Realities of Omicron should have prompted changes to pandemic response weeks ago
The latest Yarmouth COVID Wastewater Testing report issued on January 18 shows that prevalence of SARS-CoV-2, the virus that causes COVID-19, likely peaked in the town during the first week of January.
Be Well Yarmouth (BWY), a public COVID-19 awareness agency funded by state and federal dollars, samples the town’s wastewater at its treatment facility to understand the level of viral particles present in homes connected to the facility in a given 24-hour period.
SARS-CoV-2 copies per milliliter, the standard by which the agency measures prevalence of the virus, hit the highest mark ever recorded on January 4, 2022 at more than 1,100.
Levels of recorded virus dropped more than 70% in the two weeks following the peak.
Interestingly, COVID-19 cases among Yarmouth residents reported to Maine CDC look to have peaked one or two weeks after the wastewater data peak. That delay is due in some part by a natural lag in case reporting, in addition to the large backlog of individual positive test results awaiting state processing. During the agency’s Wednesday, January 26 briefing, CDC Director Dr. Nirav Shah reported that the backlog numbered a staggering 56,000 samples.
For this and other reasons, BWY notes, “Yarmouth wastewater levels of SARS-CoV-2 virus probably provide a more accurate picture of the current situation in Yarmouth than do the COVID-19 case reports from Maine CDC.”
Data from the Yarmouth reports have been extremely useful in understanding the prevalence of potential viral infection in the community in real time, without waiting for individual PCR test results to be processed and reported by the state’s public health agency. Granted, these data have only come from a single jurisdiction, so it is difficult to use them to analyze other areas of Maine.
But the sheer speed with which likely Omicron-driven infections are spreading shows that the current testing paradigm is not providing value in directing public health policy anyway. As Dr. Shah stated on Wednesday, this is reason why the agency is now significantly expanding wastewater testing in Maine to nearly two-dozen sites total. However, expanding wastewater testing now may be too little too late if spread has already peaked in other communities as it appears to have done in Yarmouth.
Genomic testing sponsored by Maine CDC has been too slow to get a real-time handle on the verified spread of the Omicron variant, although the agency is confident that it has been widely circulating in the last month. Given what science has uncovered regarding Omicron’s ability to evade both vaccine- and infection-induced immunity, the amplitude of this wave tells us that it is likely due to the new variant.
Despite 99% of Yarmouth residents having received at least one dose of COVID-19 vaccine, and despite an estimated 37% of Cumberland County residents having been infected between April and December 2021, that level of immunity did not seem to make much of a difference. The most recent peak was nearly 50% higher than the previously recorded peak in the town’s wastewater testing report in January 2021. Heading into that wave, less than 8% of the county had been previously infected, and vaccines were not yet widely available.
Until Omicron, previous infection made a big difference in whether a person would become infected upon exposure. Numerous evidence affirms the efficacy and durability of naturally-acquired immunity to SARS-CoV-2. The CDC reports that, by last October amid Delta variant prevalence, vaccinated-but-uninfected New Yorkers and Californians experienced “consistently higher” rates of infection than among “unvaccinated persons with a history of COVID-19,” by a factor of about two-to-three-times.
Recently published data from the state of New York on COVID-19 reinfections shows that before Omicron, documented reinfections were extremely uncommon: around 1-in-100,00 per week. Yet, the new variant has seemed to hit the immunity reset button for nearly everyone, driving reinfections to more than 30-times that rate in the last week of December and first week of January.
Omicron’s ability to evade existing immunity is likely due to its high number of genetic mutations, most of which are on the spike protein, even compared to recent variants like Delta, and especially to the original strain on which current vaccines are based. This has led to a never-before-seen rise in infections around the world, which will likely bring an even broader level of protection via naturally-acquired immunity, helping to keep the virus at bay, if not driving it to endemic status.
Thankfully, just as scientists in South Africa and Europe have noted, as well as the US CDC, Omicron infection brings much milder disease on the individual level. This recent wave looks to be receding as quickly as it began, prompting leaders in the United Kingdom and Denmark to relax all coronavirus restrictions.
It is becoming clearer by the day that we face a very different pandemic amid Omicron. Here’s hoping leaders across the United States follow the same path as their counterparts in Europe: focus on protecting the vulnerable instead of instituting broad public restrictions that treat everyone as if they are sick.