The astonishing spread of the omicron variant could help set the stage for the pandemic to transition from overwhelming to manageable in Europe this year, a top health official said Monday, potentially offering the world a glimpse at how countries can ease restrictions while keeping the virus at bay.
That hint of hope came with a heavy dose of caution: Immunity from the surge of infections will probably wane, and new variants are likely to emerge, leaving the world vulnerable to surges that could strain health systems. In the United States, where vaccination rates are lower and death rates are considerably higher than in Western Europe, there are bigger hurdles on the path to taming the pandemic.
Dr. Hans Kluge, director for the World Health Organization’s European region, warned in a statement released Monday that it was too early for nations to drop their guard, with so many people unvaccinated around the world. But, he said, between vaccination and natural immunity through infection, “omicron offers plausible hope for stabilization and normalization.”
The question that remains, however, is what a new normal looks like — a picture that would have seemed disastrous in 2019 could be a big improvement in 2022 — and how long it could last.
The omicron variant will undoubtedly leave behind much higher levels of immunity in the population, scientists said. But whether the world will have to endure deadly and disruptive future surges of the virus before the pandemic stabilizes is not at all clear.
And while Kluge said he believed that Europe could withstand new waves without resorting to lockdowns, countries there are still working to determine what other measures they may use. New antiviral pills are more readily available in Europe than in other parts of the world, scientists said, but countries still need to administer them more quickly.
Experts said that precautions like testing and isolating would remain essential. And if coronavirus cases climb in the coming winters, scientists said, short-term mask mandates could be a way of suppressing cases to help hospitals dealing with other respiratory illnesses, too.
Tedros Adhanom Ghebreyesus, head of the WHO, said Monday that the emergency phase of the pandemic was still very much here.
“It’s dangerous to assume that omicron will be the last variant or that we are in the endgame,” Tedros said at an executive board meeting of the organization. “On the contrary, globally, the conditions are ideal for more variants to emerge.”
Over the past two years, people around the world have become exhaustingly familiar with the wicked way the virus evolves and confounds expectations. Last fall, with vaccination spreading and the delta variant waning, there were predictions of a return to normal — only for the world to be blindsided by omicron.
No previous variant has spread nearly as fast as omicron, with reported coronavirus cases rocketing from about 600,000 a day worldwide in early December to more than 3 million a day now. (Case numbers are largely thought to be an undercount given issues with access to testing and the use of at-home tests that may not always be officially reported.)
Even as those figures level off in much of Europe and the United States, in places where omicron is just gaining a foothold, the known number of new infections is staggering.
Germany’s health minister, Karl Lauterbach, said that he expected infections to peak in mid-February, with as many as 600,000 new cases per day. Omicron is also just now spreading across Eastern and Central Europe, including in many countries with low vaccination rates.
And countries across Asia that have pursued a “zero-COVID” policy with stringent lockdowns will face steep challenges preventing outbreaks of omicron.
But the very speed and breadth of the omicron surge has also left some public health officials cautiously optimistic about how quickly countries can emerge from the latest wave. The sharp rise in cases in places already overrun by omicron has often been followed by a remarkable decline, as in South Africa and Britain.
“We know that increased vaccination and infection are strengthening our defenses against COVID,” Thomas Frieden, a former chief of the U.S. Centers for Disease Control and Prevention, wrote Monday on Twitter. “I’m more optimistic about our ability to tame the pandemic than at any point since its emergence.”
“Unless, of course, a worse variant emerges, with the infectivity of Omicron and as deadly as Delta,” he added.
In the United States, omicron cases appear to have crested in the Northeast, parts of the Upper Midwest and other areas where it first arrived, while nationally, new cases and hospital admissions have leveled off in recent days.
Still, hospitals in other areas across the country remain overstretched, straining to handle patients after multiple surges and staffing shortages, including in Mississippi, where nearly all of the state’s acute-care hospitals have been pushed to capacity. And new deaths remain high.
In the United States, 37% of people are not fully vaccinated, compared with 25% in Western Europe. Three-quarters of the U.S. population has not had a booster shot, versus half of Western Europeans.
Devi Sridhar, head of the global public health program at the University of Edinburgh in Scotland, said that the number and concentration of unvaccinated people in parts of the United States put the country in a more dangerous position than well-vaccinated parts of Europe, where the return of normalcy was underway.
“In these countries, we’re getting to what I think of as the beginning of the end, and we have the tools to manage it,” she said. “We have to shift to the next chapter of this pandemic, and move from an emergency crisis to one which is more sustainable.”
With England in the midst of lifting almost all remaining coronavirus restrictions and Spain’s prime minister telling citizens to “learn to live” with the virus, Europe offers hints of what could lie ahead, Sridhar said.
“Many countries are looking at us to see what the next stage looks like,” she said. “Can we find a way to manage this as we head into spring and summer, or are we in for another surprise?”
As research has emerged that omicron causes less severe disease and vaccines remain protective against the worst outcomes, some public health experts have encouraged less focus on cases and more emphasis on hospitalizations amid record-breaking spikes.
But scientists have also cautioned that the protection offered by a previous infection may wane over time, and may not apply as well to future versions of the virus. Infection with delta, for example, offered minimal protection against omicron.
New fast-spreading variants will most likely emerge, scientists said. And there is no reason to believe that they will only be milder.
Eventually, scientists believe that the coronavirus will become endemic — a permanent part of the disease landscape — and start circulating at more predictable levels. How serious a threat it poses at that stage will depend in large part on what levels of illness countries decide to tolerate and how hospitals manage to cope.
That stage of the pandemic appears some way off, scientists say.
As new variants burn through the population and more people are vaccinated, the virus will face more pressure to evolve in ways that allow it to infect even people with a measure of immunity, scientists said. Predicting the next variant may be as difficult as it had been to predict omicron.
“Expect the next variant to come out of left field,” said Jeremy Kamil, a virus expert at Louisiana State University Health Shreveport. He added, “It’d be a hugely foolish thing for anyone to speak with excessive certainty about what’s coming in the next two years.”
Kluge, of the WHO, echoed those concerns Monday, but said that Europe was in a much better place to deal with what might come. Commenting two years after the first confirmed coronavirus case in Europe, he offered a mix of caution and optimism and urged people to pay attention to other urgent health issues beyond the coronavirus.
“The pandemic is far from over, but I am hopeful we can end the emergency phase in 2022 and address other health threats that urgently require our attention,” Kluge said. “Backlogs and waiting lists have grown, essential health services have been disrupted, and plans and preparations for climate-related health stresses and shocks have been put on hold.”
