With 96% of schools open for in-person learning, and children younger than 5 not yet approved for a vaccination, the numbers of cases are bound to increase. Sick patients could again fill up hospital beds despite the lesser severity of omicron symptoms, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
"Many more children will be infected," Fauci said.
The omicron variant comprises an estimated 95% of cases in the U.S., with the previously ubiquitous delta variant now accounting for 5%, according to Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. The infections are also spreading rapidly, with waves of cases breaking records on a daily basis.
Nationally, there are currently 491,700 new cases per day, an increase of 98% over the prior week, Walensky noted.
The seven-day average of hospital admissions nationwide is about 14,800 per day, an increase of about 63% above the previous week. The seven-day average of daily deaths is about 1,200 per day, an increase of about 5% over the prior week, Walensky said.
Omicron symptoms are thought to be less severe than the delta and other prior variants, according to international studies and preliminary data from Texas. Omicron also differs from previous variants by getting into upper-bronchial and airway secretions, but not the lungs, Fauci said.
While there are indications that omicron causes fewer hospitalizations and less need to put patients on oxygen, there's a caveat, he said. Increased transmission rates will result in an increase in hospitalizations.
With more cases, Fauci said, "A certain proportion are going to be severe."
The number of hospitalizations appears to be growing in Santa Clara and San Mateo counties. Santa Clara County saw a 17% increase in hospitalizations from COVID-19 in one day, from Jan. 3 to Jan. 4 and San Mateo County had a nearly 9% increase during the same days, according to the California Department of Public Health COVID-19 Hospital Dashboard.
In the course of a week through Jan. 4, Santa Clara County had a 76.5% increase in hospitalizations and San Mateo County's hospital rate increased 67.8% in the same week, according to the state data.
Vaccination and its protective benefits
Federal officials are changing their strategies to stem deluges of cases almost as quickly as the virus is mutating into variants. On Monday, Jan. 3, the Food and Drug Administration shortened the recommended span of time between the second Pfizer-BioNTech COVID-19 vaccination and a booster shot to five months instead of six for anyone older than 12.
The FDA on Monday also approved the emergency use authorization for the Pfizer booster dose for children ages 12 to 15. On Wednesday, the Center for Disease Control and Prevention followed the recommendation of its Advisory Committee on Immunization Practices to allow boosters for that age group.
The CDC has recommended that 5- to-11-year-old children with compromised immune systems should receive a booster shot 28 days after their second shot of the Pfizer vaccine, said Jeff Zients, White House COVID-19 response coordinator.
COVID-19 vaccines haven't yet been approved for children younger than 5 years old, but clinical studies of children ages six months to 5 years are underway. Results could be in by the earlier part of the year, Fauci said.
Given the high degree of omicron's transmissibility, Fauci said the best way to protect young children who cannot receive a vaccine is to have them wear a mask if they are able to tolerate one in congregate settings or to surround them with people who are vaccinated.
Anyone who can be vaccinated and receive boosters should do so to reduce the most severe effects. Large studies in Israel comparing people who received boosters with those who were fully vaccinated found a booster dose reduced infection by a factor of 10 in all age groups.
Individuals older than 60 who were boosted showed an 18-times decrease in severe disease compared to those who had only received the two-shot regimen. Severe disease in people ages 40 to 59 years old decreased by a factor of 22. People who received a booster shot had a 90% lower death rate due to COVID-19 than those who did not receive a booster shot, she noted.
Although the Israeli research was done with the delta variant, health leaders think the same will hold true for the omicron variant, Walensky said.
How the federal government is responding
The Biden administration has been ramping up measures to prevent infections. It provided $130 billion in American Rescue Plan funding to schools to implement prevention measures, including ventilation and social distancing, and an additional $10 billion to support testing in schools, Zients said.
The administration has also added military doctors, nurses, and emergency medical technicians to assist local hospital staff throughout the country and additional teams are ready to be sent as needed, he said.
On Jan. 4, President Joe Biden announced he has instructed the COVID-19 response team to double the government's purchase of the Pfizer antiviral pill from 10 million treatment courses to 20 million. The administration expects it will have the first 10 million treatment courses by the end of June instead of the end of September, Zients said.
"These pills can dramatically decrease hospitalizations and deaths and are a game-changer, with the potential to alter the impact of COVID on people and on our nation," he said.
Meanwhile, many pharmacies are running out of at-home, rapid COVID-19 test kits and there are often long appointment wait times at public facilities. Zients said turn-around times are also deteriorating for lab-test results due to staffing issues. The Biden administration's promised 500 million free at-home, rapid COVID-19 tests won't be available until sometime later in January. But the government won't cannibalize the stock going to pharmacies to fill its own test-kit quota, he said.