Facebook: January 20

The Worst of the Omicron Wave Could Still Be Coming A long descent from a peak in cases could exact a larger toll than even Omicron’s blistering ascent. .......... February will be better; March, rosier still. Americans will get something like a Hot Post-Omi Spring. ........ The decline could be sharp and fast, or sputtering and slow. It could start off steep, then lose steam. It could plateau—or even reverse course and tick back up. ........ We need to prepare for the possibility that this wave could have an uncomfortably long tail—or at least a crooked one. “I do think the decline is unlikely to be as steep as the rise,” Saad Omer, an epidemiologist at Yale, told me. ......... When this tide turns hinges on when Omicron starts to run out of new people to infect—either because it has burned through everyone it can or because we, through our behaviors, starve it of hosts. ....... Yes, the United States’ population is more vaccinated than South Africa’s, but it’s also older. (And lots of Americans over 65 aren’t boosted.) The two countries’ health profiles, medical infrastructures, and approaches to controlling SARS-CoV-2 differ; so do the behaviors of their residents. Omicron also caught South Africa as it was heading into summer; the United States may have a tougher time unsticking itself from the virus during colder months. And Delta, which was already driving surges of its own before Omicron arrived, hasn’t yet disappeared here. ...........

each community will experience its own, unique Omicron spike

......... How we react to the curve could also stretch it out, and that’s the biggest wild card of all. When people hear that we’ve skittered past the top of a peak, “psychologically, they loosen up,” UNC’s Lessler told me. (This is something that many epidemic models don’t account for.) Masks come off. Schools, workplaces, and leisure venues reopen. People rejoin social circles, or kick-start new ones. Smaller shifts such as these, multiplied by millions, can turn a waterfall decline into molasses. “So much of susceptibility is tied up in behavior,” Majumder said. And as people get further out from their most recent vaccination or infection, their risk of catching the virus goes back up. .......... Even if the United States’ curve turns out to be symmetrical, half of this wave’s infections, and more than half of its hospitalizations and deaths, are still ahead, past the peak of cases. ....... We heard this lesson early on in the pandemic, when cases were first rising at alarming rates: mask up, hunker down, flatten the curve. It’s still true now. The hope is that the lower the peak, the fewer unnecessary infections can occur after it ......... The key here, then, is to avoid seeing “past the peak” as a cue to relapse into riskier behavior. “The start of a decline is not sufficient to think we’re out of the woods”