Omicron, as Infectious as Measles, Has Officials Worried About Spread, Overload of Health Care Systems

Dr. Jeanne Marrazzo in a press brief Dec. 21, 2021.

The explosive growth of the highly infectious omicron variant and a rapid rise in COVID cases since Thanksgiving prompted several officials and physicians to raise the red flag Tuesday.

Birmingham Mayor Randall Woodfin and Jefferson County Health Officer Mark E. Wilson suggested that a new surge in cases could overwhelm local hospitals and urged people to get vaccinated.

Dr. Jeanne Marrazzo, director of the Division of Infectious Diseases at UAB, said the spread of omicron is now being compared to the measles, one of the most infectious agents known to man.

Hospitalization rates are up about 12%, she said, with 524 people hospitalized because of COVID, 138 of them in the intensive care units.

Cases are rising rapidly in Alabama, where the 7-day average is now at 774 cases a day, Marrazzo said. Last Thursday, that average was 600.86 new cases per day and a week prior it was 511.57 new cases a day.

“I sadly don’t think we are going to escape this,” Marrazzo said in a press conference Tuesday morning. “There’s really no way, and with about half of our population not being vaccinated, it’s really a very big concern for our health care system.”

Woodfin during Tuesday’s City Council meeting echoed her concern. “We need to take whatever measures to ease their load so they don’t collapse,” he said.

Jefferson County is now classified as having a high rate of community transmission, the worst of four risk classifications. The state as a whole is in the substantial risk category, the third-highest classification.

Wilson said new cases of COVID in Jefferson County have “shot up” in the past week, from between 30 and 40 new cases per day to about 100 new cases per day.

“Unfortunately, we really are here to tell people that it’s time to buckle down again and be really careful in spite of the fact that we have Christmas just a few days away,” Wilson said.

“I want to implore you all to please get vaccinated,” Woodfin said during Tuesday’s meeting of the Birmingham City Council.

Marrazzo added that those who are vaccinated should get booster shots, which have shown to have greater efficacy against omicron than the vaccinations alone.

Wilson said 60.5% of Jefferson County’s population has received at least one dose of a COVID vaccine, and 49.1% has completed a two-dose regimen. Numbers for people who have had booster shots are not available.

Health officials nationwide have said they are seeing more breakthrough omicron cases among people who are vaccinated, though the booster reduces that number substantially. But people who are vaccinated and get breakthrough infections still appear to be having less serious cases of the illness.

“The really important thing about vaccines is that they still look like they help prevent severe disease that leads to hospitalization and help prevent deaths, so we are just really strongly recommending again that people who have not been vaccinated start getting vaccinated as soon as possible,” Wilson said.

Wilson urged a return to more preventive actions, as well. “During this next few weeks, in addition to vaccination, we have to again get back to the basics: wearing a mask, keeping distance, washing hands, avoiding large crowds,” he said.

Another aberration with omicron is that it does not respond to the monoclonal antibodies currently available. Marrazzo said that when she heard that news, she got a horrible pit in her stomach. UAB has treated about 2,000 people who have early signs of the disease with monoclonal antibodies, she said. People who are uncomfortable getting the vaccine have even been willing to get the antibodies she said.

But not having that weapon against the virus worries her about being able to handle early cases before they progress to the point of needing hospitalization.

There is a new variety of monoclonal antibodies on the cusp of being offered to the public, but there isn’t much of it available and it will be rationed by federal officials, she said. Two other oral therapies have been proposed but are not yet authorized, she said.

But even if those tools become available, Marrazzo is not comfortable with the omicron variant spreading around.

“This virus is just weird,” she said. “It’s a weird virus that has been unpredictable and has done things that we haven’t seen with other respiratory viruses. So I’d just really respect it.”

Holiday Travel

Marrazzo said holiday travel and gatherings are a big concern, but she realizes that many people have not gathered with their families for two years and do not want to cancel their plans, despite the risk.

“If you want to get together with family this Christmas and into the new year, the best thing you can do is make sure you are as boosted as possible. If you have access to testing, test yourself before you go. … And then if you are going to be around people whose status you don’t know, please wear masks. Masks really work, but you’re going to need to wear good masks, better masks and less permeable masks to keep out something as infectious as the measles.”

She advised people to consider their own risk level and the groups they are meeting with when deciding what to do to protect themselves.

If you have elevated risk factors or are gathering with people who are not vaccinated or in poorly ventilated areas, wear an N95 mask, which fits tightly on the face. Or double mask – wearing a cloth mask over a surgical mask – if you don’t have an N95. The key is the density of the fabric and the fit on your face, Marrazzo said.

The same precautions are valid even outside of holiday gatherings. People should consider their risk factors and the setting. And people who are at high risk from the virus should stay home, she said. The same goes for people who have COVID symptoms or who have tested positive for the disease. They should be self-quarantining, she said.

However, Marrazzo is not expecting another lockdown at this point.

“I think the context of a lockdown is frankly exhausting and scary and so demoralizing to people because the lingering damage from the last lockdown is really still tangible, particularly with younger kids, families, schools. I don’t think anyone has the appetite for another lockdown,” Marrazzo said.

“I think if we can get enough people to embrace the tools we have, we can as a society hopefully avoid anything looking like a total lockdown because I just think that would tip too many people over the edge at this point.”