Omicron Variant Update

While the Omicron variant has and continues to dominate COVID-19 headlines and news, it is important to note that currently, we still do not know much. We wanted to cover some of the available preliminary data that has been circulating around to clarify any information and provide some temporary answers to common questions at this point while also emphasizing that we are still learning and that little is certain about the Omicron variant at this point.

As of December 4, 2021, 16 states in the U.S. have reported cases of COVID-19 caused by the Omicron variant. As we have expected, there is community spread in the United States and all over the world. Globally, about 40 countries at this point have identified cases of COVID-19 due to Omicron. So far, none of the cases that have been reported in the United States have resulted in hospitalization or death. It is also important to note that while there are likely many more cases than reported, the CDC data shows that 99.9% of cases in the United States are still due to the Delta variant. Sequencing and many other public health measures have lacked the necessary energy and funding to be conducted, however genomic surveillance is improving and is necessary to better understand proportions of COVID-19 cases due to which variants. 

Currently, South Africa is our best source of up to date information on the Omicron variant. There is pre-print data that suggests Omicron is spreading so quickly because this variant is able to reinfect individuals who have already had COVID-19, even if they have been reinfected multiple times. Again, this is pre-print data and we are not sure if reinfection by the Omicron variant is more likely overall.

In addition, early data out of South Africa suggests that the Omicron variant is potentially more transmissible. This, however, is not yet certain. Omicron cases may be detected at higher rates currently because it is concerning and thus, have more surveillance related to it for now. If this pattern of increased cases shows up in other countries, then it may be far more likely that the Omicron variant is more transmissible. Also, South Africa has reported a significant uptick in hospitalizations due to COVID-19, with many of these hospitalizations being in children and pregnant women. The cases, however, have largely been mild thus far. It is unclear if the Omicron variant is more likely to cause hospitalization or if it is solely because of the increased number of cases. It is important to note that currently, according to Dr. Salam Gueye, the WHO Regional Emergency Director for Africa, only 102 million people in Africa, or about 7.5% of the continent’s population, are fully vaccinated. Over 80% of the population has not even received a single dose of a COVID-19 vaccine. Vaccines that have been promised to nations in Africa have also not been delivered, and it is undeniable that the lack of vaccine equity globally has and will continue to lead to greater chances for dangerous variants of the SARS-CoV-2 virus to develop or spread there. 

It has also been suggested that the Omicron variant originated in an immunosuppressed individual. While we are still unsure of the exact origin of this variant, this is within expectations and our understanding of viruses and of the SARS-CoV-2 virus. Those who are immunosuppressed have a weaker immune response to the virus if infected, allowing the virus to replicate to greater levels and increase the chance of mutations that can lead to a more harmful variant of the virus. That said, there is not currently any specific evidence that indicates that the variant did originate in an immunosuppressed person - it is simply plausible speculation that it might have.

One of the most crucial questions that scientists globally are trying to figure out is whether the Omicron variant is more likely to cause severe disease and lead to increased hospitalizations and/or deaths, a question we still can’t answer. Currently, most data is anecdotal and suggests that while infection is still more likely even in those who are fully vaccinated, those who are fully vaccinated with at least two doses will show mild symptoms of COVID-19 due to the Omicron variant. This is by no means definitive, but suggests that vaccinations provide some protection and prevent severe disease. In addition, there is very limited data on how the Omicron variant will affect those who have had their booster dose or additional doses of a COVID-19 vaccine.

While there is still plenty of early data out there as well as plenty of other questions still left unanswered, cases are rising, and numbers are significantly higher than earlier this year, with almost all cases reported still being due to the Delta variant, a variant we know much more about. Thus, recommendations are still the same regardless of variant: get vaccinated, get a booster or an additional dose of a COVID-19 vaccine if you’re eligible, wear masks especially while indoors, socially distance when possible, if you have children who are eligible, get them vaccinated, and follow other public health guidelines. 

More information:

New National HIV/AIDS Strategy Calls Out Racism

On World AIDS Day, President Biden announced his new National HIV/AIDS Strategy for the United States for 2022-2025. The vision of the strategy is to make the United States "a place where new HIV infections are prevented, every person knows their status, and every person with HIV has high-quality care and treatment, lives free from stigma and discrimination, and can achieve their full potential for health and well-being across the lifespan." In addition to the importance of a strong overall HIV/AIDS strategy for the country in general, the plan takes a position that is both extremely important and largely unprecedented in this type of federal initiative: It calls out systemic racism as a "serious public health threat" and a contributing factor that must be dealt with in order to properly address HIV/AIDS in the U.S.:

HIV/AIDS disproportionately impacts BIPOC in the U.S., and it is therefore critical for any coordinated response to the HIV/AIDS epidemic to acknowledge and directly address issues of systemic racism.

