Thread by @DrTomFrieden

A tidal wave of Omicron will hit the US and other countries at the worst possible time—holidays approaching, health systems strained from Delta, flu starting, many feeling pandemic fatigue. If we get our response right, Covid won't dominate our lives in 2022. Here’s how. 1/thread

It’s astonishing how quickly Omicron is spreading and leaving Delta in the dust. It may be one of the most contagious viruses we’ve ever seen. New case records have already been set in South Africa and the UK and are inevitable in the United States 2/

Omicron already made up ~3% of Covid in the US on December 11. The proportion is significantly higher now, doubling every 2-3 days. New York City, the original Covid epicenter in the US, is again at the forefront with Omicron. nyti.ms/32bowbe 3/

The “Omicron signature”? A straight line up. Delta’s dizzying rise was astonishing. Omicron’s is almost beyond belief, and must reflect BOTH characteristics of the virus that allow it to spread faster AND immune escape. 4/

https://twitter.com/EricTopol/status/1470968315992416257

There’s simply no way Covid could spread this fast unless it’s riding roughshod over immunity from vaccination and prior infection. We still don’t know how well immunity protects from severe illness. Will take weeks to figure out protection from vaccine, prior infection, both. 5/

Some are pointing to early data from South Africa and elsewhere as evidence that Omicron is less severe. The truth is that it’s too early to know for sure. Let’s not get ahead of ourselves. go.nature.com/3q3O2HS 6/

Every population is unique. It will take time to figure out the properties of Omicron, duration and effectiveness of vaccines, and how it affects different people. The plural of anecdote is not data. 7/

https://twitter.com/Craig_A_Spencer/status/1471640447743414278

Think of it this way. Omicron is 2-3x more infectious than Delta. 80% of people in the US have NOT received a booster dose—more than 250 million people. There are likely to be tens of millions of Omicron infections in the coming months in the US. 8/

Even if Omicron is less severe, unless it’s LOTS less severe, it could double the current already-high US death rate to 2,000/day or more by mid-February. There’s a major risk that hospitals will be overwhelmed in the next two months. 9/

Bottom line: Omicron is still Covid, it’s still capable of doing damage to your body. And it’s still capable of overwhelming our health systems. It’s shaping up to be a hard winter. Get vaccinated and boosted ASAP. 10/

Omicron has complicated the holidays, but we’re not back at square one. Each of us can take steps beyond vaccination to reduce risk. Mask up with N95s. Increase ventilation. 11/

Keep schools open in January/February and beyond; in-person schooling is essential and doesn’t worsen community spread. Prioritize activities that really matter to you, as @CMO_England aptly said this week. 12/

Look out for people around you—especially those who are older or more vulnerable. Covid can be spread by people with no symptoms. Even if you feel fine, you could spread the virus to someone who dies from it. 13/

Consider testing before gathering indoors with friends/family you don’t live with. It can take days after exposure to become infectious. You can test negative in the morning and positive in the afternoon. Test immediately before your gathering & consider multiple day testing. 14/

Perhaps the most important things countries can do right now are to boost, mask, shield the most vulnerable, and preserve health systems. 15/

Every single nursing home resident and staff member should be boosted. Older adults face the highest risk of hospitalization and death from Covid, and they need all the protection they can get. 16/

Vaccine mandates for health care workers save lives. At least 10,000 lives could be saved among health care workers—and thousands of deaths among patients and nursing home residents could be prevented—if vaccine mandates are implemented everywhere. 17/

Our behavior can affect others, and health care workers have a special responsibility. Vaccine mandates in hospitals and nursing homes are ethical—no one should be put at greater risk in a health care setting. bit.ly/3EbMz73 18/

We can’t forget that much of the world remains unacceptably at risk. Vaccine acceptance is high across Africa but less than 10% of Africans have been vaccinated. Countries need consistent vaccine supply and additional logistical support. New report: bit.ly/329Qnsm 19/

The threat we face from Omicron is real, and there's no guarantee that Omicron is the worst this virus will throw at us. We must get past division and pandemic fatigue and use the tools we have to fight Covid. 20/

Fundamentally:

—Vaccinate/BOOST
—Mask (consider N95s esp to protect elderly/immunocompromised)
—Balance risk/benefit: Do what’s most important to you, as safely as possible
—Protect health care/health workers

Never forget, so we never go through anything like this again. 21/end