Monday, Jan 3, 2022 • 26min
Why Omicron Is Counterintuitive
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The Omicron variant is fueling record-breaking cases across the world and disrupting life. But it may not present as great a danger of hospitalization and severe illness as earlier variants. We explore why this is and what it means for the next stage of the pandemic.
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(4)
Carl Zimmer
Michael Barbaro
Ira Glass
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Transcript
Verified
Break
Michael Barbaro
00:35
I'm
Michael Barbaro
. This is a daily today.Share
00:48
Nearly half a million new
covid-19
cases were recorded in the U. S. The U. S.Share
Speaker 5
00:53
Has averaged more than 300000 new cases a day. Hospitalizations are also rising fast here.
Share
Michael Barbaro
00:59
The highly contagious omicron variant is fueling record breaking infection rates across the world and
the United States
. There are three americans are testing positive for covid
every second. And I mean these numbers are absolutely staggering and disrupting basic services. Thousands of flights had to be canceled from flights to subways in the process.Share
01:22
The Fire Department says 30% of its E. M. S.
Share
Michael Barbaro
01:25
Personnel is out sick here in the
US
new cases are higher really than they've ever been during the pandemic. But here's the thing deaths are down but what it's not doing is killing or hospitalizing those it infects at the same rate as previous variants are lower than I spoke with my colleagues, science writer Carl Zimmer
about why that is and what happens next.Share
02:05
It's Monday, January 3.
Share
02:12
Mm hmm.
Share
Michael Barbaro
02:14
So, Carl, Happy new Year.
Share
02:16
Is it a happy new year?
Share
Carl Zimmer
02:18
It is certainly a new year like no other.
Share
Michael Barbaro
02:22
And yet it kind of feels familiar, right?
Share
Carl Zimmer
02:26
Yeah. There's a weird sense of deja vu. We're all hunkering down hopefully. And just not seeing people as much as we might have before. We're we're giving up the things that we had thought we could have back in 2021. And yet, even though it feels familiar in a way, all Macron is is actually kind of a new pandemic. What do you mean by that? Well, oh, Macron is really different than other variants in some really important ways.
Share
02:53
On the one hand, it does seem to be milder and it does seem like we get protection from vaccines in an important way and yet it's spreading like crazy and has this potential to really break a lot of our social systems in the next month.
Share
Michael Barbaro
03:09
Right, Well, let's ground this a little bit as we start to understand What ο has done over the past 10 days or so since we last talked to you by talking through the biggest action that our government has taken, which I think will help put everything you just said into some context and that's the CDCs decision to cut the length of time for self quarantining after a
covid
infection and not just by a little, but by a lot.Share
03:40
And I felt that was surprising given that we are experiencing this record spike in infections that you just mentioned, but it also felt related to that fact. So can you explain the CDCs Decision?
Share
Carl Zimmer
03:52
Sure. So until recently, the center for disease control had recommended that infected patients isolate for 10 days after they tested positive for the virus.
Share
04:03
But then on the Monday after Christmas, the
CDC
slashed that period to just five days for those without symptoms or who didn't have fevers. And there's other symptoms were resolving.Share
04:15
The thing is that experts have been debating about whether maybe we should be cutting back on that 10 day rule for some time now, In fact, people were pointing out that actually some people, especially vaccinated people, they may not be infectious long before that 10 day point.
Share
04:34
And there were public health experts who are also saying, you know, 10 days is a long time. And so people may actually avoid testing Because they don't want to be out of work for 10 days.
Share
04:45
So maybe there could be a sweet spot where you could really reduce a lot of transmission and not be so disruptive to people's own lives and to the economy and in fact in October
Cornell University
just on its own had gone ahead and cut back their rules to five days, you could get out of isolation after five days only if you had two negative PCR tests.Share
05:09
So omicron shows up and it even more than previous variants, seems to be really arguing for a shorter isolation period. Why, why is that? Well, this variant moves fast and this became really apparent once epidemiologists could start to look at some of the first outbreaks of omicron.
