December 3, 2022

The Omicron variant spreads so quickly and generally causes such a mild form of illness among vaccinated populations that countries are tolerating greater Covid-19 outbreaks, willingly letting infections balloon to levels that not long ago would have been treated as public-health crises.

From different starting points, authorities in North America, Europe and the Asia-Pacific are moving in the same direction, offering a glimpse into a future in which Covid-19 becomes accepted as a fact of everyday life, like seasonal flu.

Health officials everywhere, many for the first time, are forgoing some of the sharpest tools they have to combat Omicron—even as infections soar. They are accepting the virus like never before to minimize disruptions to economies, education and everyday life.

At the moment, deaths and hospitalizations are at highs in many countries, and in some, hospitals are overwhelmed. But they are a much lower percentage of total cases than earlier waves. Vaccines have made the disease less deadly, and treatments hold a greater promise of recovery for those who are infected and get seriously ill.

That improving outlook, coupled with the reality that the measures taken to contain earlier surges of the virus don’t work as well against the more-contagious Omicron, is informing the decision by policy makers to abandon restrictive steps aimed at containment amid growing public fatigue over restrictions.

That makes Omicron a key turning point in a pandemic rounding into a third year. Public-health authorities had long championed flattening infection curves and shouldering personal responsibility to socially distance, wear face masks and get vaccinated. But the Omicron variant is regarded as so transmissible that even the harshest and economically most-damaging lockdowns are unlikely to keep the virus out. In South Africa, the U.K. and some countries hit earlier than the U.S. by Omicron, case counts surged rapidly and then declined quickly, a different pattern than earlier variants.

The U.K.’s prevalence of Covid-19 hasn’t translated into deaths to the extent seen earlier in the pandemic.



Photo:

andy rain/Shutterstock

That assessment is forcing a recalculation by health officials over what can—and should— constitute success. “Governments don’t want to be accused of being slow to relax anymore,” said Teo Yik-Ying, dean of the National University of Singapore’s Saw Swee Hock School of Public Health.

Meanwhile, millions of people are becoming infected and suffering mild or no symptoms. From South Africa to Europe to Asia, governments have largely experienced manageable levels of hospitalizations and death.

Rapidly rising case counts are no longer the bellwether they once were, undermining the conclusion that more cases call for more restrictions.

“We’ve understood we’re not going to be able to eliminate the virus,” said Monica Gandhi, an infectious-disease specialist at the University of California, San Francisco.

There is a growing acceptance among governments that Covid-19 will need to be dealt with like other infections, focusing on treating hospitalized patients, as vaccines keep many people from becoming severely ill, she said.

Anthony Fauci,

President Biden’s top medical adviser, said recently that levels of death and hospitalization associated with Covid-19 in the U.S. justified precautions including masking in many settings to continue for now. But a future in which the disease is under sufficient control is in sight, he said.

“We believe we can get there because we have the tools with vaccines, with boosts, with masks, with tests and with antivirals,” Dr. Fauci said. “We still have a way to go.”

Australia has reported more infections and deaths this month than it had throughout the entire pandemic. During past outbreaks, the country’s border closures were so strict that some citizens were stranded overseas or faced two-week quarantines once back home. This time Australia has imposed no such limits.

“You have two choices here. You can push through, or you can lock down,” Prime Minister Scott Morrison said in January. “We’re for pushing through.”

Queuing up for Covid-19 tests in South Korea, where authorities have pledged not to tighten restrictions.



Photo:

yonhap/Shutterstock

Tools that were used earlier in the pandemic, such as contract tracing and long self-isolation periods, are being abandoned in many countries. Five U.S. public-health groups recently said they supported a move away from blanket Covid-19 case investigations and contact tracing.

The groups, including the Association of State and Territorial Health Officials and the Council of State and Territorial Epidemiologists, said the wide availability of vaccines and Omicron’s infectiousness made a comprehensive monitoring approach less optimal. Instead, the groups said health officials should focus on targeted investigations in higher-risk settings that serve vulnerable populations.

Schools that once shut down for months when hit by a Covid-19 outbreak are now closing for days. In the U.S., Burbio Inc., a data company that tracks K-12 school closures, showed 7,461 schools weren’t offering in-person learning one or more days during the week beginning Jan. 10. The number had dropped to 2,103 in the week of Jan. 24.

The healthcare industry is also shifting away from strict isolation measures. ShiftMed, an online platform with more than 60,000 users that allows U.S. healthcare workers to pick up open shifts at healthcare facilities, said many nurses are being asked to work despite testing positive for Covid-19.

