p Dr. Dennis Y. Fong, M.D.
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Covid Advice #19 (01/09/2022):
Omicron is Not a Blessing

- from Dr. Dennis Fong -

The best of 2022 to you!

Is Omicron a blessing? While Omicron is ripping through the country, there are some voices saying that Omicron is actually a blessing in disguise, that it will
    A. Lead to herd immunity and
    B. Turn Covid into nothing more serious than the flu.

A. Omicron Itself Proves There Will Be No Herd Immunity for Covid

The idea of herd immunity is that if most everyone would just go and get infected, some old and weak people may die, but the majority will recover and become immune, and then the pandemic will be over. With Omicron, the idea is that it's so contagious that it's inevitable that most everyone will get infected, but then it will make most everyone immune to Covid and thus end the pandemic. I say, however, that not only will Omicron not bring herd immunity, but that Omicron itself proves that herd immunity for Covid is not going to be possible.

Omicron has a very strong ability to evade the immune system, and therefore breaks through immunity whether gained from vaccines or prior infection. In the past 20 days I have had way more of my patients infected by Covid than in any other similar period of time since the pandemic, and all have had the booster. Similarly, Omicron has no respect for prior infection either. Being infected is only 19% protective, and to get herd immunity you need at least 60% protection even if way over 80% of the population get infected.

But when most people have gotten infected with Omicron, wouldn't that constitute a herd immunity to Omicron? Not to Covid, however, because after Omicron peaks in the population, there will be another variant, just as capable of breaking through immunity from prior infection. There will be an Omicron version 2, 3, 4, and so on. Even influenza, which is far inferior to Covid in mutation ability, does this every year, such that we need a new flu shot every year, so having new Covid variants that don't respect prior infection is inevitable. And variant generation will happen faster than influenza, because not only is Covid all season while the flu is only in the winter, but also the number of infections both in America and the rest of the world is so big, and Omicron has just made the number dramatically bigger. The virus keeps getting more and more millions of human bodies in which to mutate.

Would anyone suggest that everyone getting the flu one winter will end the flu for all the winters to come? No, we all know that every winter there will be a new flu "variant". Suggesting that everyone gettig the Omicron Covid now will end the Covid pandemic is just as unrealistic.

B. Omicron Will Most Likely Not Change the Pandemic Into Just the Flu

Omicron has fewer deaths per 1,000 infected persons than Delta or the original Covid. Some people are saying that after some weeks of high numbers, Omicron numbers will decrease and then Covid deaths will become just like the flu, with only 10,000 or 20,000 dead a year. Then there will be nothing to worry about. I hope that's going to come true, but I am afraid not, because of 4 things.

  1. Total deaths haven't decreased: The death rate % has decreased but the number of cases has increased, so the total has not decreased. While during the 4 months from August to November 2021 when Delta was dominant, the average total daily deaths was 1,369 (Johns Hopkins data), from December to January 8th yesterday when Omicron has been dominant, the average total daily deaths has been 1,465. It is even more in the most recent week ending yesterday, at 1,635. Now for the flu, with only 10,000 to 20,000 people dying a year, the average daily increase should be only 27 to 54. Even if we make allowance that the pandemic will exceed the flu, at 50,000 deaths a year there should still be an average daily death of only 137 people, a far cry from what we are seeing.

  2. More variants coming: Like I said in Section A above, there will be another Covid variant after Omicron peaks, and another peak of infections will bring another peak of deaths, much higher than the flu.

  3. Long Covid: There is no "long flu" but there is long Covid. It is not known how high the incidence of Omicron's "long Covid" is. If it is like the original Covid, it will be 10-30% according to the New England Journal of Medicine. Now we may be lucky and the incidence of long Covid for Omicron is much lower, but the number of infections is so great and there are so many children and young adults infected (long Covid happens mostly to younger people), it will probably be a great burden for many individuals, families, and the country as a whole.

  4. Chronic infection?: there's no "chronic flu" but there just might be chronic Omicron. It is not yet known whether Omicron, which can evade the immune system so well, can evade it long term so as to survive indefinitely in the human body, like the hepatitis B virus. If so, then in the years to come it may lead to chronic diseases, cancer, etc. Moreover, Omicron is not limited to the liver. The ACE2 receptor, which is the gateway into the cell for Covid viruses, is mainly found, other than in the lungs, in the lining cells of the tiny capillary blood vessels. That means most of the human body, especially the brain, heart, kidney and gastrointestinal tract. So it's possible that Omicron or other Covid variants can cause many more diseases than just liver ones like with Hepatitis B. This would be worst for those who get infected when young. I am hoping that chronic infection doesn't happen, but with such great ability to evade the immune system, it is a possibility.

Therefore, I say that we should try not to get Omicron, even though the death rate is low, and even though we may have been vaccinated. We should still take strong personal protection measures, and protecting ourselves will also protect everyone else.

There's a lot of research going on, soon we will know more about Omicron's and Covid's long term effects, and soon we will get medical breakthroughs. Yes, hopefully Omicron will make things all rosy like some people are thinking, but until we know that for sure, we should be prudent with our health and everyone else's -- getting infected usually means possibly spreading it to someone else.

Wish you happiness! Stay healthy and stay safe!

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