Important developments in the pandemic

The omicron variant is poised to rip across the United States in the coming weeks, upending daily life for huge swaths of the country. Cases from the hyper-transmissible new variant appear to be doubling every two days. Public health experts and government officials warn that the all-but-inevitable wave will overwhelm health systems still battling the delta variant and clobber communities where few people are vaccinated. With hospitalizations rising, sports leagues canceling games and colleges sending students home early, Americans are starting to feel an unpleasantly familiar sense of whiplash.

Officials urged people to protect themselves as cases rise by getting the vaccines and boostersgetting tested and masking up. While omicron can more easily slip past immune defenses than other variants, boosters appear to prevent severe illness quite well. “The only real protection is to get your shots,” President Biden said this week. 

Early research on omicron has suggested that it may cause milder illness than other variants. But South Africa’s health minister said Friday that the apparent mildness of some omicron infections could be attributed largely to protection provided by vaccines and past infections. Whatever the case, it’s too early to lower our guard. Scientists are still trying to figure out how virulent omicron really is. What we do know is that it’s extremely infectious and poses grave risks to the unvaccinated.

We’ve heard a lot in the past few weeks about omicron’s unusual assortment of mutations. To help us make sense of it, my colleagues Bonnie Berkowitz and Aaron Steckelberg have laid out everything we know about the variant’s changes in a series of easy-to-follow graphicsCheck out their work to see how omicron’s mutations compare to past variants, and what they mean.

Even with the new variant spreading, more than 100 million Americans are expected to travel between now and Jan. 2. Travel experts say a combination of confidence in the vaccines and pandemic fatigue is motivating people to accept a bit more risk and leave their holiday plans intact. News about omicron might put a small dent in travel, but mass cancellations probably won’t happen.

Omicron is expected to weaken some critical disease-fighting tools. But laboratory studies have shown that one type of monoclonal antibody treatment, sotrovimab, will hold up against the variant. It works by latching onto an area of the virus spike protein that is less likely to change than other virus components. Sotrovimab appears to work so well that the U.S. government is now stockpiling supplies so the treatment can be deployed when omicron becomes more prevalent

It can be hard to tell the difference between a cold, the flu and covid-19, especially if the symptoms are just beginning to hit you. Some early accounts indicate that omicron cases present more like a common cold — headaches, runny nose, sore throat — than the version of covid-19 we’ve grown accustomed to. If you do start feeling sick, one epidemiologist advises that it’s best for now to assume you’ve got covid “until proven otherwise.” Stay home and keep away from others until you get test results. It’s one more step that can help contain infections this winter.

Other important news

The Centers for Disease Control and Prevention recommended the Pfizer-BioNTech or Moderna vaccines over the Johnson & Johnson vaccine, citing rare but potentially fatal blood-clot issues.

Pfizer will test a third vaccine dose in young children after research showed that two doses didn’t trigger an adequate immune response. It’s a setback for pediatric vaccines that many had hoped would be available early next year.

The World Health Organization added a ninth vaccine to its emergency use list. India’s Covovax is now cleared for worldwide distribution.

Colleges throughout the country are moving exams online, closing offices and canceling events amid the rise in cases

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Your questions, answered
I am 80 and my husband is 84, both vaccinated and boostered. If family members do not have the vaccine how much more likely are they to spread COVID to those of us who are vaccinated, and is their reasoning that because I am vaccinated, I will not get as sick? This seems to be a non-ending disagreement and with Christmas approaching, I would think there are many others facing this dilemma. — Carol

I’m so sorry to hear this is causing tension in your family. With Christmas around the corner, I’m sure many other families are butting heads over this, too.

When you gather with loved ones for the holidays or any other occasion, your risks are lowest when everyone is vaccinated. The risks are much higher when there are unvaccinated people in the mix.

A growing body of research shows that unvaccinated people are more likely than vaccinated people to transmit the coronavirus. Scientists have also found that vaccinated people get rid of the virus faster and produce less virus overall, meaning they’re contagious for a shorter period of time than the unvaccinated.

There’s no doubt that the vaccines and boosters do a great job preventing severe illness. But the fact that you and your husband have been immunized doesn’t mean that your unvaccinated family members should skip the shots. They’re more likely to infect you than vaccinated relatives. They could also get sick themselves, and if they do, they’ll almost certainly have a harder time kicking covid-19 than if they’d just gotten the jabs.

“Vaccination for everybody in a family serves two purposes — it protects those who get vaccinated, and it protects those who they spend time with,” Thomas Holland, an infectious disease specialist at Duke University Hospital, said in an email.

“There is a lot of evidence now that vaccinated people are protected from severe disease, and if they do get infected, they are less likely to pass COVID or flu on to others,” Holland said. “So, healthy people who get vaccinated are protecting everybody else they come in contact with. This includes our most vulnerable family members who might not be able to mount their own protective immune response, for example due to medications for cancer or autoimmune diseases that prevent the body from making antibodies.”

If you do end up spending time with unvaccinated family, consider wearing masks indoors and try to make sure the space you’re in is well ventilated. This will lower the risk of transmission.

Even if everyone at your gathering is vaccinated, it’s still a good idea to take some precautions, especially around elderly family members, people with underlying health conditions and children who aren’t yet eligible for the vaccines. Our Travel team asked six health experts for advice around holiday travel and family gatherings. You may find it helpful.

Thomas Denny, chief operating officer of the Duke Human Vaccine Institute, recommends getting tested as close as possible to the time that you’ll be getting together with loved ones. With omicron spreading quickly, he said, the extra vigilance is worthwhile.

“In a family that’s fully vaccinated and willing to exercise some caution,” Denny said in a briefing this week, “I think we can have some family gatherings.”

“Having said that, this variant has thrown us a curveball at the worst possible time,” he added. “Every family has to decide what’s the norm for them, what they’re comfortable accepting.”

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