Initial Thoughts on Omicron and Vaccines

You've no doubt seen discussion in the news and social media about the emerging coronavirus variant called Omicron. It was first detected in South Africa, but is now in many countries including the U.S. Because it is fairly new, it's hard to say much definitive about it. I recommend keeping an eye on knowledgable commentators (a few links below).

Initial data from South Africa suggest that it is spreading very fast, and that prior infection with COVID does not give protection (at least robust protection) against Omicron. How well the vaccines protect remains to be seen, but we will likely see a lot more breakthrough cases than with Delta. The reason, simply put, is that the Omicron spike protein has changes that will prevent some of the antibodies that were previously generated from recognizing the Omicron spike. It's not all or nothing; rather, it's degradation by degree.

I made the following figure to illustrate how I think about COVID vaccines. Ideally, most people stay in the first stage, and very few people proceed to the bottom stages. With Omicron, we will probably see more people (either vaccinated or previously infected) go further down than they would if this was just another Delta wave. People with no COVID or vaccination history are simply at the mercy of nature.

What can you do? The same kinds of things you've already been doing. However, you need to be fully vaccinated, including the booster. For one thing, the Delta variant is still very prevelant and we are heading into winter [1]. So you want to be as protected as possible against it. But even if the vaccine isn't as potent against Omicron, there is every reason to expect that it will still be helpful. Whether you have previously had COIVD or not, get fully vaccinated so that your immune system is as prepared as possible for Omicron. Even if the antibodies are not as good as they could be, having them at higher concentration will help. Also, there's more to the immune system than antibodies (namely, T cells), and they need to be on high alert too.

A Few Suggested Information Sources [2]:
Your Local Epidemiologist (Katelyn Jetelina) (Twitter / Substack)
Scott Gottlieb (former FDA commissioner)
Carl Zimmer (science reporter - one of the best in the business)

Notes:
1. As our family was leaving for our Thanksgiving trip, we learned of deaths in the extended family of some friends. The friends were vaccinated, but their rural relatives refused to get vaccinated (for the reasons you can imagine), even though an uncle had died of COVID. A birthday party for the father became a superspreader event, resulting in four hospitalizations. The father died, and at the last update a 31 year-old cousin was on a ventilator and expected to die [update: confirmed dead]. You make your choices, but you don't choose the consequences.
2. I've chosen a few relatively non-technical resources. Keep your eyes on these professionals and those they recommend. Beware of contrarians.