Here we go again.
As Americans endure their second pandemic winter, for many the holidays suddenly have an eerily familiar sense of uncertainty and foreboding. Mask mandates have been reinstituted in some places. There are long lines for testing in others. Booster shot appointments are filling up fast. Social media feels overrun with friends and loved ones announcing positive diagnoses. Cases are rising nationwide. Many hospitals are overrun. The US is girding for yet another deadly wave of COVID infections — its fifth or sixth, depending on where you live.
“It’s just another wave. Any additional wave is too many,” said virologist Angela Rasmussen, who prefers not to keep count. “I’m tired of waves! I want to leave this beach!”
Like millions of Americans, Rasmussen and her husband are now reevaluating their Christmas plans. At this stage, she’s still comfortable with the family gathering she had organized with other vaccinated loved ones who have received their booster shots, but she’s already thinking she’ll skip getting drinks with friends when she visits her hometown for the holidays.
“I think at this point I’m just exhausted. Probably most people are,” she said. “Every time this happens, it’s like, Oh no, you got too hopeful there for a minute. Then something else happens. First Delta, now Omicron. It feels like we’re going through the same cycle.”
“What’s most frustrating,” she said, “is that we don’t seem to be learning from it.”
New cases and hospitalizations are up week over week by about 5%–7%, the CDC said in a Wednesday briefing. Roughly 1,100 Americans are still dying each day. More than 90% of the country is considered an area of high transmission, and with cases of the highly infectious Omicron variant already located in 36 states, the forecast is only expected to worsen. The current surge is still largely driven by the Delta variant in most of the country.
The CDC said it predicts that COVID cases will have further exploded as Americans gather for the holidays. It estimates as many as 1.3 million new infections will be reported in the week ending Dec. 25 — a potential 55% spike over the previous week. Looking to exploding case numbers in the UK as a potential model, January could be even more horrendous.
Facing this expected avalanche of yet more death, burned-out healthcare workers aren’t sure how they’ll cope. “Honestly, I don’t know how I’ll do that. I don’t know how we’ll keep going,” said Kansas physician Alix Oreck through tears. “We have none of the confidence that we initially did. We know the chances are so slim once people get to us that they’re gonna make it.”
In the past month, things had already been getting markedly worse at her small 45-bed hospital in Parsons, a rural town in the state’s southeast where Oreck said it feels like people are pretending the pandemic is over. She recently initiated an ethics and allocation committee in order to make decisions about prioritizing patient care. They’re out of beds, IV poles, and other basic supplies. There’s just one ventilator left. These are not the kinds of decisions Oreck went into medicine to make.
“We’re exhausted. We’re trying so hard. We’re trying to be generous of spirit even as we’re getting pummeled on all sides,” Oreck said. “But I have never seen healthcare workers cry so much. Everyone is hurting so much.”
A number of factors have converged at an unfortunate point in the pandemic. Cold weather has once again forced much of the US inside, and people are gathering for the holidays — far too many of them unvaccinated. Now, the Omicron variant has arrived on top of the already circulating Delta variant, which still comprises 96% of recorded US cases. But Omicron seems to be more contagious, even among vaccinated people. Even office holiday parties at companies with strict vaccine mandates have been followed by a spate of infections, including at BuzzFeed’s own in New York City. Omicron is likely to be the dominant variant across the country by early January.
“It’s spreading like wildfire, even among vaccinated people,” Rasmussen said. “One thing is really clear: We’re gonna have a huge surge in Omicron cases. What’s going to determine how bad it’s going to be is how severe the disease will be and whether it will cause that in vaccinated people.”
Some preliminary studies suggest Omicron cases are more often milder ones, but even if that holds true — a big if, as experts agree much more data is needed — its effect on hospitals could be easily counteracted depending on its spread. “If twice as many people get Omicron than Delta, but only half as many get severely ill, that’s still the same amount of severely ill as in a Delta wave,” Rasmussen said.
But all is not without hope. The world looks very different now than at this point last year, when COVID vaccines began rolling out of factories and into the first Americans’ arms. Scientists have developed new tests, treatments, and lifesaving vaccines. “It’s important to remember that we have far more tools to fight this virus than we ever did just one year ago,” CDC Director Rochelle Walensky told reporters Wednesday.
Gerardo Chowell, a mathematical epidemiologist at Georgia State University’s school of public health, said people in his Atlanta community aren’t postponing travel plans or holiday gatherings. They’re just being sensible. “People are ready to go on with their lives while managing COVID-19 risks,” he said. “I feel calm and optimistic. We have learned so much about this new enemy over the last two years and have reliable tools to mitigate the COVID-19 risk.”
According to experts, there is one clear step Americans can take to protect themselves — and society at large — during this next wave.
“The message remains clear: If you are unvaccinated, get vaccinated,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters Wednesday. “And particularly in the arena of Omicron, if you are fully vaccinated, get your booster shot.”
Fauci pointed to emerging studies showing vaccinations still offer considerable protection against severe disease caused by Omicron. Booster shots offer even more so. “Our booster vaccine regimens work against Omicron,” Fauci said. “At this point, there is no need for a variant-specific booster.”
So how should Americans navigate these next few weeks and make decisions about holiday festivities?
Ashish K. Jha, dean of the Brown University School of Public Health, told the Today show on Thursday that, unlike last year, there are now ways to gather safely with loved ones.
“If everyone is vaccinated and boosted, I think it’s pretty safe for people to get together,” he said. “But if there are people who are high risk — elderly, immunocompromised — I would definitely add a layer of testing to that. Everybody just get a quick rapid test before they get together. It'll make it that much safer.”
“If you’re mixing vaccinated and unvaccinated people, obviously it increases the risk,” Jha added. “There, testing becomes essential.”
Virologist Rasmussen echoed this caution.
“Don’t cancel Christmas, but maybe don’t invite over 50 people,” she said. “Don’t go to a party where your anti-vax relatives are hanging out. Be selective about who you’re with. Don’t be afraid to ask their status. Use rapid tests. Wear masks in public places.”
After the last two years, it’s understandable to want to be with loved ones and eke out some sense of normalcy, Rasmussen said.
But if there was ever a time to think of others, it’s now.
“It’s the holiday season. We should be thinking about our communities, our families, and those who may be more vulnerable,” she said. “Please think about them before you decide you’re not going to let Omicron ruin your Christmas.”