In a survey of 600 nurses, 33% said they were asked to work despite having asymptomatic Covid-19 and 37% said they were asked to come into work despite being exposed to Covid-19 by a close contact. About 90% of nurses surveyed were vaccinated.

In the U.K., where case counts at the start of the year were running at almost triple the rate of the previous highs a year earlier, the government allowed pubs and restaurants to remain open and major sporting events to go ahead with large crowds.

Amid a surge in cases, some countries are handing out second booster shots. In Israel, early data suggest a fourth vaccine dose can increase antibodies against Covid-19, but not enough to prevent infections from Omicron. WSJ explains. Photo composite: Eve Hartley/WSJ

In parts of the country, one in 10 people was carrying the virus at the start of the year before infections started to drop. Even so, more recently, some 12% of children between the ages of 2 and 12 were estimated by the Office for National Statistics to be infected.

That prevalence hasn’t translated into deaths in the way that previous surges did. The number of people on mechanical-ventilator beds has fallen this month, belying previous experience. The U.K. has now lifted just about all of its restrictions related to Covid-19.

A possible obstacle to the shift toward living with Covid-19 is the development of another variant that provokes more serious illness or better evades immunity from vaccines.

Omicron isn’t the last word of the coronavirus. Early evidence indicates that a derivative of Omicron known as BA. 2 spreads even faster and is gaining ground in countries such as the U.K. and Denmark. It has been identified in about 40 countries world-wide, including the U.S.

So far there is no evidence that it causes more serious illness or that it sidesteps vaccines better than Omicron. In Denmark, where scientists say BA. 2 might already be the dominant variant, the government has decided to join others across Europe in relaxing controls, lifting most mandatory restrictions on Feb. 1.

In Singapore, where infections have risen and are expected to increase more, some 99.7% of cases in recent weeks have been asymptomatic or mild. Local media, taking the cue from health officials, now emphasize the number of patients hospitalized or requiring intensive care rather than highlighting daily case counts. Of the city-state’s 5.7 million people, 13 are in intensive-care units.

Those results, coupled with the nearly 90% vaccination rate in Singapore, have meant it no longer uses an army of contact tracers to identify and crush all transmission, opting for automated detection. Residents who had backed tight restrictions, even when outbreaks were fractions of the size today, are expressing openness to marching on.

‘We’ve understood we’re not going to be able to eliminate the virus.’


— Monica Gandhi, infectious-disease specialist, University of California, San Francisco

“We’re going to get it sooner or later; it seems like it’s just luck of the draw,” said Grace See, a 29-year-old recruitment specialist at a Singaporean firm. “We’ve reached a stage of acceptance.”

As recently as last fall, South Korea’s toughest distancing measures were reserved for only when daily infections averaged roughly 2,000 for a week. Omicron shattered the country’s metrics. On Sunday, the country reported daily infections had hit a record of more than 17,000 ahead of Lunar New Year holidays that could see cases more than double. The country’s health officials pledged not to tighten restrictions.

Instead they relaxed them, citing relatively low rates of death and severe illness. They let groups of six gather, up from four. They dropped its test-everyone policy that had long corralled outbreaks. They shortened quarantine times from 10 days to seven for vaccinated individuals who get Covid-19 but don’t show severe symptoms.

“Distancing is a measure that incurs high socioeconomic costs,” said Sohn Young-rae, a senior health official.

Lee Yeon-jin, a 30-year-old office worker in Seoul, has decided enough is enough. “We’re no longer staying home because there are thousands of cases,” Ms. Lee said.

In Japan, the number of daily cases was around 100 in early December, but Omicron sparked a surge to more than 80,000 this past week.

Despite the numbers, Japan has relaxed some rules. Doctors and nurses are allowed to continue to work even if they become close contacts as long as their Covid-19 tests turn up negative. The government dropped its policy of hospitalizing all Omicron-positive patients, allowing asymptomatic or mild patients who are young and at low risk to recover at home.

“It’s important to tackle this issue in such a way that society and economic activities can continue,” said government spokesman Hirokazu Matsuno on Thursday.

Hong Kong, under pressure from international business groups, this past week shortened what had been one of the world’s longest quarantine requirements for inbound travelers from three weeks to two.

Some public-health measures will still be necessary in places to buy people time to get booster shots and manage stress on hospitals, said Ben Cowling, a professor of epidemiology at the University of Hong Kong.

“The next few months will be challenging because of Omicron, but lockdowns are no longer justified,” he said.

Alice Uribe in Sydney and Miho Inada in Tokyo contributed to this article.

Write to Dasl Yoon at [email protected], Feliz Solomon at [email protected] and Julie Wernau at [email protected]

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