So much has changed, and much more has stayed the same over the past year. Mid-seventies on Christmas isn’t the only thing going wrong right now; the Omicron variant of SARS-CoV-2 is about to show us just how bad things can get. Last year, I was full of hope and high on my job helping distribute COVID-19 vaccines at Lake Regional Health System, while still picking up the pieces of my personal life after Mary’s car accident and the subsequent difficulties.
Since Last Christmas
I’m happy to say that on the personal front, things are great. Mary is essentially back to normal, especially considering just how bad she was injured the in the accident. You’d never know anything ever happened to Amelia. And, I’m back home in Salem.
Public Health Passion
I have often said that my experience at the Lake distributing COVID vaccines is what ignited my latent passion for Public Health. I think I’ve always had a passion for it, though, and it was really just the ongoing pandemic that made it impossible for me to deny my desire to serve any longer. Either way, a year ago, I never would have guessed we would be entering into the worst part of the pandemic in 2022.
When the COVID vaccines first came out, they were extremely effective. It was some of the best data I had ever seen. There was a lot of discussion before the FDA authorization about if we would take it or not, but overall, once the data were available, most of my peers eagerly lined up for the vaccine. I was one of the first, getting mine about a week before Christmas. Early on, we saved every last precious drop of vaccine from every vial, as supply was severely limited and demand seemed endless.
Today, we have more than we need and next to no one getting their first doses.
Vaccine Failure?
And I have to admit… with Omicron about to go scorched earth on us… it does make me wonder if it even matters at this point. The Delta variant was the first hit in the vaccine’s efficacy. When it came around, we no longer had that robust protection against all COVID disease, but it remained effective at keeping people out of the hospital and dying.
Omicron, with its dozens of mutations, has rendered the 10-week efficacy of BOOSTER doses down into the 30-40%. This is extremely disappointing, but not surprising, given what we know about Omicron.
Related: Hospital Occupancy Rates
30-40% is terrible compared to the 95% we saw early on against the original SARS-CoV-2 and the Alpha variants, but it’s not useless. With hospitals continually full of COVID patients, we must remember how important even that will be. Data is still sparse, but it looks like Omicron is likely nearly as contagious as measles, and slightly less deadly than Delta. Less deadly is great, but its not going to be enough to make up for the vaccine resistance and the increased infectivity of this variant. We need a new vaccine, yesterday.
Still, Get Vaccinated.
With that said, for reasons previously mentioned, I would still highly recommend everyone to get vaccinated and get boosted as soon as possible. At this point, its unlikely that the vaccine will keep you from getting COVID, but it does still offer a considerable reduction in your risk of death and will help keep you out of the hospital.
Our other tools for keeping people out of the hospital, the monoclonal antibodies, are also affected by the mutations present in Omicron. Both Regeneron’s and Lilly’s mAb combinations are ineffective against Omicron. Only sotrovimab, which is not widely available, retains activity against it. Unlike the vaccine, people rarely have reservations about getting a mAb infusion. It is difficult to say for sure, but it is likely the Delta wave we experienced this summer would have been much worse without the mAbs. I can only imagine what will happen this winter.
Other Tools
The only bright spot is the emergency authorization of paxlovid, a 5-day oral treatment for COVID-19. This can be given at home and preliminary data seems to indicate a huge reduction in hospitalizations when the medication is given at the right time. It has to be given early though, so quick detection through widely available testing and rapid delivery of the medication will be necessary.
The Path Out
A year ago, the path out of the pandemic was clear; vaccinate 90% of the population and then go on with life. Today, I don’t see that same path. The vaccination rate in Dent County is 33%. Only 1 out of 3 people are vaccinated. Uptake of the pediatric version of the vaccine has been extremely slow. I’ve been essentially called a child-killer on social media for even mentioning that the pediatric version even exists.
With this degree of vaccine hesitancy, there is simply no way that the vaccines are going to get us out of this. Now we’re facing a likely requirement to develop a new vaccine, and we will have to go through all of this again. My team members are tired. Distributing vaccine is a lot of work. And now it feels like it was for nothing.
The only bright spot on the vaccine front is that the US military claims it is very close to developing a new COVID-vaccine already which will work against all current strains and all future strains. I think this is certainly possible, and I do think that vaccine manufacturers don’t always choose the most ideal targets for vaccines… possibly out of the idea of planned obsolescence. Maybe a vaccine developed by the military…without a profit motive… will be the answer. However, given the military’s shameful past, which includes spreading toxic gas throughout St. Louis on purpose, there will be another large segment of the population that will not trust this vaccine either.
More Bad News
The early data we have available on Omicron suggest that it will require an N95 mask to have any effect on reducing transmission of this variant. They are more widely available now, but I guarantee that if people won’t wear a cloth or disposable mask, they aren’t going to go out and get N95s.
It feels hopeless.
From full of hope in December 2020 to hopeless in December 2021.
From almost over, to just getting started.
It has become clear that we are not all in this together. It has become clear that many more people are going to die, and there’s probably very little I can do about it. It is clear that Public Health has become a political topic while trying to defend and promote a vaccine that is not living up to expectations right now.
No Christmas
COVID finally hit my family this month. Some are still recovering. As a result, we did not get together on Christmas Eve and we won’t get together tomorrow morning either, for the first time in my life. We even managed to do a COVID-appropriate get-together last year. But this year we decided it was better to put it off.
I’m tired of this. I’m tired of COVID. I’m tired of people suffering. I’m tired of people dying. I’m tired of fighting the non-believers. I’m tired.
Keep Going
But, we have to keep going. We have to keep trying. We have to keep fighting.
If we don’t… If I don’t… more people will die. More will get sick.
We need tests. Lots and lots of tests. Everyone should test every other day.
Everyone should still get vaccinated.
Everyone should have 5 days of paxlovid sent to their house.
Everyone should get an injection of Evushield.
Everyone should get 14 days paid leave when they are diagnosed with or exposed to COVID.
A brief Diatribe
We do still have tools to fight this. And we must. Honestly, it starts with people STAYING AT HOME when they are sick. I can’t tell you how many people come in for a test who said, “I thought it was just a cold, but its not getting better” or something similar. So many people are walking around spreading it for DAYS before they finally test or decide to stay home. You wonder some people think we need mask mandates, quarantine orders, and vaccine mandates? Because SO MANY PEOPLE don’t have enough COMMON SENSE to STAY AT HOME when they are sick!
“But it’s my right…”
No, it’s not your right to go around spreading a deadly virus. End of story.
I think all we can hope for at this point is that Christmas 2022 brings us blankets of snow instead of waves of COVID variants. At the rate things are going, I wouldn’t hold my breath.
Signing Off
Merry Christmas.
