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How much could the omicron variant disrupt American life this winter?

STEVE INSKEEP, HOST:

How much could the omicron variant disrupt American life this winter? That depends on many factors, from the virus itself to the way people respond. But some scientific projections do not look good. In a moment, we're going to hear from a doctor in New York City. We begin with NPR health correspondent Rob Stein, who got a glimpse at the range of possibilities. Rob, good morning.

ROB STEIN, BYLINE: Good morning, Steve.

INSKEEP: Three months ago, I want to remind people, you shared scenarios with us that showed possible steady improvement through the winter. Things looked quite optimistic three months ago. Seems pretty clear we're in a different place now.

STEIN: Yeah, absolutely. That was before omicron emerged. And there are still, you know, lots of mysteries about omicron, the big one being, how sick does it make people? And that makes it impossible to know, really, how bad things could get as it sweeps across the nation. But several teams of scientists are using computer models to try to project possible scenarios for the CDC. And the first one to be made public comes from the UT COVID-19 Modeling Consortium. Lauren Ancel Meyers at the University of Texas at Austin runs the consortium.

LAUREN ANCEL MEYERS: We are modeling the emergence of the omicron variant in the United States under 16 different scenarios that cover a range of how quickly it spreads, how easily it evades immunity and how quickly we're able to roll out booster shots.

STEIN: And those scenarios lay out a big range about how bad it could get from just kind of intensifying the delta surge that's already underway to triggering a tidal wave of infections that could make things take a dramatic turn for the worse.

INSKEEP: Ugh. Now, I want to...

STEIN: Yeah.

INSKEEP: ...Pause for a moment and remember. You said 16 different scenarios, which is a way to emphasize that we don't really know what's going to happen.

STEIN: Yep.

INSKEEP: The most likely scenario from three months ago hasn't turned out to be, and yet there is this range of scenarios, including some bad ones. How bad are the worst ones?

STEIN: Yeah. So the bad ones are pretty bad. According to the most pessimistic scenario, things would get worse than last winter's horrific surge. We're talking about a wave that could peak around the end of January, with more than a half a million people catching the virus every day. That's more than double last week's peak - last winter's peak and nearly 30,000 people being hospitalized with COVID-19 and well over 3,000 people dying every day in the following weeks. Here's Meyers again.

MEYERS: The most pessimistic scenarios are scary, and we need to sort of equip ourselves to make changes - change policies, encourage more cautionary behavior if and when we start to see hospitalizations ticking up in this country.

STEIN: But Meyers stresses that the most dire scenarios assume the very worst - that we do nothing, even as the numbers soar, that omicron is amazingly good at evading our immune system and that omicron makes people sicker than delta. And, you know, so far, evidence suggests omicron may cause milder illness, but that remains the biggest and probably the most consequential open question.

INSKEEP: Oh, so some of the evidence so far suggests that the variables might move us toward a less scary scenario. What are some of the more optimistic ideas of the future?

STEIN: Yeah, those are far less frightening. Under the most optimistic scenario, the omicron wave peaks around the middle of January and never gets nearly that bad. Cases would be about double what they are now, leading to a few thousand more hospitalizations and a few hundred more deaths every day than now. Here's Meyers again.

MEYERS: It's just sort of a little bump. It's not a catastrophic surge that overwhelms our hospitals and leads to record numbers of deaths.

STEIN: That scenario assumes things like omicron isn't quite as good at sneaking around our immune system, it doesn't make people any sicker than delta, and more people get boosted. But the bottom line is the U.S. has to take omicron very seriously. You know, even under the most optimistic scenario, it still isn't pretty. Hospitals are already struggling in many parts of the country. And millions of people are still totally vulnerable to what looks like the nastiest variant yet because they aren't vaccinated.

INSKEEP: Yeah, we should remember there's a lot of people who, for religious reasons, have said they don't want to get vaccinated, a lot of people who have been persuaded or deluded for political reasons not to take the vaccines and endanger themselves. But let's talk about those people who do choose to get vaccinated. What is the CDC now saying about the options among vaccines?

STEIN: Right. Last night, the CDC recommended that COVID vaccines other than the Johnson & Johnson should be preferred. That's after its advisers cited increasing evidence that the company's shots can trigger a rare blood clot disorder now linked to dozens of cases and at least nine deaths in the United States last year.

INSKEEP: OK. That's NPR health correspondent Rob Stein. Rob, thanks very much.

STEIN: Sure thing, Steve. Transcript provided by NPR, Copyright NPR.

Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
Rob Stein is a correspondent and senior editor on NPR's science desk.