasons for cautious optimism, but there are wild cards. Protection from Omicron infection may not be strong or long-lasting; less severe infections often result in less lasting immunity. And although vaccine protection has held up well against severe disease, we may need additional doses to stay up to date.
The biggest wild card: SARS-CoV-2’s ability to mutate. It’s highly unlikely that Omicron will be the last variant. What’s to say a deadly, highly transmissible, immune-escape variant won’t arise? Frankly, it could.
But even if a worse variant emerges, we’re better prepared than ever: more immunity, more vaccines, more treatments, better masks and more of them, better tests, better understanding of Covid, more sequencing. Covid doesn’t have to keep dominating our lives, and with our improved defenses, we may soon be able to safely resume many activities.
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