UVMMC doctor: Vermonters must be vigilant against omicron to ease burden on hospitals
The omicron variant has in recent weeks surged through the country, leading to what seems like comparably swift adjustments to public health guidance.
The director of the CDC recently said the agency needs to do a better job communicating. And in Vermont, officials with the Agency of Education caught flak for abruptly ending surveillance testing and contract tracing in public schools after the first week of the semester.
The fast pace of changing guidance has led to uncertainty over how to respond to the omicron variant. VPR's Liam Elder-Connors spoke with Tim Lahey, an infectious disease physician at the University of Vermont Medical Center, about navigating this stage of the pandemic. Their conversation has been condensed and edited for clarity.
Liam Elder-Connors: How should individuals be thinking about assessing risk at this stage? For example, whether they're deciding whether or not to go to a concert or fly across the country to visit a family member.
Dr. Tim Lahey: Throughout the pandemic, we've all been trying to figure out, "How do I keep myself safe?" And also, "How do I do my duty not to endanger others?" And that has changed a little bit in the middle of the omicron wave, where the number of cases is surging enough to endanger our health care systems' ability to provide even the most basic care. That, to me, says that the obligation to invest in protecting others and protecting the integrity of the health care system has grown.
That means this is a period of time in which we should be more careful to avoid indoor grouped gatherings; we should avoid optional travel. But I do think we must expect that those kinds of sacrifices are short term. And we cannot live life in a perpetual state of emergency. And so I think the fact that the omicron surge is expected to not last for very long — it's already peaking on other parts of the world — suggests to me that we can invest over the coming weeks in special measures to keep the health care system functioning, keep society functioning — with the expectation that we should come back to a more relaxed way of living soon.
Dr. Lahey, the way you're describing this mentality, it seems like it's not necessarily just assessing risk of whether or not you personally are going to get sick, but how your actions affect the larger community. Is that is that kind of what you're trying to get at here?
It has always been true that no man is an island. But certainly the COVID pandemic has made us all so intimately familiar with the fact that our actions can endanger or protect others. For me, I think the biggest challenge is that there's a tension between those two — my personal freedom is affected by my efforts to protect you, and vice versa. And so you can't expect too much of my efforts to protect you. And nor can I.
What's enough, what's too much — is a big societal decision. If my behavior affects the ability of my neighbor to go get a heart surgery, I am going to feel responsible as a good neighbor to protect her. On the other hand, if the magnitude of that risk is smaller, and our hospitals are not endangered, and the number of deaths in our community is not super high, we should give each other more personal freedoms and not infringe more than we have to right now. Because of the omicron surge, that need is once again emerging. And so it makes sense to make those sacrifices — but to look for the end of them.
We've been hearing about what it will be like in the future — in the months and years ahead — to live with this virus instead of acting like it's just a perpetual emergency. What actions do you think we need to be taking in the coming weeks and months to get to that place? What does that look like?
I think that the average lower severity of disease from omicron is a sign that the endemic transition is coming in closer than it was before. When we cross over from the state of emergency into just living with a low level of the virus is a judgment call.
But I think what we need to do is be very clear about what metrics we're going to use to define that line. We should not be using case counts, for instance, because an increasing number of those cases are so mild as to not be important. But we should be using the number of deaths in our communities, how over-extended our hospital systems are, how much illnesses are affecting business's ability to stay open — and use that collection of parameters to make wise decisions about whether we're in emergency, or if we're sort of getting better but still need to take some measures. Or if, at long last, we finally can just go back to normal life and say, "That's a small enough burden that we're just going to bear it."