Dean's Update
December 10, 2021 - Aron Sousa, MD
Friends,
In the last week, I’ve had a number of people asking about the omicron variant of COVID-19, and what it all means. There are a lot of opinions and preliminary data swirling around the interwebs, and while much of it gives one reason for hope, as of today, there is still too much uncertainty to say anything with conviction…except that there is a lot of uncertainty.
Data from South Africa does suggest that omicron is very transmissible, but probably not more dangerous than the delta variant. Still that same data gives one reason to look a little deeper. The study I linked to above has not completed peer review, and there is an oddity in the results. From the data it appears that, compared to prior variants, omicron is more transmissible and more likely to reinfect people who have already had COVID-19. Fair enough. What does not make complete biological sense is that, from that same data, people who have never been infected were at lower risk of getting the omicron variant than people who were previously infected with other variants. That is the opposite of what we would expect – prior infection should make you at least at little protected from a second infection and certainly not more at risk.
I think this problem is probably about the population sample. My guess is that people who have been previously tested are more likely to get tested again, so the testing system is probably missing a lot of infected, untested, never-before-infected people. But there are many possible reasons this data can be confounded. To get past these confounding issues, we will just have to wait for replicated studies in South Africa and other regions before coming to any real conclusions.
So far, the people in South Africa with omicron are doing well medically, although the population is young, and those folks tend to do well with COVID-19. The New York Times headline about increasing hospitalized childhood cases in South Africa on Thursday morning was just misleading. The article itself was clear, there may be more cases of children with COVID-19 than before, but those children are in the hospital for something else and not hospitalized for COVID-19.
On Wednesday, Pfizer announced that its internal, preliminary analysis suggests boosters will help effectiveness against omicron, and we think Moderna will release similar data soon. This suggests that boosters will be needed for everyone and that boosters may be given earlier than the current schedule. And, from an interview with the CDC director, it appears that people in the US with omicron are doing well.
So that is all good reason for hope, but honestly, things here are a mess now. Michigan has more hospitalizations per capita than any other state; our hospitals have canceled “elective” procedures to convert post-operative wards into ICU and acute care beds. Deaths continue to rise, and when I go around the state, I see some really bad masking. Germ theory will not be mocked, as we sow our germs, so shall we reap them.
Next week is the winter graduation for master’s and doctorate students (not the MDs). Congratulations to the College of Human Medicine’s PhD, MS, and MPH graduates! That commencement will preempt Town Hall next week, and with the holidays, Town Hall will not return until January 7, 2022. I will do weekly updates for the next couple of weeks, but then the update will take a couple of Fridays off after the Solstice (December 21, 2021 at 10:59AM ET).
I hope as many of you as possible can get some time away during this time. It has been a truly extraordinary couple of years, and many folks have not had any time away. It is time for a rest if you can arrange one. Please also arrange a booster when you can, continue wearing your mask, and know that even vaccinated people can transmit COVID-19 to people at greater risk. Take care of each other.
Serving the people with you,
Aron
Aron Sousa, MD
Interim Dean