As we move deeper into January, it will be important to monitor whether the steep rise of Omicron cases is followed by a rapid decline, as has been seen in South Africa. This would make the Omicron wave intense but short-lived. However, a rapid decline is not guaranteed. South Africa has a younger population compared to the United States, and younger people are more likely to have mild, undetected infections. South Africa is also in summer, which is less favorable for virus transmission.
Other countries like Britain, which has demographics more similar to the United States and is also in winter, will be critical to watch. If Britain also experiences a rapid case decline, that may bode well for the United States.
The implications for hospitalizations and deaths here from the Omicron wave are even less certain. While Omicron is causing record numbers of infections, the hope is that vaccinations, booster shots and prior infections by other variants will still protect most people from the worst effects of the virus. Early evidence supports this conclusion. However, Omicron may still greatly affect our daily lives in other ways: If teachers test positive and schools move to remote instruction; if flights, subways and buses are disrupted because of a lack of workers, or if elective surgeries are postponed because of staffing shortages.
What will happen beyond January? We don’t yet know the ultimate fate of SARS-CoV-2 and all its variants. The future burden of Covid depends in large part on whether highly transmissible variants able to evade pre-existing immunity, such as Omicron, continue to emerge.
If new variants arise roughly twice per year, for example, then we should expect multiple outbreaks each year, even in the summer. If such variants emerge less frequently, then outbreaks might occur annually or even less frequently. The severity of these outbreaks will depend on the characteristics of those new variants and whether prior infections, vaccination and new drugs can keep people at a lower risk of severe disease.
The long-term implications of Omicron remain unknown, but in the near- term, everyone should expect an intense month of disruption. Still, the familiar advice remains the best: get vaccinated, get booster shots and prepare for a bumpy January.