Jan. 6, 2022 -- The record-setting surge in COVID-19 cases nationwide – including more than 1 million new infections reported on Monday – raises questions about whether the more contagious Omicron variant will speed a transition from pandemic to endemic disease.
Also, does the steep increase in number of people testing positive for coronavirus mean the United States could finally achieve a meaningful level of “herd immunity'?
Infectious disease experts weigh in on these possibilities.
An Endemic Eventuality?
Whether the current surge will mean the predicted switch to endemic COVID-19 will come sooner, however, "is very hard to predict," Michael Lin, MD, MPH, says.
"It's an open question," `he says, "if another highly transmissible variant will emerge."
On a positive note, "at this point many more people have received their vaccinations or been infected,” says Lin, a hospital epidemiologist at Rush Medical College in Chicago.
"It could end up being a seasonal variant," he says.
COVID-19 going endemic is "a real possibility, but unfortunately … it doesn't seem necessarily that we're going to have the same predictable pattern we have with the flu," says Eleftherios Mylonakis, MD, chief of infectious diseases for Lifespan, which operates hospitals and clinics across Rhode Island Hospital.
"We have a number of other viruses that don't follow the same annual pattern," he says.
Unknowns include how long individuals' immune responses will last going forward.
A transition from pandemic to endemic is "not a light switch and there’s no metrics associated with what endemic means for COVID-19," says Syra Madad, a doctor of health care science and infectious disease epidemiologist at Harvard’s Belfer Center for Science and International Affairs.
"Instead, we should continue to focus on decreasing transmission rates and preventing our hospitals from getting overwhelmed," she says.
A Hastening to Herd Immunity?
"The short answer is ‘Yes,’" Lin says when asked if the Omicron surge could get the U.S. closer to herd immunity.
"The twist in this whole story," he says, "is the virus mutated enough to escape first-line immune defenses, specifically antibodies. That is why we are seeing breakthrough infections, even in highly vaccinated populations."
Mylonakis was more skeptical regarding herd immunity.
"The concept of herd immunity with a rapidly evolving virus is very difficult" to address, he says.
One reason is the number of unknown factors, Mylonakis says. He predicts a clearer picture will emerge after the Omicron surge eases. Also, with so many people infected by the Omicron variant, immune protection should peak.
"The majority of the population will be exposed and will mount some degree of immunity,” he says.
Madad agreed. The Omicron surge has led to increased vaccinations. That, coupled with the spike in new patients who will have natural immunity from infection, will help move us toward herd immunity.
Immunity " from vaccination is the safest option and already over 1 million doses of the COVID-19 vaccine are going into arms per day,“ says Madad.
A Shorter, More Intense Surge?
The United Kingdom's experience with COVID-19 has often served as a bellwether of what is likely to happen in the U.S.. If that continues with Omicron, the peak should last about 4 weeks, Mylonakis says.
In other words, the Omicron era could pass more quickly than Delta.
Also, some evidence shows antibodies produced by Omicron infection remain effective against the Delta variant –reducing the risk of Delta re-infections over time.
The current surge could also mean enhanced protection in the future.
"As we look at getting to the other side of this Omicron wave, we will end up with more immunity," Madad says. "And with more immunity means we’ll be better guarded against the next emerging variant."