U.S. policymakers must implement practical pandemic strategies that save hospitals while minimizing societal disruption, according to an op-ed published Jan. 3 by The Washington Post.
The viewpoint is penned by Leana Wen, MD, visiting professor at Washington, D.C.-based George Washington University Milken Institute School of Public Health and former health commissioner for Baltimore.
Dr. Wen reconciles the often contradictory current state of affairs with this: "The risk to individuals is low, while the risk to society is high." She cites research that suggests omicron causes less severe disease than other variants, and vaccination — especially with a booster — appears highly effective against hospitalization and death. Many vaccinated people will have breakthrough infections, she writes, but most will only have mild cold or flu symptoms.
Therefore, "it's unreasonable to ask vaccinated people to refrain from pre-pandemic activities," Dr. Wen writes. Individual risk is low, and there is a high price to keeping students out of school and halting travel and commerce. However, a wildly spreading virus poses existential threats to society, as hospitals across the U.S. shift to crisis standards of care or postpone nonurgent procedures.
The U.S. has three options. Dr. Wen believes reimposing lockdowns is "a nonstarter" lacking public backing. The second option is letting omicron run its course, which would most likely push many hospitals to the brink and patients unable to access care could die, she writes.
The third option, which Dr. Wen is a proponent of, is a "practical middle path that balances what Americans can tolerate with what we need to do to avert the collapse of our healthcare system." Americans wouldn't have to stay home, but would have to wear high-quality masks in all indoor public spaces. Gatherings wouldn't be canceled, but instead proof of vaccination and boosters would be mandated at all indoor dining, gyms and sporting events.
The CDC's shortened isolation period for those with COVID-19 can go even further, Dr. Wen writes, suggesting reduced isolation and quarantine (while requiring high-quality masks) for those working in public safety, transportation, education and other critical jobs.
Meanwhile, officials must do more to protect vulnerable Americans, including ensuring boosters for nursing home residents and staff, increasing production of preventive monoclonal antibodies for the immunocompromised and expediting vaccine approval for children under 5.
This is our new reality, Dr. Wen concludes. "As long as vaccines continue to protect against severe illness and the risk to most individuals remains low, our paradigm has to shift from preventing infection to stopping societal devastation."