David P. kirjutas Reede, 28. jaanuar 2022 kl 10:34:50 UTC+2:
> Omicron Is Spreading. Resistance Is Futile
> By Daniel Halperin, 1/24/22, Wall St. Journal
>
> As the Omicron wave crests, there’s bad news and good news. The
> bad news is that the main strategies for slowing its spread—
> repeated testing, masks and vaccine boosters—are largely futile
> for that purpose. The good news is that while protecting the
> vulnerable remains vital, slowing the spread of the virus needn’t
> be the priority. The biggest danger from Omicron is probably acute
> hospital staffing shortages, in part because of asymptomatic
> employees who stay home from work after testing positive.
>
> Although Covid testing can be useful, it also has important
> limitations. The “gold standard” PCR tests are frequently too
> sensitive; research has shown that in many cases people who test
> positive are no longer contagious. The increasingly used rapid
> antigen tests have the opposite problem, often failing to detect
> infections during the earlier part of the 5-day isolation period
> of presumed contagiousness.
>
> This coronavirus, especially the Omicron variant, is so fast-moving
> that mass testing and contact tracing, and probably even isolation
> & quarantine, can’t slow it down significantly. The U.K. & other
> countries, unlike the U.S., already had widespread rapid-testing
> capacity during their recent surges, yet they experienced the
> same meteoric rise in cases. As with other interventions such as
> booster shots, testing is most useful for those at high risk of
> serious complications, who might benefit from early treatment.
>
> As for masking, the CDC recently acknowledged that cloth masks
> do relatively little to prevent spread. Some experts on corona-
> viruses, including epidemiologist Michael Osterholm, for nearly
> two years have questioned the efficacy of masks. A recent rigorous
> review by his University of Minnesota research group concludes:
> “We are well past the emergency phase of this pandemic, and it
> should be well-known by now that wearing cloth face coverings or
> surgical masks, universal or otherwise, has a very minor role to
> play.... It's time to stop overselling their efficacy & unrealistic
> expectations about their ability to end the pandemic.”
>
> The first large randomized community-level study, published last
> month in Science, found that while generic surgical masks provided
> a modest (about 10%) reduction in the risk of infection from Delta,
> cloth masks didn’t significantly reduce risk. Masks may be even
> less protective against an extremely contagious variant like Omicron.
>
> That has led to calls for mandatory N95-type masks, which are
> more effective but harder to use. Some schools have even mandated
> them for kids. Yet two years is a long time for anyone’s face to
> be covered for many hours a day, and it’s an interminably long
> time for youngsters, possibly leading to lasting psycho-social &
> other harms. Like Delta and earlier variants, Omicron doesn’t
> seriously threaten the vast majority of kids; preliminary evidence
> suggests much less risk for youth than from Delta. An increasing
> number of public-health experts, including infectious-disease
> specialist Monica Gandhi, have called for ending school mask
> mandates soon.
>
> And while vaccines & boosters continue to offer strong protection
> against serious illness & death—& are therefore vitally important
> to those at high risk—they’re less effective at preventing infection,
> especially with the Omicron variant. While a new CDC study finds
> that boosters substantially reduce risk of infection as well as
> hospitalization from Omicron, countries like the U.K. and Israel
> that had widespread booster coverage before Omicron struck have
> also seen unprecedented surges in cases.
>
> In any case, even if you get a booster now, the current surge
> probably will have subsided by the time immunity kicks in. It’s
> possible that future variants will arise against which currently
> administered boosters would still be useful, although by then
> immunity may have waned significantly. The European Medicines
> Agency recently cautioned that repeated boosters may weaken the
> immune system over time.
>
> Which brings us to the good news: Because the new variant is
> relatively mild and so many people already have some immunity
> from vaccines, prior infection or both, Omicron’s explosive spread
> is much less threatening than previous waves. A recent Southern
>
> California study looked at over 50,000 patients infected with the
> new variant. Not one required mechanical ventilation and only one
> died, compared with 14 deaths and 11 ventilations out of some
> 17,000 infected by the Delta variant during the same period.
> Consistent with evidence from other countries, hospitalizations
> were considerably lower and average hospital stays much shorter
> among Omicron than Delta patients.
>
> Although reported numbers of “Covid hospitalizations” are up
> nationally, these figures include patients admitted for other
> reasons who incidentally test positive. Based on data from several
> states & the U.K., it appears that roughly half these admissions
> likely aren’t caused mainly by the virus. HHS Dept data indicate
> the total number of patients in U.S hospitals has hardly budged
> over the past six months.
>
> Because the new variant primarily targets the upper airways
> instead of the lungs, doctors report that few patients are
> requiring ventilation or even supplemental oxygen. Christopher
> Murray of the Institute for Health Metrics & Evaluation estimates
> in the Lancet that the number of Omicron deaths “seems to be
> similar in most countries to the level of a bad influenza season
> in northern hemisphere countries.” In 2017-18, the flu caused some
> 52,000 deaths in the U.S., probably peaking at over 1,500 a day.
>
> Public-health authorities are beginning to come to terms with the
> passing of the Covid emergency. Six experts who advised the Biden
> transition, including Osterholm, earlier this month called for a
> pivot toward accepting Covid as an endemic disease, following the
> example of several European countries. As Fauci has acknowledged,
> “just about everybody” will eventually become infected. Some
> scientists have even suggested that Omicron may end up providing
> a kind of global “superimmunity” against serious illness from
> future variants.
>
> It’s past time to shift focus from trying to stamp out all new
> infections to protecting the most vulnerable from severe disease
> directly thru vaccination and other evidence-based measures &
> alleviating hospital staffing shortages. Ending mask mandates,
> de-emphasizing isolation and encouraging vaccination ought to be
> a compromise most of us can live with.
>
> Mr. Halperin is an adjunct professor at the Gillings School of
> Global Public Health at UNC Chapel Hill & author of “Facing
> Covid Without Panic.”
>
> https://www.wsj.com/articles/omicron-is-spreading-resistance-is-futile-masking-mandate-n95-vaccine-requirement-boosters-covid-11643064353

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