COVID-19 Resource Center

COVID-19 Resource Center

Issue: January 2022
Disclosures: Adalja, Biden, Marrazzo and Offit report no relevant financial disclosures.
January 21, 2022
3 min read
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Rise of omicron complicates response to pandemic

Issue: January 2022
Disclosures: Adalja, Biden, Marrazzo and Offit report no relevant financial disclosures.
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In late November, at the behest of independent advisors, WHO classified omicron as a SARS-CoV-2 “variant of concern” amid signs that it was highly transmissible and carried an increased risk for reinfection.

Officials in the United States began preparing for a surge of infections, even as evidence emerged that omicron may cause less severe disease than the delta variant. The CDC urged all adults to get COVID-19 booster shots, citing data released by the vaccine manufacturers that an extra shot increased protection against omicron.

“This variant is a cause for concern, not a cause for panic,” President Joe Biden advised in a press briefing.

Experts were critical of several aspects of the U.S. response to omicron, including Biden’s announcement on Dec. 21 that the U.S. — as part of a plan to combat the variant — would purchase 500 million at-home rapid tests and distribute them for free to Americans beginning in January.

“The president’s plan has some laudable actions, most notably the provision of rapid diagnostic tests to help people ascertain whether they pose an infectious risk to friends and family in the coming weeks. Unfortunately, this effort is coming too late to avert what is sure to be a huge wave of omicron cases related to gatherings over Christmas,” said Infectious Disease News Editorial Board Member Jeanne M. Marrazzo, MD, MPH, director of the division of infectious diseases at the University of Alabama at Birmingham.

Jeanne M. Marrazzo, MD, MPH
Jeanne M. Marrazzo

Questions also remained about who would end up getting tested, said Paul A. Offit, MD, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“I think the people who are most likely getting testing are people who care about their own health and care about the health of those with whom they come into contact. Those are likely vaccinated people,” Offit told Healio | Infectious Disease News.

Paul A. Offit, MD
Paul A. Offit

In late December, the CDC updated its guidance to say that any asymptomatic people with COVID-19 could isolate for 5 days instead of 10, followed by 5 days of wearing a mask around other people — similar to guidance it issued for health care workers.

It also loosened quarantine recommendations for people who had been exposed to a case. The guidance for unvaccinated people and people who were more than 6 months removed from a two-dose messenger RNA series or 2 months removed from a shot of the Johnson & Johnson vaccine was the same: quarantine for 5 days, followed by strict mask wearing around others for another 5 days.

CDC Director Rochelle P. Walensky, MD, MPH, noted the omicron’s quick spread and its “potential to impact all facets of our society.”

“CDC’s updated recommendations for isolation and quarantine balance what we know about the spread of the virus and the protection provided by vaccination and booster doses,” she said in a statement. “These updates ensure people can safely continue their daily lives.”

The guidance was met with some criticism, including from experts who said the CDC did not place enough emphasis on testing.

Amesh A. Adalja, MD
Amesh A. Adalja

Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, said the updated recommendations reflected the virus’ new status as endemic.

“It’s been clear for some time that a one-size-fits-all period for isolation did not fit the period of contagiousness. The updated guidance reflects the fact that this is going to be an endemic virus, and the disruption that a case causes can be safely minimized based on the enhanced scientific understanding that has accumulated,” Adalja told Healio | Infectious Disease News.

“I am, however, unclear as to the differential quarantine recommendations for those boosted vs. those who are not,” he said. “I do not think it’s justified to treat those fully vaccinated as identical to those who have zero vaccine doses.”