Share
05:31
So for example, in Oslo in Norway there was a christmas party, they were all vaccinated and roughly three days later, the majority of the people of that party were feeling sick. They had
covid
, right? You told us about this party? Yeah, yeah. And so this variant comes on fast and for many people, especially people who are vaccinated, it clears out fast. And so this is days faster than other variants.Share
05:56
So on top of that, you now have omicron surging around and infecting people there testing positive. And so these companies are following
CDC
guidelines, they're telling their staff will don't come into work for 10 days.Share
06:11
So it's incredibly disruptive. You don't have enough people to fly planes, You don't have enough people at clinics, you know at stores and so on. I mean, and so business people were telling the government, could you please change this policy, is there any way that we can lessen this blow and the
CDC
says yes.Share
06:29
And so the
CDC
decides right after christmas and we're going to cut that down to five days, what they say is that if you don't have symptoms or you don't have a fever and your other symptoms are clearing that you can leave isolation but wear a mask, a really good mask for the next five days. So that was the policy that they ended up with.Share
Michael Barbaro
06:49
So what began as a medically motivated decision which had been under consideration for a while, it feels especially suited to the properties of a Mark on the speed of an omicron infection.
Share
07:03
And this decision you're saying is nudged along pretty powerfully by the reality that the economy is starting to collapse because so many people are out of work for 10 days, that's basically how we get to this five instead of 10 day self isolation.
Share
Carl Zimmer
07:19
That's right. And we should be clear that this is a decision that is not uncontroversial. You know, there are a lot of experts who have been very critical of it because maybe five days is a good policy, but it has a central flaw which is that there's no test involved.
Share
07:40
So remember, you know, when Cornell put their policy in place, they said you can get out after five days with two negative tests because the fact is that just because people have different biology, people get infected with a little virus or a lot of virus, some people will be totally clear at day five And other people, they'll keep testing positive for a little while longer and thus be contagious.
Share
08:04
Yeah and so it could defeat the whole purpose to just let people go at five days instead of 10 if you're letting people go off and infect others. So why didn't the C.
Share
Michael Barbaro
08:16
D. C.
Share
08:17
Issue any kind of Requirement for a negative test to leave isolation after five days?
Share
Carl Zimmer
08:23
Well my sense would be that it's really hard to get a test right now.
Share
08:27
So if you're requiring people to go get some at home antigen test and have it test negative before they come back to work well people aren't going to be able to go back to work because they're not going to be able to find these tests because we've run out of those tests right So it would undermine what kind of central purpose of reducing this isolation by half.
Share
08:49
It's just not practical right now to say that testing is going to be an integral part of some sort of five day policy.
Share
Michael Barbaro
09:00
Carl you said at the start of this conversation that omicron is milder and I want to talk about that because that is something I know that public health officials and people like you colleagues of ours have been reluctant to say firmly for many weeks but you said it pretty firmly. So why are we now able to say that an omicron infection is milder And I wonder if that fits into the CDCs decision at all.
Share
Carl Zimmer
09:29
Well it's actually hard to describe what it is about omicron and we use the word milder as sort of a shorthand. But it's tricky because Macron is killing people right now.
Share
09:42
It's just not killing as many people as delta. The clearest evidence of this is now emerging from
the United Kingdom
where they came out with a pretty clear conclusion that the risk of hospitalization from omicron is cut in half compared to other variants that's meaningful. Yeah, absolutely, Absolutely. That is a big deal. And that's for all populations Carl, that's whether you're vaccinated or unvaccinated boosted on boosted.Share
10:09
Well that's where things get more complicated. The fact is that if you are vaccinated you are well protected against hospitalization. And here again,
the United Kingdom
has come out with lots of good numbers and they have just reported that if you have two doses of the Pfizer
vaccine, your risk of hospitalization is reduced by 65%.Share
10:38
And if you have a booster your risk Of hospitalization is reduced by 81%. Huh?
Share
Michael Barbaro
10:46
So that's interesting. A baseline of hospitalization rates for omicron is 50% less than delta and if you're vaccinated and boosted, its really, really good. So that's why we can use the word mild.
Share
Carl Zimmer
10:59
That's right. The problem is that vaccines and boosters are not as effective as just preventing you from getting infected. So you're getting infections in people who are either unvaccinated or vaccinated but what then happens next is that the unvaccinated people are at much much higher risk of ending up in the hospital.
Share
11:19
And even now when you look at the numbers, the vast majority of people who are filling up our hospitals now are unvaccinated.
Share
Michael Barbaro
11:28
Well let's somewhat optimistically focus on the idea that oh Macron for those vaccinated boosted and even unvaccinated is generally less likely to cause severe illness and hospitalization and Carl. What is the science of that? I mean kind of chemically biologically, Why is this less likely to put you in the hospital than delta?
