Fauci: It's too soon to say if we'll need lockdowns and mandates to contain the new variant

Is it?

As a thought experiment, try to imagine what we’d need to learn about the new variant to make a population as pandemic-fatigued as ours amenable to new lockdowns. I doubt there’s any degree of transmissibility that would lead a majority to condone stay-at-home orders. The argument against it would be that we’re all going to get COVID eventually anyway from Delta so who cares if Omicron accelerates the process by making everyone sick at the same time? (Hospital staffs would care but they’re a tiny minority.)

Only if the new variant turns out to be meaningfully more virulent than Delta will Americans consider draconian measures, and even then the definition of “meaningfully” would vary from jurisdiction to jurisdiction. Deep blue states would lock down because there’s no electoral penalty in doing so but Democratic-run purple states would think twice after the backlash to school closures in Virginia produced a 12-point shift towards Republicans. And God only knows what heightened level of death red states would be willing to tolerate in the name of keeping businesses open. The culture-war politics of lockdowns and mandates has been so insanely polarized that GOP governors will probably begin ruling out stay-at-home orders this week, before the U.S. even has its first confirmed case.

Of course, the scarier the variant is, the less those orders would be needed to keep people at home. Even most risk-averse Republicans will avoid public places if the data on severe illness and death from Omicron looks sufficiently ugly.

Anthony Fauci is prepared to do “anything and everything” necessary to meet the threat, assuming there’s a threat at all. I wonder how many Americans agree with him after 21 months of COVID misery.

The best piece I’ve read on why Omicron has caused such alarm among experts is this one in Science, which is littered with statements from virologists about how their jaws dropped when they looked at the variant’s genome. This “family tree” generated by Trevor Bedford efficiently captures why they’re astonished. When other variants mutated, their spike proteins changed incrementally. Omicron, pictured in red at the top right, is an entirely different beast.

The vaccines were developed to target the spike protein on the original Wuhan coronavirus. Because the spike proteins on previous variants differed only a bit from that original spike protein, the vaccines have held up well. The antibodies they generate still “recognize” the spike on those variants. It’s anyone’s guess at the moment whether they’ll “recognize” Omicron’s spike. It’s like trying to identify a criminal suspect based on a “wanted” poster: If the suspect has changed his appearance only slightly since becoming a fugitive, such as by dyeing his hair, you might still ID him based on his facial resemblance to the poster if you ran into him. But what if the suspect has had extensive plastic surgery? He might walk right past you and you’d never know. That’s Omicron — maybe.

The head of Moderna isn’t mincing words about the potential threat. Scientists know from studying previous variants which mutations on the spike protein are associated with evading immunity. Omicron has all of them and then some:

“This is the highest level of alert we’ve ever been on, by far,” since devising the initial batch of vaccines last year, said Stephen Hoge, Moderna’s president. “What’s most scary about this virus is it’s managed to put all of its greatest hits into one [omicron] variant, and then has added maybe 10 mutations that we don’t even know what to think of yet.”…

The first data on omicron “scared the heck out of us, because it was like a Frankenstein mixture of the greatest hits,” said Hoge, Moderna’s president. The company on Friday announced a three-part strategy to combat the new variant, including work on targeted booster shots. “The world is primed to fight this thing again,” Hoge said.

Omicron’s spike is so radically different from previous incarnations of the virus that even the pros don’t have a sense of what they’re dealing with yet. What they’re able to infer isn’t promising, though: “Many of the changes in spike are around the receptor binding domain, the part of the protein that makes contact with the human cell. ‘That is very troubling,’ Farrar says. Structural biology mapping last year showed that some of these changes made the virus bind to the receptor much better.”

Still, there remains a real possibility that the variant will turn out to be more of a “scariant,” a new twist on the virus that seems ominous at first blush because of its mutations but then proves to be nothing special relative to Delta in practice. This is encouraging:

[T]he rising frequency could still be due in part to chance. In San Diego, a series of superspreading events at a university resulted in an explosion of one particular strain of SARS-CoV-2 earlier this year, Andersen says: “It was thousands of cases and they were all the same virus.” But the virus wasn’t notably more infectious. South Africa has seen relatively few cases recently, so a series of superspreading events could have led to the rapid increase of Omicron. “I suspect that a lot of that signal is explained by that and I desperately hope so,” Andersen says. Based on a comparison of different Omicron genomes, Andersen estimates that the virus emerged sometime around late September or early October, which suggests it might be spreading more slowly than it appears to have.

Cases in South Africa have risen rapidly this week but one health official said yesterday that there’s been no uptick in hospitalizations. If Omicron really is so hyper-contagious that it’s able to out-compete Delta, it seems strange that it took two months to generate a major outbreak and still hasn’t produced a spike in people needing emergency care. Maybe that’s just a byproduct of the variant spreading mainly among younger people so far, as they’re always less likely to need hospital care from COVID. But it could also be that Omicron is less virulent than Delta, which would be wonderful news.

I’ll leave you with Moderna’s Chief Medical Officer, who told the BBC yesterday that his company began mobilizing against Omicron on Thanksgiving morning and believes it can have a new vaccine tailored to the variant on the market in early 2022. Americans obviously aren’t going to put up with a long lockdown but I wonder if they’d tolerate a short one — say, if there’s a major outbreak of Omicron this winter just a few weeks before the new jabs are expected to reach pharmacies. There’d be no justification for a lockdown once the vaccine is available but many (most?) people might be willing to hunker down at home for a month or so to ride out the wave while waiting for the new shot to be made available.