An Urgent Message About Omicron

Almost two years into this godforsaken pandemic, we find ourselves staring into a dark new reality likely to upend our daily lives – all over again. The Omicron variant is spreading so easily that we will quickly see cases in previously unimaginable numbers, setting off chains of events we can't yet fully predict.

Prepare to be disrupted.

When a new COVID variant emerges, health scientists immediately seek answers to three burning questions: Does it spread faster? Can it evade protection from vaccination or prior infection? Is it more deadly?

Based on about a month of data, the preliminary answers for Omicron are yes, yes, and maybe not.

The variant is estimated to be at least four times more transmissible than Delta, which was itself twice as transmissible as the original strain of the virus. The number of Omicron cases is thought to double every 2.2 days.

Part of the reason for this rapid spread is that it appears to evade immunity, not only from previous infections but also from two vaccine doses. That is scary indeed.

COVID spreads rapidly through households and workplaces – or anyplace people gather in enclosed spaces. With Omicron, those unable to avoid such contacts have a high probability of exposure.

Is there any good news?

Yes. Early data shows that, on average, Omicron cases may be slightly milder. The double vaxxed appear to have greater protection against serious illness, and those with a third booster shot appear to have strong protection against both infection and serious illness.

Here's how it's looking:

Today, the number of new cases in Ontario is 3,124; within that number is an alarming subset: 778 unvaccinated and 2,120 fully vaccinated. Considering that there are about 8 times as many vaccinated as unvaccinated in Ontario, that doesn't mean that the vaccinated don't have higher protection. But it is a clear warning that Omicron intends to spare no one.

In Toronto, today's new case number was 827 – 10 times higher than a few weeks ago. Hospital and ICU admissions aren't rising as quickly, but there is typically a several week lag between infection and serious illness.

At the current rate of increase, 10,000 new daily cases in Ontario by Christmas and 50,000 by New Year's seems optimistic. And from there? Perhaps to numbers that exceed our capacity to identify all of them.

Even if Omicron turns out to make only half as many people seriously ill (and there is no evidence yet that we will be nearly so lucky), the smaller percentage of a much larger number of people getting sick will still lead to a major surge in hospitalizations and the likely overwhelming of ICU units.

It's hard to imagine that a rise in the already-high number of cases in schools won't disrupt them, perhaps to the point they can't stay open. Teachers will get Omicron, as will doctors, nurses, and personal support workers. Even if their cases are mild, they'll be off work for a while.

And then there's the impact on businesses, the economy, and workplaces of all sorts.

As always, our ability to keep this even remotely under control requires a combination of effective government policy and responsible individual action.

What Government Is Doing:

The Province has re-imposed a variety of restrictions, starting Sunday:

  • Indoor social gatherings are limited to 10 people, outdoor gatherings to 25.

  • Bars and restaurants are limited to 50% capacity and must close by 11 PM; liquor sales end at 10 PM.

  • Retail stores, including grocery stores, pharmacies, shopping malls, personal care services and gyms are reduced to 50% capacity.

  • Sports and concert venues, theatres and other similar sites holding more than 1,000 people will have their capacity cut to 50%; food and drink services will be prohibited.

  • New limits do not apply to weddings, funerals or religious services.

In what feels like a rerun of previous phases of the pandemic, these actions, while helpful, fell short of the "circuit breaker" called for by the Province's independent science table. The advisors are concerned that half measures won't slow the spread enough to buy time for most people to get a booster dose.

What Individuals Can Do:

  • Get a booster shot as soon as possible (see article below for details).

  • Minimize indoor exposure outside your household, especially where people are not masked.

  • When you are around others, observe social distancing, wear a mask, and create as much air ventilation as possible.

  • If possible, wear an N95 or KN95, or double mask, when you can't avoid exposure –e.g. when grocery shopping.

  • Use rapid tests before holiday social gatherings, if you can get your hands on them.

I hate to present such a glim outlook just as most of us are looking forward to seeing family and friends over the holidays. My intention is to provide enough information to help you assess your personal situation and evaluate what you think is an acceptable risk, hopefully based on science.

Please take care.

- John