Share
Carl Zimmer
11:52
This has been amazing. I mean scientists have been working like crazy to try to figure out what omicron is doing on on a cellular level.
Share
12:00
And so they all basically spent their holidays not opening presents so much as you know, injecting viruses into hamsters or into dishes full of cells to try to figure out what is going on with omicron house omicron different. And the results are really just coming out just now and twitter is is where you go to get those hot new results. Okay.
Share
Michael Barbaro
12:22
And what are those hot new results?
Share
Carl Zimmer
12:24
The fact is that omicron really does work in a fundamentally different way than other variants in the sense that when you get infected say with the delta variant, you know it goes into your nose first.
Share
12:38
It sort of sets up shop there and then it starts multiplying and spreading down your airway and if you're unfortunate it'll get into your lungs and into the deep recesses of your lungs. It can cause lung scarring and cause difficulty breathing, it can leak out from the lungs to elsewhere. Cause really serious disease and potential death. Right?
Share
Michael Barbaro
12:56
Those are the people who end up on respirators. Yeah.
Share
Carl Zimmer
12:59
However, um
Akron
does a really lousy job. It seems of multiplying in the lungs. So, you know, when scientists look at these animal models for covid
, omar khan just really isn't there in the lungs, The lungs are usually undamaged. And so it's a really striking difference from other variants.Share
13:20
On the other hand, if you look at cells taken from the lining of the nostrils, you will find that omicron is really good at infecting those. Hmm. So what we may be looking at is something that is specializing more in the upper airway where it's generally causing milder disease. And it is also in a good place to go and spread to the next person because it's right there in your nose and ready to go.
Share
Michael Barbaro
13:47
So we're basically getting pummeled by a gentler version of
Covid
than we've seen before, which is a pretty weird concept.Share
Carl Zimmer
13:58
It is a very weird concept, very counterintuitive, but you just have to bear in mind that here we have this variant that is already producing twice as many cases a day on some days then are passed peak. So even if it's half as likely to send people into the hospital. You've got twice as many, you're still putting as many people into the hospital.
Share
14:21
And so scientists are now working on models trying to to look forward and you know, they actually see the number of cases from omicron going up even higher. So maybe we're looking at 607 100,000 cases every day. And when you're talking those numbers in a very short period of time, you're gonna have a whole bunch of people showing up at the hospital at once.
Share
14:46
You know, I've been, I've been trying to think of a good metaphor for this because this is so counterintuitive. How could something that's milder be as dangerous or more dangerous than what we've already been through? And I think about hurricanes.
Share
15:03
Imagine that a category five hurricane hits your house one day, it slams your house and it does a lot of damage and you lose power and you're covering for days. And then somebody comes by and says, hey, did you see the weather forecast? There's another hurricane coming and you say, oh great.
Share
15:20
And they say no, no, no, it's it's okay. It's okay. It's just a category three hurricane. And you think, well, I guess category three is better than category five and then they say, oh and by the way, they're actually gonna be four of them.
Share
15:35
Amber Icon, is that string of category three hurricanes milder but potentially just as bad or worse.
Share
Michael Barbaro
15:42
Right In that case mild isn't necessarily all that much better if 700,000 people a day are getting an infection.
Share
Carl Zimmer
15:53
That's right. It could be worse just because of the sheer number of cases that we're seeing, we'll be right back, get ready for the next great workplace comedy.
Share
Speaker 1
16:13
American auto on
NBC
critics are raving its the next the office or superstore and no wonder american auto is from the creator of superstore, Justin spitzer. It stars SnL's ana Gasteyer as the new Ceo of a struggling car company and the funniest part is she knows nothing about cars with a hilarious cast and sharp, clever writing. American auto might become your next comedy obsession. American auto tonight on NBC
.Share
Ira Glass
16:39
Hello Daily listeners, this is
Ira Glass
, the host of this american life maybe you know our show maybe you don't. It's a radio show and podcast where we apply the tools of journalism to stories that are super personal.Share
16:50
Often stories that unfold like little movies, we like it when they have emotional moments, funny moments and surprising plot twist even when we take on subjects that are in the news, it's with stories like that and the reason that I'm here today doing an ad on the daily Is that we're turning 20 five years old And to celebrate our 25th year, I want to invite you to check out our show again or for the first time We've gathered together some of our very favorite episodes into a special collection at our website.
