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In today's edition:

  • What have we learned since omicron emerged a few weeks ago?
  • The vaccine inequity
  • How can we help the young at risk of addiction?
The Latest on Omicron
Andy Pekosz returned to the podcast today to give an update on the Omicron variant. Not much was known about the new variant a few weeks ago, but there were reasons for concern, Pekosz said last week on Public Health on Call. A major concern about omicron, he explained, had to do with the specific placement of mutations and its potential ability to bind more tightly to cells in the respiratory tract and establish infection in human cells much faster. There are still reasons for concern, some optimism, and still many unknowns. Here’s where we are now:
 
What looks good so far:
  • Relatively mild disease: Data from South Africa indicate that most cases so far are relatively mild or asymptomatic.
What’s still concerning:
  • Effective transmission: Omicron is spreading at a rate that’s equal to delta, if not higher, and there are reports of “super-spreader” events where one person infected five or more individuals at one time.
  • Infection of vaccinated individuals: A large number of reported cases are in individuals who have already been vaccinated or received a booster. 
  • More risk of reinfection: Data from South Africa shows the risk of reinfection with omicron is 3x greater than it was with previous variants.
The unknown:
  • Disease severity data: Because it takes about 10–14 days before people develop severe COVID, disease severity lags behind infection in reporting of cases.
  • How much protection current vaccines provide. Pekosz expects the virus to evade some of the vaccine- or infection-induced antibody responses. But, “it'll be really important for us to understand if [omicron] doesn't induce severe disease, what aspect of that vaccine-induced immune response is really providing some level of protection.”
The bottom line: Omicron data indicate that we may see more infections and surges, but if cases remain relatively mild, this could be a variant vaccinated people can live with. 
 
Read the Q&A or listen to the podcast


And in the words of David Dowdy, “Just because we have a new variant doesn’t mean we have a crisis on our hands.”
Omicron’s rise in South Africa, where presently less than 25% of the population has been vaccinated, underscores the importance of boosting vaccine confidence globally, and also getting more vaccine doses to countries that need them. Until vaccine coverage is expanded globally, more variants will continue to emerge.
 
"High-income countries not only have vaccinated a much higher proportion of their populations they’re also storing—or hoarding—large numbers of vaccine doses that could be distributed to the rest of the world," explained William Moss, executive director of the International Vaccine Access Center, in an interview last month.
 
Yesterday our social team illustrated the divide, which you can share to raise awareness.
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Twitter
Anna Durbin, director of the Johns Hopkins Center for Immunization Research, told STAT News this week that T cells—which have been trained by vaccine or infection to look for and attack a particular pathogen, in this case SARS-CoV-2—may not be enough to prevent infection with the omicron variant, but should help shut down the disease it triggers, if infection occurs.⁠

“You will have some protection if you were vaccinated,” Durbin said. “Our immune systems have seen parts of that spike protein before.”⁠
 
Our social team had some fun translating that little nugget.
 

TOMORROW ON THE PODCAST:
Better Together: Helping Young People at Risk for Addiction

Addiction prevention often comes in the form of “Just Say No” campaigns. But Terri Powell knows that to be successful, prevention strategies must be thoughtful and holistic—and focus on connections and support systems that help young people make the best decisions for themselves. Josh Sharfstein talks with Dr. Powell about Better Together, a prevention program that's based in a public library. Joining them is Diana Fortee-Mason, one of the young leaders of the program.
 
Look for the podcast here 🎧
Omicron Is Fast Moving, but Perhaps Less Severe, Early Reports Suggest (The New York Times)
Researchers in South Africa, where the variant is spreading quickly, say it may cause less serious Covid cases than other forms of the virus, but it is unclear whether that will hold true. Emily Gurley says “it would not be shocking” if signs that the variant is less severe prove to be true, though she warns it may be too soon to conclude. 
 
New York City will now require private workers to get vaccinated—and other cities could follow (CNBC)

New York City will now require employees at private companies to get vaccinated against the coronavirus, Mayor Bill de Blasio announced yesterday. More cities could emulate the mandate; however, Gigi Gronvall says in order for vaccine mandates to be successful, “we also have to fight vaccine mistrust.” The future of these mandates and who the rules cover, she says, will depend on people’s stance on vaccines in different cities. 
 
With Omicron, a Chance for a Public Health Reboot (Governing)
Vaccinations are rising in response to the new variant. While much is unknown, health officials hope the public — and politicians — will be inspired to get back to the basics of protection. People who have grown tired of pandemic-related habits need to be inspired by political leaders to stay vigilant, Josh Sharfstein says. “The basics will help us,” he says, “even if the new variant is a threat.”
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