The Data Shows Omicron is Milder. How Should That Affect Your Behavior? - The New York Times

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How should that affect your behavior?

The details of the Omicron variant are becoming clearer, and they are encouraging.

They’re not entirely encouraging, and I will get into some detail about one of the biggest problems — the stress on hospitals, which are facing huge numbers of moderately ill Covid-19 patients. But regular readers of this newsletter know that I try to avoid the bad-news bias that often infects journalism. (We journalists tend to be comfortable delivering bad news straight up but uncomfortable reporting good news without extensive caveats.)

So I want to be clear: The latest evidence about Covid is largely positive. A few weeks ago, many experts and journalists were warning that the initial evidence from South Africa — suggesting that Omicron was milder than other variants — might turn out to be a mirage. It has turned out to be real.

“In hospitals around the country, doctors are taking notice,” my colleagues Emily Anthes and Azeen Ghorayshi write. “This wave of Covid seems different from the last one.”

There are at least three main ways that Omicron looks substantially milder than other versions of the virus:

1. Less hospitalization

Somebody infected with Omicron is less likely to need hospital treatment than somebody infected with an earlier version of Covid.

An analysis of patients in Houston, for example, found that Omicron patients were only about one-third as likely to need hospitalization as Delta patients. In Britain, people with Omicron were about half as likely to require hospital care, the government reported. The pattern looks similar in Canada, Emily and Azeen note.

Hospitalizations are nonetheless rising in the U.S., because Omicron is so contagious that it has led to an explosion of cases. Many hospitals are running short of beds and staff, partly because of Covid-related absences. In Maryland, more people are hospitalized with Covid than ever.

“Thankfully the Covid patients aren’t as sick. But there’s so many of them,” Craig Spencer, an emergency room doctor in New York, tweeted on Monday, after a long shift. “The next few weeks will be really, really tough for us.”

The biggest potential problem is that overwhelmed hospitals will not be able to provide patients — whether they have Covid or other conditions — with straightforward but needed care. Some may die as a result. That possibility explains why many epidemiologists still urge people to take measures to reduce Covid’s spread during the Omicron surge. It’s likely to last at least a couple more weeks in the U.S.

2. Milder hospitalization

Omicron is not just less likely to send somebody to the hospital. Even among people who need hospital care, symptoms are milder on average than among people who were hospitalized in previous waves.

A crucial reason appears to be that Omicron does not attack the lungs as earlier versions of Covid did. Omicron instead tends to be focused in the nose and throat, causing fewer patients to have breathing problems or need a ventilator.

As Dr. Rahul Sharma of NewYork-Presbyterian/Weill Cornell told The Times, “We’re not sending as many patients to the I.C.U., we’re not intubating as many patients, and actually, most of our patients that are coming to the emergency department that do test positive are actually being discharged.”

In London, the number of patients on ventilators has remained roughly constant in recent weeks, even as the number of cases has soared, John Burn-Murdoch of The Financial Times noted.

3. And deaths?

In the U.S., mortality trends typically trail case trends by about three weeks — which means the Omicron surge, which began more than a month ago, should be visible in the death counts. It isn’t yet:

Data as of Jan. 3.Source: New York Times database

Covid deaths will still probably rise in the U.S. in coming days or weeks, many experts say. For one thing, data can be delayed around major holidays. For another, millions of adults remain unvaccinated and vulnerable.

But the increase in deaths is unlikely to be anywhere near as large as the increase last summer, during the Delta wave. Look at the data from South Africa, where the Omicron wave is already receding:

South Africa reported identification of Omicron on Nov. 24.Source: Johns Hopkins University

The bottom line

Given the combination of surging cases and milder disease, how should people respond?

Dr. Leana Wen, Baltimore’s former health commissioner, wrote a helpful Washington Post article in which she urged a middle path between reinstituting lockdowns and allowing Omicron to spread unchecked.

“It’s unreasonable to ask vaccinated people to refrain from pre-pandemic activities,” Wen said. “After all, the individual risk to them is low, and there is a steep price to keeping students out of school, shuttering restaurants and retail shops and stopping travel and commerce.”

But she urged people to get booster shots, recommended that they wear KN95 or N95 masks and encouraged governments and businesses to mandate vaccination. All of those measures can reduce the spread of Covid and, by extension, hospital crowding and death.

What about elderly or immunocompromised people, who have been at some risk of major Covid illness even if they’re vaccinated?

Different people will make different decisions, and that’s OK. Severely immunocompromised people — like those who have received organ transplants or are actively receiving cancer treatment — have reason to be extra cautious. For otherwise healthy older people, on the other hand, the latest data may be encouraging enough to affect their behavior.

Consider this: Before Omicron, a typical vaccinated 75-year-old who contracted Covid had a roughly similar risk of death — around 1 in 200 — as a typical 75-year-old who contracted the flu. (Here are the details behind that calculation, which is based on an academic study.)

Omicron has changed the calculation. Because it is milder than earlier versions of the virus, Covid now appears to present less threat to most vaccinated elderly people than the annual flu does.

The flu, of course, does present risk for the elderly. And the sheer size of the Omicron surge may argue for caution over the next few weeks. But the combination of vaccines and Omicron’s apparent mildness means that, for an individual, Covid increasingly resembles the kind of health risk that people accept every day.

More on the virus:

• The U.S. doubled its order for Pfizer’s Covid treatment pills, to cover a further 10 million patients.

• Public school officials in Chicago have canceled all classes today amid a clash with the teachers’ union.

• The Australian Open granted Novak Djokovic, the No. 1 men’s tennis player, an exemption to its vaccine requirements. But it is unclear whether he will be able to enter the country.

