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The forecast is not looking good. I’m not talking about weather (although climate change is its own crisis). I mean the COVID-19 case numbers.

When vaccination rates were high in June, it looked like we might have been near the end of this whole pandemic thing, but then came Delta. And now that Delta is beginning to fade, we have to figure out what to do about Omicron. This winter isn’t going to be easy, especially since the flu and other respiratory viruses are on the rise as well.

Vaccines still work against Omicron

There’s good news and bad news about the hot new variant in town. First, the bad: Omicron seems to be more transmissible than Delta, which was already drastically more transmissible than previous variants.

But there’s good news, too: Evidence is emerging that Omicron might cause less severe disease. Ironically, the best-case scenario would be if we got a variant that was incredibly transmissible, so that it would out-compete all the other variants, but that would also cause only mild or asymptomatic illness. That would put it on the level of the common cold, something we can resign ourselves to living with. We don’t know yet if Omicron is mild enough to be that best-case variant. But at least it’s not more virulent, which is what passes as a bright side for now.

Okay, but then there’s more bad news: Caccines (and previous infection) don’t protect as well against Omicron as they did against previous strains. And more good news: The vaccines do still work against Omicron, you may just need more of them. (Definitely get your booster.)

Hospitals are already overwhelmed, and the situation will probably get worse

If you don’t work in healthcare and you don’t know anyone who does, you might not realize that our healthcare systems have been in red-alert crisis mode for almost two straight years. Workers are burned out, intensive care units keep filling up, and people are dying who shouldn’t have to.

Minnesota hospital leaders just took out a full-page newspaper ad saying “We’re heartbroken. We’re overwhelmed,” begging residents to get vaccinated and wear masks. It’s a pretty much universal sentiment. On a recent press call about the state of hospital care, emergency physician John Hick said that “every shift I’m working these days is the worst shift of my career.”

If you need corroboration, take a quick scroll down the r/nursing subreddit. People are dying, hospitals are constantly running out of room and resources, and the people who provide care are exhausted and underpaid.

Studies of how hospitals are faring are full of more bad news. For example, CARES act funding for hospitals was distributed inequitably, worsening disparities in Black communities. One analysis of COVID deaths from last year calculated that as many as 1 in 4 of those deaths may be due to hospitals being overwhelmed.

What we can do

In that press call about hospitals, I asked what we can all do given the current state of healthcare. One important tip from Hick was to stay up-to-date on preventive care and get minor issues taken care of before they turn into major issues.

Since there are more breakthrough cases with Omicron, we can no longer rely on vaccines as our only means of protection. Remember in the pre-vaccine days, how protection from COVID was a matter of a “swiss cheese” model where we layered imperfect protections on top of each other? If you wear masks and avoid crowded indoor spaces and get tested if you might be sick, those protections add up. Same deal these days, you can just think of the vaccine as a particularly thick slice of Havarti. It’s no guarantee, so the other cheese layers will help a lot.

That means that as we head into this winter, we need to think about risks in much the same way we did last year. Masks will help, and crowded indoor spaces are still not a great place to be. If you’re vaccinated and you get COVID, it’s reassuring to know you’re less likely to get severely ill and you’re less likely to pass it on to others. But even statistically-mild cases of COVID are worrying for susceptible people (like young children and people who are immunocompromised), and in large numbers they’re especially bad for communities. So it’s worth taking extra precautions.

   



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