Analysis: Omicron’s biggest threat is to our weakened public health system

Thinking about risk individually won’t cut it, now more than ever. Are we up to the challenge?

British Columbia’s public health system is frail and ravaged from two years of COVID-19 pandemic response. Now, it faces what could be its biggest threat: a surge in cases fueled by the super-contagious Omicron variant. 

Omicron poses a much bigger challenge to us collectively than individually. Reporter Ed Yong, who recently won a Pulitzer Prize for his coverage of the pandemic, eloquently made that case in the American context in a recent article for The Atlantic

Most young, vaccinated people are unlikely to get very sick from Omicron. The individual risk, for many people, is low. But the collective risk is very high. Because it spreads faster, this virus will quickly find its way to vulnerable people, many of whom will need care for COVID-19 at the same time. The B.C. government is already cancelling surgeries to make room for an anticipated surge in COVID-19 patients. 

Hospitals, already pushed to their limits, will be asked to do more. Staff shortages will be exacerbated as doctors and nurses contract the virus and are forced to self-isolate. The result will be worse care for everyone, not just COVID-19 patients. And the impacts will continue to fall more heavily on those who are already marginalized and vulnerable, making inequalities in our society even worse. 

This wave, like the others that came before, will pass. But it has the potential to leave a lot of damage in its wake.

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When provincial and federal governments ask you to cancel your holiday travel plans, to cancel your parties and un-invite your unvaccinated loved ones, it’s not for your safety — not exactly. You’re being asked to make sacrifices that aren’t necessarily in your self interest in order to protect overwhelmed hospitals, exhausted health-care workers and people you don’t know. 

It’s important to be honest about that. As journalists Jesse Brown and Nora Loreto say in a recent episode of the CANADALAND podcast, both governments and the media are guilty of trying to scare people into doing the right thing. That deflects attention from the systemic issues and policy failures that put us in this position. It also degrades trust. 

I wrote last week about ways to consider and manage risk when making holiday plans. Those individual actions are important. But to get a handle on this pandemic, we’ll need to think about risk beyond our immediate circles. 

Related article: As COVID cases rise, here’s what you need to know

I don’t have all the answers. But I’ll do my best to address some of the questions and concerns I’ve heard in response to my column last week. 

Doesn’t Omicron cause milder disease than other variants?

It may be true that Omicron is less likely to send you to hospital than Delta or the variants that came before. Many experts take the position that we still don’t know enough to say. Omicron is behaving quite differently from other variants, and it is so new and has emerged so quickly that the global community is still scrambling to understand it. 

But even if Omicron turns out to cause milder disease, on average, than other variants, its potential to quickly overwhelm hospitals remains very real. That’s the trajectory that B.C. is on, officials said on Tuesday. Reducing transmission is urgently needed to blunt the impacts on the health-care system.

By the crude calculation of CBC reporter Justin McElroy, even if Omicron was (hypothetically) half as likely to send an individual to hospital, B.C. could soon see three times as many people needing hospital care for COVID-19 as the previous high. 

This emphasizes, again, how the Omicron variant poses a bigger threat to us collectively than individually. 

If vaccination doesn’t protect against infection, what’s the point?

I received an email last week from someone who said that, since vaccination won’t prevent infection, they’d rather contract the disease and get immunity that way. 

Based on what we know now, it seems that twice-vaccinated individuals are no longer well-protected from infection. But the vaccines still offer significant protection against severe disease and death. We also don’t know enough to say what the long-term effects of Omicron infection will be. Previous variants have caused significant long-term symptoms even in people whose initial disease was considered to be mild.

The vaccines still offer protection, and some protection is better than no protection, both from an individual and public health perspective. Atlantic reporter Ed Yong suggests that the protection offered by two doses against Omicron is roughly similar to the protection of one dose against Delta. By the same measure, getting a third “booster” dose offers similar protection to what two vaccine doses offered before.

Immune system benefits through vaccination and infection aren’t mutually exclusive. They offer layers of protection. It is much safer to get an immune response from vaccination than infection.

Why won’t the media talk about the risks of vaccination?

It’s not true that the media won’t cover the risks of vaccination. Rare-but-serious side effects tied to the AstraZeneca vaccine, for example, led governments to pull access and offer vaccines with fewer known risks. 

That said, the overwhelming evidence is that vaccines are critical for individual and community protection from COVID-19. Vaccines are not perfectly safe. But it is far safer to be vaccinated than not to be vaccinated during this pandemic. 

I know that there are individuals who feel their concerns around vaccine safety have been ignored. And there can be a reluctance among journalists to seriously talk about this, for fear of encouraging doubt and hesitation around vaccines. But that can backfire. When journalists shy away from complexity, they lose trust and fuel conspiracy theories. The media can and should do better.

Why should I trust you?

Through this pandemic, I’ve done what I can to stay on top of the best available information. I care deeply about sharing information that is grounded in solid evidence and useful to people where I live. I want my articles to contribute to stronger, healthier, more resilient and more equitable communities. 

The Discourse is supported directly by its readers, which means our business model depends on building trust. Fear-mongering erodes trust, and I do my best to never overstate or understate the facts as I understand them. I’m not perfect, but I do my best to be transparent, including when I make mistakes. 

I’m fully vaccinated and I’m not scared of Omicron. I’ve done everything right and I just want to see my friends and family. Why should I cancel my plans to protect people who chose not to get vaccinated? 

I don’t have a perfect answer. All of us must make very complicated decisions right now about personal risk, the risk to our loved ones, the risk to our communities and the risk to public health systems. I hope we’ll all do what we can to blunt Omicron’s spread. 

It’s so important to connect with loved ones in these dark and difficult days. Little actions to do that in safer ways, such as keeping your bubble small and tight, make a meaningful difference. Those actions multiply when we all do them together. 

I believe that all of us are trying to make good decisions with the resources we have and the information available to us. If we can spend more energy focused on systemic issues rather than individual blame, I think we’ll all be better off. 

It’s one variant after another, with this pandemic. Are we just going to keep fighting this losing war forever? 

Speaking of systemic issues: the global failure to get vaccinations distributed around the world plays a huge role in the mess we find ourselves in. 

The future is uncertain. Is another, scarier variant coming in 2022? Or is it possible, as Provincial Health Officer Dr. Bonnie Henry suggested on Tuesday, that we could soon turn a corner on the worst of the pandemic as population immunity increases? 

I hate that we’re still in this. I want to give up and give in, a lot of the time. But I also understand that what’s being asked of me is a small thing next to what’s being asked of health-care workers and many others. The consequences of giving up, individually and collectively, remain far worse than doing what we can to limit the impacts of this pandemic. [end]

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