Five things about omicron that I want my friends and family to know

As a health reporter who’s been writing about coronavirus since early January 2020, I often get questions about the pandemic. But after the omicron variant emerged last month, those questions became more urgent - with some readers complaining of mixed messages about the new variant and existing vaccines - and deeply personal, as friends and family tried to plan their winter holidays.

Over the weekend, I wrote a Facebook post trying to distill what I’ve heard from experts and officials as they race to fight the new variant. A lightly edited version of that post appears here.

1. Omicron might not be ‘mild’ for the unvaccinated.

The omicron variant is real, and the reports of it being “milder” appear mostly based on the generally mild breakthrough cases in vaccinated and previously infected people.

If you’ve been vaccinated and boosted, there’s reason to expect your omicron infection will lead to minimal symptoms.

If you haven’t previously been infected, and you haven’t been vaccinated, there’s no reason yet to expect a “mild” case.

Experts have warned, again and again: The bulk of the pain will be felt by Americans who remain unvaccinated, have had immunity wane from prior vaccines and are yet to get boosted, or are immunocompromised.

But anyone who swears that omicron will surely lead to a mild case in a vaccinated person is overpromising. Again, there’s good reason to expect it, but we don’t have the data to know for sure. This variant was only detected a month ago. Researchers are racing to keep up and study it in real-time.

And the picture from overseas isn’t always clear, especially because the demographics in southern Africa, where omicron first exploded, don’t line up perfectly with the older U.S. population.

2. Brace yourself for a positive test result. Omicron’s mutations make it very transmissible.

Many, many people who are vaccinated or previously infected are going to test positive in the next few weeks, given the omicron variant’s sheer transmissibility and ability to evade antibodies.

Every expert I’ve interviewed, including some of the nation’s top health officials, has adjusted his or her mind-set and now is mentally bracing to test positive after spending two years dodging the virus. “Breakthrough” cases are going to be normalized in a hurry, if they aren’t already.

To put it very simply, while earlier forms of the virus got stopped at your body’s front door if you were “fully vaccinated” or previously infected, omicron can get inside. Still, vaccines and boosters hold the power to defang the worst consequences of omicron and fight off infections. It’s possible that some folks reading this have omicron right now and don’t know it because their immune system is doing such a good job containing the infection and the symptoms are small or nonexistent.

3. This is exactly what boosters are for.

Boosters can specifically help by bringing your antibodies back to a level where there are enough of them, like bouncers at a club, to often keep omicron from getting inside.

Underlining that point: Boosters are one of the best tools to fend off omicron, per every study so far.

We also have far better testing than in early 2020 - though the United States dropped the ball on ensuring access to rapid tests, as anyone hunting for a test now has experienced. There is one monoclonal antibody treatment that appears to still work against omicron, but it’s in short supply.

4. Expect hospitals to be pushed to their limits.

Federal officials are bracing for U.S. infections to skyrocket into January 2022, with numbers that could top 500,000 new cases per day. (The previous peak was 250,000 cases per day in January 2021.) Some experts predict daily case rates that could be much higher, because so many vaccinated Americans are going to test positive, although we may not capture all the data from people taking at-home tests.

Even if only a small percentage of those people need hospital care, it will tax a health system that is already straining under pandemic fatigue and treating cases linked to the older delta variant. It’s also going to be a psychological blow after the past two years of fighting the pandemic, and businesses, families and others will surely be racing to adjust plans.

5. Upgrade your mask and think twice about taking risks. This month will be crucial.

Officials hope that the peak of the omicron wave will be over by early February.

A rise in covid cases is followed days later by a rise in hospitalizations, which is followed days later by a rise in deaths. This has been the consistent pattern for two years.

As a result, the next month in America could rival the worst days of the pandemic, as a sheer wave of cases crashes into our country. Every expert I spoke to is cutting back on scheduled plans, and several urged: Don’t take risks that could land you in a doctor’s office or hospital emergency room at a moment when demand on our health-care system is going to surge.

If you are passing through an airport or train station, you are undoubtedly being exposed to someone with omicron at this point.

As someone who’s been boosted and wears an N95 mask indoors, I feel like I’m taking the best precautions I can. I’m also exhausted with the pandemic and had started to get back to hobbies like swimming, going to movies, having dinner with friends.

But for me, the omicron variant means I’m going to pause some of those activities, and I’m going to make sure I’ve always got a high-quality mask with me to navigate crowds and indoor spaces. Even if infections are inevitable, I don’t want to help omicron along, especially until we get more data in the coming weeks. And I don’t want to unwittingly get sick and carry an infection to family members this holiday season.

Dan Diamond is a national health reporter for The Washington Post. He joined The Post in 2021 after five years at Politico, where he won a George Polk award for investigating the Trump administration’s response to the coronavirus pandemic.