Share
17:17
The best of the more than 700 episodes that we've made. And then I've written a little words that explain what makes each one make the list.
Share
17:27
That's at this american life dot org slash 25.
Share
17:30
I hope you check it out again.
Share
17:33
This american life dot org slash 25
Share
Michael Barbaro
17:39
Crow as omicron sweeps across
the United States
and hospitalizations are creeping up, it feels like one area that has stood out is the hospitalization of Children. So, talk to us about that.Share
Carl Zimmer
17:51
It's a very scary Issue I think for many of us. So the center for disease control said at the very end of December that 378 Children were being admitted two hospitals on average every day. And that is a jump of 66% from the week before.
Share
18:12
So, you know, that is a serious thing. But you know, we do also need to put this in some perspective. If you look at people over 70 right now, Almost 30 200 people a day in that age group are going into the hospital.
Share
18:28
So compared to other age groups, this is a very small risk that Children are facing overall. But still, when you're looking at a new record for hospitalization of Children because of this variant, that's something to sit up and take notice of ifo Macron is generally milder.
Share
Michael Barbaro
18:47
Why are Children going to the hospital in larger numbers.
Share
Carl Zimmer
18:52
They are just not as vaccinated as older people. If you look at kids between five and 11, about a quarter of Children have had at least one dose of the vaccine, they're not even allowed to have boosters yet, Children under five are not eligible for any vaccine yet.
Share
19:09
Now there's no evidence that omicron is making kids sicker than other variants. It's just a big pool of unvaccinated hosts that it can get into. And so they are just bearing the brunt of this new variant Carl.
Share
Michael Barbaro
19:26
When this episode airs, it will be the monday after for many people, a long holiday break, which means that a lot of kids are going to be returning to school and given what you just established about their vulnerability to omicron, especially young kids. How should parents in schools be thinking about returning kids to the classroom this morning?
Share
Carl Zimmer
19:48
Well, one thing we've learned from this pandemic is that kids really suffer when you keep them out of school and we have to do everything we can to keep them in school as much as possible without creating, you know, a massive public health crisis and you know, we are in a very special condition right now, the kids are going to be coming back into school after a holiday break where maybe a lot of them have spent time with lots of other people and so they may be showing up with omicron.
Share
20:20
What's going to be the situation with the teachers. You know, if a teacher wakes up with a scratchy throat tests positive, they can't come into school and so you could have schools this month where teachers and administrators are just M. I. A.
Share
20:34
You actually are seeing some schools already acknowledging the gravity of this situation and saying like, okay well we will maybe spend the first week or two of school this month virtually and we'll see how things go.
Share
20:51
But there are lots of other things that can be used as well masking testing ventilation. There are lots of ways of preventing schools from becoming incubators for omicron. But yeah, this coming month is going to be a real roller coaster ride for parents for kids and for teachers. Mhm.
Share
Michael Barbaro
21:09
Carl is there a world in which the omicron variant? Because it is mild and because it moves so fast, ends up infecting lots of people creating antibodies against
Covid
and ultimately protecting lots of people from getting covid
and perhaps a more severe version of Covid
in the future.Share
Carl Zimmer
21:34
This is not really the ideal way to develop immunity to
covid
.Share
21:39
You know, we could be looking at tens of thousands or hundreds of thousands of people dying through this omicron wave, but at the same time it is fascinating from a sort of scientific perspective to see omicron showing up in
the United States
, a country that is dominated by another variant Delta
and Delta
causes very severe disease and they're fighting it out like some sort of cage match between viruses and scientists have been doing studies on how well you're protected from one variant if you got infected by the other.Share
22:15
So if you got infected with
Delta
, let's say in the spring you don't have a whole lot of protection against infection from omicron. What's interesting though is that you know, when scientists do experiments in labs using the blood of people who've gotten omicron, it seems like omicron infections actually really protect quite well against DELTA
.Share
22:41
So as more people get infected with omicron is going to get harder for
Delta
to find new hosts. And we're actually seeing this play out right now as omicron cases are shooting up Delta
is actually going down.Share
Michael Barbaro
22:54
So omicron is beating
Delta
in this cage match of variants.Share
Carl Zimmer
22:58
Yeah. Oh Macron seems to be winning. It seems kind of weird. The milder virus seems to be winning but that's what's happening. And so you know, would you rather have a country with a huge massive rates of delta or omicron?
