Gov. Roy Cooper, left, applauds 8 year-old Daniel McCullock after McCullock received the Pfizer child COVID-19 vaccination from Dr. Kathy Merritt at Chapel Hill Pediatrics and Adolescents in Chapel Hill, N.C., Thursday, Nov. 4, 2021.  The new Omicron variant of COVID-19 is a reason for concern, but public health leaders believe vaccination will offer some protection. (AP Photo/Gerry Broome) COVID Vaccine
Gov. Roy Cooper, left, applauds 8 year-old Daniel McCullock after McCullock received the Pfizer child COVID-19 vaccination from Dr. Kathy Merritt at Chapel Hill Pediatrics and Adolescents in Chapel Hill, N.C., Thursday, Nov. 4, 2021. The new Omicron variant of COVID-19 is a reason for concern, but public health leaders believe vaccination will offer some protection. (AP Photo/Gerry Broome)

The new variant is a reason for concern, but public health leaders are optimistic vaccination and boosters will offer some protection.

The Omicron variant is officially in the United States.

This new strain of a virus that we’ve already had more than enough of has been designated a variant of concern by the World Health Organization, because its mutations suggest all sorts of bad omens.

But while the variant was for sure a cause for concern, President Joe Biden said this week, it was “not a cause for panic.” It’s the message sung by many health officials. 

“The effect of this variant on transmission, severity of disease, and how well current vaccines’ treatment work remains speculative, regardless of what we’re hearing in the press,” Dr. Anthony Fauci, the nation’s leading health official, said in a news conference Tuesday. 

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Awful isn’t it? That our fears, weariness and anxieties can be so loud while the solutions speak in whispers and ask for patience. But reality is unmoved. So while we wait for answers let’s look at what we know and what we don’t know about the variant.

WHAT WE DON’T KNOW

The Omicron variant has an absurd number of mutations in the areas that have helped other viruses spread faster and evade protections, health officials say. But, it is too early to know how that will play out and what it means. Health officials are furiously trying to answer three big questions about Omicron:

Is it more contagious? It’s very likely that it’s more contagious than the original strain, but, Fauci said we don’t know enough about how it compares to Delta. So we just have to wait.

Does it cause more serious illness than Delta and other strains? Maybe. “With the small number of cases, it is very difficult to know whether or not this particular variant is going to result in severe disease,” Fauci said.  “Although some preliminary information from South Africa suggests no unusual symptoms associated with the variant, we do not know and it is too early to tell.” 

Some of the cases in South Africa have been mild so far, Angelique Coetzee, the chairwoman of the South African Medical Association, told several news publications this week, but she echoed Fauci and other doctors in saying that it is too early to tell what this means. 

Will it evade the vaccines? Back to the common refrain, it’s too early to tell. But there is reason for hope, Fauci said. Remember that not all breakthrough infections are equal. The vaccine’s main job is to keep you from dying from the disease. 

In a White House briefing on Wednesday, Fauci repeatedly emphasized the need for all eligible adults to get a booster shot now, and not to wait for an Omicron specific vaccine to be produced. For one, he said, it may never be needed. 

“Our experience with variants such as the Delta variant,” Fauci said, “is that even though the vaccine is not specifically targeted to the Delta variant, when you get a high enough level of immune response [from a booster] you get spillover protection even against a variant that the vaccine wasn’t specifically directed at.”

“And that’s the reason that we fell, even though we don’t have a lot of data on it, there’s every reason to believe that that kind of increase you get with the boost would be helpful at least in preventing severe disease of a variant like Omicron.”

WHAT WE KNOW

While we’re doing all this waiting on the unknown, we can take some comfort in what we already know, health officials say. That the layered approach of masks, vaccines, testing, ventilation and distance has been highly effective against the coronavirus in every stage.  

The unvaccinated are six times more likely than fully vaccinated people to get infected with Delta, Dr. Mandy Cohen, the head of NC’s Department of Health and Human services said on Tuesday, and are 25 times more likely to die. Being vaccinated is still a crucial part to any attack plan against this virus and all its variants.

We know that surviving a COVID infection offers a less stable immunity than the vaccines.  We know that masks work – the evidence here is glaring and indisputable – and is not likely to change with Omicron. 

The other thing to keep in mind: We have long known this day was coming.

Because global vaccination rates remain low, the virus has had plenty of time to do what viruses do: mutate.

Health officials have been warning about this general possibility throughout the pandemic.

“All viruses change over time,” Cohen said on Tuesday, “and COVID-19 is no exception.”

In the next couple of weeks, “we’ll get a better handle on the severity of the illness,” Dr. Peter Hotez, a pediatrician and the co-director of the Texas Children’s Center for Vaccine Development, told Reuters this week. And in the same time frame, Reuters wrote, we should know about the vaccine’s effect on the variant.

On Wednesday, after the news broke about the first case in California, Hoetz, a frequent presence on television segments about the pandemic, offered on Twitter some initial conjecture on how the variant might play out here.

“First, this is not a surprise,” he tweeted. “We’ve been saying the finding of omicron in the US was practically inevitable given that it’s in multiple European countries, Australia, Hong Kong. This [is] a pattern we’ve seen for most variants. They go global very quickly. That in itself [is] not a red flag.”

He said that based on his reading of the variant’s genetic sequence, he did not think Omicron would be able to displace Delta as the main villain in the US. 

“Instead,” he wrote, “I see a possible twin epidemic or syndemic unfolding in which Delta continues accelerating among the unvaccinated,” while the variant affects unvaccinated people recovering from previous infections, or those who have been vaccinated more than six months ago but who have not been boosted. 

He concluded that he was confident that a booster of the mRNA vaccines would continue offering strong protection against severe illness in the new variant. 

While officials warn against reading too much into early anecdotal evidence, the first case of Omicron in the US was detected in a person who had recently returned to San Francisco from South Africa, the CDC said in a news release. They were fully vaccinated, but had not gotten their booster. The person’s symptoms were mild, the CDC said.