You will not be surprised to know that I am all-in on the promotion of words. In case you missed it, the dictionary people Merriam-Webster announced their Word of the Year recently. “Vaccine” won. The cheekier short-form “vax” was the duly anointed by the Oxford English Dictionary. Hard to argue with those choices as they were already really important words long before last year’s champion “pandemic” was on the tip of every tongue. Vaccine is derived from the Latin word “vacca” which means “cow.” The term was first used by Dr Edward Jenner, a British physician and scientist, who in 1796 invented an inoculation for smallpox using doses of cowpox. Jenner famously observed that milkmaids who had been infected with cowpox never contracted that disease’s more contagious and deadly cousin, smallpox. This discovery led to the world’s first modern vaccine and the eventual eradication of a disease that plagued human civilization for two thousand years. Personally, I was pulling for the Word of the Year runner-up “cicada” as I am just a little weary of the new and expanding vocabulary that has dominated our lives for nearly two years.
I am even less enthused about the ongoing pervasiveness of the Greek alphabet. Each new one we learn seems to push the finish line of COVID-19 farther from our grasp. Such is the case with Omicron, the letter assigned to the latest significant mutation of original SARS-CoV-2, the coronavirus that originated in Wuhan back in the day. By now, most people know that Omicron was first identified in South Africa two weeks ago as a potentially more contagious and immunity-busting strain, setting off a maelstrom of prognostications, judgements and performative travel bans. I will admit that my first reaction to this unsettling news was “FFS, not again”, or something to that effect. Then I begin to read and try to piece together the facts, perspective and outlook from sources I have come to trust.
It is safe to say that Omicron will be the dominant story of the pandemic for the next few months. The good news is that it is transmitted like all the other variants so our layered arsenal of protections, mitigations and protocols are as valid and important as ever. It is certainly advantageous to get an early warning of the emergence of this variant so we can strengthen our defenses. The bad news is that the concern about Omicron is well-justified. Scientists are worried for two main reasons. Firstly, early analysis suggest it is at least twice as transmissible as Delta, today’s dominant variant and the most virulent form of SARS-CoV2 to date. Secondly, Omicron looks very different, scientifically, from all the other variants. While mutations have become commonplace during this pandemic, Omicron has many more mutations to its spike proteins than Delta. Recall the spike proteins are “the pins” in the pin cushion appearance of SARS-CoV2 that attach to human cells in the process of COVID-19 infection. More mutation is potentially bad. Just how bad will be determined in the coming weeks with more study and more data. While it is too soon to make a meaningful estimate of Omicron’s breakthrough ability, many experts currently believe that the variant will reduce the potency of neutralizing antibodies from prior infection and vaccines. However, even if Omicron reduces vaccine effectiveness at preventing infection, it remains reasonable to expect the immunized will have continue to have good protection from serious illness, just as we’ve seen with other variants.
It may be too early to predict Omicron’s future but the hard truth is that Delta is already here and its new winter wave is gathering steam across North America. Rising case counts are yet another reminder that SARS-CoV-2 is annoyingly and dangerously persistent. With colder weather upon us and reduced enthusiasm (to be kind) for preventative measures, it is not a big shock to see case counts rising in our communities. Within Black & McDonald, our internal infections have been simmering at a relatively low level in the past two months. At one brief point in October, we had no active cases. That lasted a single day. As of Friday, we have 6 active cases.
The emergence of Omicron emphasizes the fact that COVID-19 is a global problem capable of piercing every local bubble. We remain mired in the middle of this pandemic. As long as there are large populations of unvaccinated people around the world, there will be new mutations of the virus and subsequent circulation of freshly-minted variants. Smallpox is the only human disease to ever be eradicated. It began with Dr. Jenner’s invention followed by nearly two centuries of tenacious vaccination efforts. All other diseases are suppressed or mitigated with a combination of immunology, engineering and medicine so that we can live safely with lower levels of infection and negligible serious illness and death. This is the most likely scenario for SARS-CoV-2. Protection from vaccines and prior infection eventually reach levels capable of limiting arising infections and associated severity at consistently lower levels. The virus becomes endemic like the seasonal cold or flu.
Vaccines are and will continue to be the centerpiece of a strategy to live safely with COVID-19, together with the strong public health measures with which we are all very familiar. Unfortunately we are nowhere near an acceptable level of endemicity right now. The current levels of transmission, active cases, hospitalizations and deaths are too high and global vaccination rates are too low. Beyond the moral obligation to find solutions, we simply cannot sustain the current pressure on our healthcare systems indefinitely. That means multi-layered measures such as masking, indoor density and capacity limits, air ventilation, testing, contact tracing, physical distancing and various forms of isolation and quarantining are likely to be imperative for a while yet as we wait for a much higher number of global citizens to be immunized.
This coronavirus isn’t going anywhere soon. Delta and now Omicron are real world proof that it is a predatory and opportunistic entity. SARS-CoV-2 adapts to us and mutates in pursuit of an advantage in transmission. This viral evolution and our waning immunity could combine to derail all of our progress if we don’t continue to pursue and sustain defenses from airborne transmission and strengthen our immune systems with additional doses of vaccine.
We may need to make “vaccine” the Word of the Decade because if we want to live safely with this virus, we need to continue to adapt to it before it adapts to us.