Share
23:11
Well, omicron of course because you're gonna have fewer people in the hospital. And also as people recover mostly from mild omicron infections, they will have this immunity. And if you add that immunity on to say vaccination, like you're going to be really strongly protected.
Share
23:27
So the long term possibility is that we are looking at
COVID-19
eventually kind of really going down to substantially lower levels and you know as we get more people vaccinated. Maybe we update vaccines that will help us even more. Of course there could always be a new variant. But if you look out over the long term, there is some comfort to be had.Share
Michael Barbaro
23:55
Oh, Macron's potential silver lining is pushing delta out, creating antibodies that protect against delta and potentially giving lots of people protection against future
covid
and therefore ushering us a little bit closer to the end of the pandemic.Share
Carl Zimmer
24:14
That's that's a possible outcome. That's the optimist take Carl. No, no, no, I know that that is a very plausible take. It's just that let's just not forget the death and the suffering that's going to have to come along until we get there.
Share
Michael Barbaro
24:32
Well, as we conclude this conversation Carl, I'm curious when omicron is expected to reach its peak here in the
US
. I know that peek doesn't mean over, it just means the height of infection.Share
24:49
But when do we think, given the unique and rapid properties of
Omar khan
that that is likely to happen.Share
Carl Zimmer
24:56
It could happen pretty soon.
Share
24:57
When you look at what happened in
South Africa
, which is where Omicron
had its first big surge, it shot up at a really astonishing pace in just a few weeks and suddenly started falling back down and so scientists are doing their best with very complex computer models to try to forecast or at least offer a projection of what's going to happen and some of those are finding that you know, maybe as soon as january 9th next week we might reach a peak.Share
25:28
I mean that would be a very high peak and you know there will be a lot of shock to the system to deal with. But you know if it then falls as quickly as what happened in
South Africa
then we could be looking at a much better situation by the end of the month by february.Share
25:45
You know hopefully we can take that opportunity to get more people vaccinated set up systems to get more people you know medicines that can treat infection in the hospitals. We can be overall in a much better place soon.
Share
26:01
But you know again we'll have to see.
Share
Michael Barbaro
26:09
Well Karl thank you as always for your time, we appreciate it.
Share
26:14
Thank you.
Share
Speaker 8
26:21
One of the things that we hope for is that this thing will peak after a period of a few weeks and turned around, we've seen that happen in
South Africa
on sunday in an interview with Abc News
, the biden administration's top adviser on the pandemic dr Anthony.Share
Michael Barbaro
26:41
Fauci said he was optimistic that omicron infections would quickly peak. Meanwhile Fauci acknowledged growing criticism of the C. D. C. S decision to shorten the recommended period of isolation after an infection From 10 to 5 days without requiring a negative test and said that adding such a testing requirement was now under consideration.
Share
Speaker 8
27:08
The C. D. C. Is very well aware that there has been some pushback about that. Looking at it again, there may be an option in that, that testing could be a part of that and I think we're going to be hearing more about that in the next day or so from the c d C.
Share
Michael Barbaro
27:24
We'll be right back.
Share
27:30
Mm hmm, mm hmm.
Share
Speaker 1
27:36
This podcast is supported by
Georgetown's
Mccourt School of Public Policy
where they are working to help communities recover from the covid
19 pandemic from the center of the policy world Washington
D. C.Share
27:47
Mccourt school researchers are collaborating with members of
Congress
and healthcare experts to ensure that medically complex patients have access to the critical care they need regardless of their proximity to major hospital systems, learn more at org dot Georgetown dot e D U.Share
Michael Barbaro
28:03
Here's what else you need to know Today. President Biden has declared a suburb near
Boulder
colorado
a federal disaster area. After a fast moving wildfire destroyed nearly 1000 homes there late last week. At least three people are feared dead from the fire, which was fueled by hurricane force winds.Share
28:26
Soon after the fire, a winter storm dumped nearly a foot of snow on the same community complicating recovery efforts. Today's episode was produced by mood Sadie and Lindsay Garrison. It was edited by lisa chow contains original music from Marion, Lozano and
dan Powell
and was engineered by Corey shrapnel.Share
28:54
Our theme music is by
Jim Brandenburg
and Ben Landsberg of wonder lee, that's it for the daily. I'm Michael Barbaro
, See You Tomorrow.Share
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