More information:

COVID-19 Surge Continues in Michigan

The COVID-19 surge in Michigan is continuing, with the state once again leading the U.S. in the number of COVID-19 cases in the past week and fourth in the number of COVID-19 deaths. Michigan also had the most hospitalizations of any state in the last week.

The Michigan Health & Hospital Association announced on Thursday that approximately 76% of those hospitalized with COVID-19 in the state are unvaccinated, 87% of COVID-19 ICU patients (i.e., the most severe cases) are unvaccinated, and 88% of people on a ventilator due to COVID-19 are unvaccinated.

According to the state's latest weekly outbreak report, there were 93 new COVID-19 outbreaks linked to schools in Michigan in the past week alone, infecting over 700 students and staff. Included in the new outbreaks were Vera Ralya Elementary School in Haslett and Riley Elementary in Dewitt. Among the 534 ongoing school outbreaks in the state were 8 in Ingham County, 15 in Clinton County, and 3 in Eaton County. These include Lansing's Sexton High School, Haslett Middle and High Schools, and Bath Elementary, Middle, and High School.

The message is clear: Get fully vaccinated as soon as possible, get your children vaccinated, get your booster shot as soon as you are eligible, wear a mask when in public, avoid crowds and large gatherings, get tested before gatherings, and stay home if you have any doubts about whether you might be sick or infected.

More information:

Legislators Proposing Police Budget Increase After Oxford School Shooting 

This week, a 15 year old Oxford High School student brought a handgun to the school and killed 4 students and injured 7 more individuals, including a teacher. The student, who had 18 rounds of ammunition on him, was apprehended by a school resource officer within five minutes. While Oxford High School has a long standing school resource officer, most schools do not, due to budget cuts in recent years. On Thursday, the Michigan House of Representatives approved plans to increase funding for school resource officers (i.e., school police) from $10 million to $50 million for the next fiscal year. This was in direct response to the school shooting, said legislators. This was something that could be done immediately to help, but there is data showing that school resource officers don't help reduce school shootings. In fact, one study shows that schools with resource officers have higher rates of suspension and expulsion. Preventing shootings in the first place with mental health support could be more impactful than implementing police officers in school. The Oxford student showed signs of mental distress and asked for help, but support was lacking in the school. Additionally, more than 50 gun-related bills have been introduced to the Michigan legislature this year but have stalled due to the Republican majority. While Governor Whitmer and other Democrats are pushing for gun safety and legislation, the efforts are still falling short. Governor Whitmer called gun violence a “public health crisis” in the state and has proposed violence prevention initiatives, but only time will tell if Republicans in the Michigan legislature will move bills forward to prevent these types of incidents. As funding for police-related budget items continues to increase, one has to wonder what the state would look like if that funding was put into mental health and community initiatives. 

More information: 

President Biden Announces New COVID-19 Plan

On Thursday, President Biden announced "New Actions to Protect Americans Against the Delta and Omicron Variants as We Battle COVID-⁠19 this Winter." The new plan includes nine components:

For full details on each component, read the full White House statement.

More information:

Civil Rights Scorecard Grades Senators

In November, a coalition of civil rights groups led by the NAACP released the first-ever civil rights scorecard grading U.S. Senators on their performance defending voting rights. In addition to the NAACP, the other groups involved were the National Urban League, National Action Network, National Coalition of Black Civic Participation, Fighting for Our Vote Initiative, and National Council of Negro Women. The grades are based on each Senator's votes on the American Recovery Act, Freedom to Vote Act, John Lewis Voting Rights Advancement Act, and their support for eliminating the filibuster. The protection of voting rights for all people is critical, and both recent and historic efforts to disenfranchise voters has largely targeted people and communities of color, and in particular, Black people.

In Michigan, Senator Debbie Stabenow received an "A" while Senator Gary Peters received an "Incomplete" grade. To view details and grades for other states, visit the Civil Rights Scorecard website.

More information:

This Week's QM Round-Up Contributors (in alphabetical order):