‘WE’RE NOT SURE JUST WHAT THAT MEANS YET’ — After weeks of skyrocketing Omicron cases and feeling like everyone you know, and their brother, has Covid — a surge that has led deaths to surpass 2,100 a day, the highest since early 2021 — experts are saying that a period of reprieve is in sight. Even Michael Osterholm, an epidemiologist at the University of Minnesota who is known for never celebrating victory against Covid too early and correctly projecting Omicron’s destructive path as a “viral blizzard,” says we may have a moment to breathe in a few weeks once the new variant completes its rapid burn through the country. Nightly talked with Osterholm about what we know about the approaching lull in the pandemic and how it should inform our behavior and public policy. This conversation has been edited. Describe the lull that you and other experts say is in sight. When we talk about a lull, we’re not sure just what that means yet. Maybe case numbers will come back down to baseline and what they were before Omicron showed up, but maybe they’re not going to be. But nonetheless, they’ll still be substantially lower in incidence than we saw in December, early January. We’re following closely what’s happening in countries that experienced Omicron before we did, and it’s notable. If you look at South Africa right now, the number of cases increased dramatically from a baseline, hit the peak and then came down sharply. But if you look today, they still have almost 12 times as many cases a day as they did before Omicron occurred. But what’s even more concerning is what we’ve seen in the United Kingdom. If you look there, and it appears to be tied to school kids and their parents — we saw cases come down 10 days ago, we saw them level off, and go back up again. Over the last two days, they’re going back up, not dropping. And so that could also signal that this tail is going to be more volatile than you might imagine. I think that we could very easily see another variant emerge. I don’t know that to be the case, but I don’t know any scientific evidence would support it wouldn’t. I know you don’t have a crystal ball, but how long do you expect this lull to last before we see another variant? I actually do have a crystal ball! It’s just coated in 5 inches of mud. But we don’t know. This is where humility has to be the main point we keep reinforcing. I saw some of the talking heads six weeks ago who said, “Well, don’t worry, this surge won’t be that bad because we have vaccines. It’s not going to be like 2020.” Some of them now are the very people saying how bad this is. Anybody who does any model that predicts more than four weeks out, be careful. Because their models are based totally on pixie dust. If in the first week of November, just as Omicron was emerging, someone said, “I’m going to model it for the next 30 days,” you would have never picked up any of this. Is that what we should expect at this point in the pandemic — a period of reprieve and then a new variant? I see people wanting to immediately say we’re heading to the endemic stage. I’m a card-carrying epidemiologist of 46 years. I’ve written a lot about epidemics, and pandemics and endemics, and I can’t tell you for the life of me what the hell endemic means right now. If we go into a four-month period of relatively limited transmission, is that endemic? Well, then what happens if in September, we see a new variant emerge that suddenly causes an Omicron-like situation? We have to be careful about the choice of terms. Is this virus going to go away? The answer is no. Will it cause future challenges? The answer is likely yes. We will not likely see the kind of immunity that will come from either vaccination or from previous infection that will be sustainable. You saw the Israeli data today; they’re recommending a fourth dose for everybody 18 years of age and older. Only a third of people who have had two doses of vaccines — so they’re vaccine friendly — have gotten a booster, which we know has been important in reducing the risk of serious Omicron infection. So do you think we’re going to do better with a fourth dose? We’re going to have to learn to live with this virus. But at the same time, I’m optimistic that if we can really put in place very aggressive and well-described systems for testing and drug deployment, we can surely do a lot to reduce serious illness. Welcome to POLITICO Nightly. We had a couple more questions for Osterholm, including on Omicron-specific vaccines and what life will look like in The Lull. Read on, and reach out with news, tips and ideas at nightly@politico.com. Or contact tonight’s author at mward@politico.com, or on Twitter at @MyahWard.
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