THE LATEST NEWS

Politics

• The House committee investigating the Capitol attack is asking Sean Hannity about his communications with Donald Trump.

• U.S. authorities have made more than 700 arrests in connection with the attack. Here’s where the investigation stands.

• President Biden’s expanded child tax credit was supposed to be too popular to expire. Here’s why it wasn’t.

Business

• More than 4.5 million Americans quit their jobs in November, many for new jobs with higher pay.

• Toyota outsold all other carmakers in the U.S. last year, a first for a foreign manufacturer.

Other Big Stories

Stranded drivers in Carmel Church, Va., yesterday.Steve Helber/Associated Press

• A snowstorm in Virginia stranded hundreds of drivers, including Senator Tim Kaine, for more than 24 hours.

• An epidemic of gun violence is killing American children, fueled in part by rising gun sales.

• Canada reached a settlement over its mistreatment of Indigenous children.

• Ben Smith, The Times’s media columnist, is leaving to start a global news organization.

Opinions

Relaxing is a skill. Farhad Manjoo has tips.

Two years into the pandemic, public health officials still aren’t leveling with us, Zeynep Tufekci writes.

MORNING READS

Yohei Matsuki at Sushi Ginza Onodera in West Hollywood.Rozette Rago for The New York Times

Taste: Tejal Rao explains how Los Angeles developed America’s most robust sushi scene.

Ask Well: Can you exercise too much?

Faking it: The epic rise and fall of Elizabeth Holmes.

The 30,000-acre lab: Wildfire research is helping foresters prepare for a hotter planet.

The Coronavirus Pandemic: Key Things to Know

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Card 1 of 6

The global surge. The virus is spreading faster than ever at the start of 2022, but the last days of 2021 brought the encouraging news that the Omicron variant produces less severe illness than earlier waves. As such, governments are focusing more on expanding vaccination than limiting the spread.

Boosters. The C.D.C. endorsed booster shots of the Pfizer vaccine for children ages 12 to 17, citing rising infections in teens and young adults. The agency also said being “up to date” on the vaccine now includes having a booster, though it was not yet changing its definition of “full vaccination.”

School disruptions. The post-holiday surge has caused some U.S. districts to postpone reopening or switch to remote instruction. In Chicago, classes were canceled entirely as teachers resisted returning to school. But other large school systems, including New York City, have stayed open.

I.C.U.s and Hospitals. Covid hospitalizations in the U.S. are surging, but a smaller proportion of patients in Omicron hot spots are landing in intensive care units or requiring mechanical ventilation. Use our tracker to see how I.C.U.s in your area have been affected.

Around the world. President Emmanuel Macron of France drew criticism for saying the government should make life miserable for the unvaccinated, while the W.H.O. said a different variant found in the country is not a concern. In India, a sharp rise in Omicron cases is bringing a grim sense of déjà vu.

Staying safe. Worried about spreading Covid? Keep yourself and others safe by following some basic guidance on when to test and how to use at-home virus tests (if you can find them). Here is what to do if you test positive for the coronavirus.

Live long and prosper: An exhibit explores the Jewish roots of “Star Trek.”

Lives Lived: Lisa Brodyaga took on the cases of refugees fleeing bloodshed in Central America pro bono and was a thorn in the side of border agencies. She died at 81.

ARTS AND IDEAS

Paramount Pictures

A new “Scream”

In 1996, “Scream” turned every slasher trope on its head: Its characters were talky and well-versed in the genre’s rules, rolling their eyes at its clichés. The movie infused horror with self-aware humor, inspiring many imitators and reviving its director Wes Craven’s career. His final film before his death would be “Scream 4” in 2011.

After more than a decade, Neve Campbell, Courteney Cox and David Arquette have returned to the meta-horror franchise with a new film. The plot: another killer in a Ghostface mask is plaguing the fictional town of Woodsboro, demanding the attention of the original trio.

The shoot was moving for Arquette. In circumstances mirroring the former couple’s real life, Arquette and Cox acted out a story in which their “Scream” characters have split up. “There were moments when I felt Wes’s spirit around a lot,” he said. “There would be a wind blowing and I’d see Courteney’s hair move back. And then it’s just like —” He made an exaggeratedly mournful weeping noise. “It made it really easy to tap into those feelings.”

Campbell said she was grateful to play a horror-movie heroine who wasn’t a helpless victim. “I’m very lucky, as a woman, to have gotten a role where people come up to me and say, ‘Sidney Prescott inspired me — Sidney Prescott made me more courageous, made me less insecure, made me stand up for myself,’” she said. — Sanam Yar, a Morning writer

PLAY, WATCH, EAT

What to Cook

Linda Xiao for The New York Times

Sheet-pan recipe of the week: Roasted butternut squash bread salad, an earthy take on panzanella.

What to Read

Jean Chen Ho’s debut story collection, “Fiona and Jane,” follows the milestones of growing up, Tammy Tarng writes in a review.

What to Listen to

5 minutes that will make you love the mezzo-soprano voice.

Late Night

Stephen Colbert has a backup plan for parents in the pandemic.

Now Time to Play

The pangram from yesterday’s Spelling Bee was pantheon. Here is today’s puzzle — or you can play online.

Here’s today’s Mini Crossword, and a clue: Toy bear named for a president (five letters).

If you’re in the mood to play more, find all our games here.

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Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. A hidden haiku from the story about sushi chefs: “They know what you want, / and sometimes even what you / don’t yet know you want.”

Here’s today’s front page.

“The Daily” is about the riot at the Capitol.

Natasha Frost, Ian Prasad Philbrick, Tom Wright-Piersanti, Ashley Wu and Sanam Yar contributed to The Morning. You can reach the team at themorning@nytimes.com.

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