The COVID-19 pandemic is a rapidly changing landscape. We are long gone from the days of being threatened by a rampant Alpha virus to having several successive variants. It now appears that the very fast-spreading Omicron may become dominant over yesterday’s Delta variant. We now have multiple vaccines – mRNA and traditional in the U.S. and an even greater array outside the U.S. We have the emergence of monoclonal antibodies and protease inhibitors being utilized or being considered as treatments for various stages of disease. We even have a pile of misinformation.
Today CDC provided important insight into the ability of the new variant to make headway with a highly vulnerable population when it released data on infections in the nursing home environment.
What is evident in looking at the profile provided by the CDC is that the most at risk or infection in the wake of the rise of Omicron is naturally among the unvaccinated. However there is also an alarming rise among people who have completed their primary vaccination. While there were people who were infected with the booster, the profile and trend is low.
This begs the question that has been circulating for a while now with a new urgency. Many policies – from return-to-work to allowing admission to various facilities have been premised on people showing evidence of being “fully vaccinated” meaning having completed two rounds of vaccination with an mRNA vaccine or had one dose of the Johnson & Johnson vaccine.
It would seem that Omicron has rendered that definition outmoded. Because so many decisions, both institutional and personal, rely on that definition, it is clear that it needs to be changed to incorporate the role of additional vaccination.
The change is not only important for the immediate environment, but it stands to reason that as future variants emerge, there is going to be a need to consider additional interventions, either by boosting existing vaccine status with more shots, or with the development of multi-variants. What is fully vaccinated today may not be fully vaccinated tomorrow. It is clear that COVID is something we are going to have to learn how to live with and work around. Given the fluidity of the environment, part of that effort includes re-examination and recalibration of the way we talk about the pandemic, particularly with definitions on which so much policy is decided.