Viewpoint: Those Who Underestimate Omicron Aren’t Doing the Math


Infectivity causes more harm and deaths than lethality and in the case of Omicron more than makes up for its somewhat milder infections in immunologically naive individuals.

From what I have seen, the data on Omicron has been spun to paint a rosier picture than what the data truly show. The mild results are largely from the large number of reinfections and breakthrough infections in those who, if they had Delta, probably would not have been infected in the first place. Infectivity causes more harm and deaths than lethality and in the case of Omicron more than makes up for its somewhat milder infections in immunologically naive individuals.

Kevin Kavanagh, MD

Kevin Kavanagh, MD

For example: If for every infection the virus spreads to 2 people in the first week a person is infectious, then in 1 month 16 people will develop the disease. If the virus is 10% fatal, then 1.6 will die. If you double the case fatality rate, then 3.2 individuals will die. But if you double the infection rate to 4, then 256 will become infected and 25.6 will die. Thus, in this example doubling infectivity results in over 8 times the deaths as doubling the case fatality rate.

When you walk into a retail store your chances of dying are a combination of your chances of being infected and the case fatality rate of the virus. Your chances are much better with a virus which is twice as lethal as one which is twice as infectious.

With Omicron, the math does not indicate a mild wave in the United States. We have too high of an unvaccinated population for this wave to be mild and in the young, this variant may cause even more severe disease.

Currently, Ohio has the highest rate of COVID-19 hospitalizations it has ever had during this pandemic and there are critical staff shortages with the triaging of care in some areas of our nation. The disinformation that hospitalizations are being inflated by needlessly hospitalizing mild COVID-19 cases is ridiculous. In actuality, needed care for heart disease and cancer are being postponed because the unvaccinated are needlessly filling the hospitals with severe illness.

With Omicron there is little upside of its infectivity. Herd immunity is not possible due to fleeting immunity with a highly mutating RNA virus which already resides in animal hosts.

Our best protection is to become fully vaccinated, including boosters, along with optimizing ventilation in buildings, wearing N95 masks and frequent testing. Schools might be able to be opened with a degree of safety, if these mitigation strategies are rigorously followed, but if not, both students and teachers will be at risk. In addition, it needs to be remembered that Omicron causes more severe disease in children than with other variants.

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