December 19, 2021
The last 4 days have seen a significant 36% rise in cases in Alabama compared to the same 4 days last week. The rate of infection is accelerating - by comparison, the daily average during the last 7 days rose just 25% over the prior week. Today, 96 hospitals reported having 384 confirmed patients - or 4.0 per hospital - a 16% increase in 4 days. While we have not yet experienced the meteoric rise observed elsewhere, that is cold comfort. Omicron is clearly on its way here, so buckle up.
A year ago this week, Alabama received one of God’s greatest gifts - the gift of vaccines. Who can forget the look of joy and relief on the face of UAB’s Tomi Ann Boackle, Associate Chief Pharmacy Officer, as she described how it felt to open the first crate of Pfizer vaccine to arrive in our state? (Watch it here - https://frankmcphillips.substack.com/p/december-15-2020).
Last Christmas, I hoped - indeed I expected -that the pandemic would be over by now. The emergence of the Delta variant, and now the Omicron variant, has been profoundly disappointing. Nevertheless, we should be grateful that the U.S. vaccination program has likely averted 1.1 million deaths and over 10.3 million additional hospitalizations through the end of November, according to a recent study by The Commonwealth Fund. If it were not for the divine gift of vaccines, Delta’s rapid spread last summer and fall would have added up to 36 million cases to the 51 million cases previously reported in our country.
Omicron is a setback, but we must recognize this is not March 2020 all over again. We are in a different place. Although Omicron infections will likely soar in the coming days, we have the tools to limit hospitalizations and death. That must be our focus. We cannot afford to further deplete our already exhausted health care system, consuming limited hospital staff and resources that then cannot be used to treat people with other serious illnesses.
Expert opinions differ widely over whether Omicron infections are innately less severe than prior strains of the virus. Early evidence from South Africa raised hopes that Omicron is milder than Delta, having less impact on the lungs, for instance. But South Africa’s experience could be skewed by its younger population and other factors. Two relatively small studies from Denmark and the U.K. have suggested that Omicron is no less severe than Delta. Dr. Scott Gottlieb said this morning on one of the Sunday talk shows that there is “no indication” Omicron causes more severe illness, but he did not specify that it causes less severe illness.
Honestly, the commentary on the future of Omicron is muddled right now, but there are two matters on which there is widespread agreement. First, although two shots of an mRNA vaccine (Pfizer or Moderna) provide diminished protection against the Omicron virus (e.g. 30-35% efficacy), they remain a significant shield against severe outcomes (e.g. 70-75%). Second, a booster shot is the key to avoiding infection in the first place. It therefore seems inevitable that two shots will eventually come to be referred to as “partially vaccinated”, while “fully vaccinated” will be reserved for those who have gotten the booster shot.
In the coming days, rising case counts will be shocking, but it is important to maintain perspective and hope. If you get your booster shot today, you have little to worry about. If a booster shot is not feasible, two shots will help you avoid severe illness, but remember that your immunities are waning with each passing day. Finally, if you are determined to remain unvaccinated, cross your fingers and hope you are lucky enough to avoid two highly contagious variants this winter. If your luck runs out, an exhausted health care professional may, or may not, be there to help you. The totals:
12/5 - 361
12/6 - 281
12/7 - 630
12/8 - 687
12/9 - 549
12/10 - 592
12/11 - 713
12/12 - 330
12/13 - 294
12/14 - 814 (excluding 841 older cases)
12/15 - 647
12/16 - 816
12/17 - 908
12/18 - 692
12/19 - 552