The Omicron surge has peaked and is falling rapidly as the number of people living in Colorado who remain susceptible to the virus shrinks. Our communities are returning to normal.
However, a new Omicron subvariant that appears to partially overcome preexisting immunity to Omicron is likely to increase the number of Colorado infections in the coming weeks. Fortunately, most of these infections will be mild and not result in hospitalizations and deaths, especially when people are fully immunized or have had prior recent Covid-19 infections.
The Omicron wave is likely to infect 50% of the world’s population by the end of March, according to Dr. Christopher Murray of the Institute for Health Metrics and Evaluation in Seattle. Murray suggests that SARS CoV-2 will then become endemic and have an impact similar to influenza during a bad season.
As we enter the Omicron recovery phase in Colorado, it is time to do a comprehensive analytical review — called a “hot wash” of what we did right, what we did wrong, and what will be needed to prepare for the emergence of new SARS-CoV-2 variants of concern.
The United States has had the highest number of cumulative deaths during the Omicron wave among all other wealthy countries of the world. Covid-19 not only threatens our physical and mental health, but also our children’s education as well as our economy and livelihoods.
The pandemic has highlighted deep divides in health equity and access to vaccines, medications and medical care. The pandemic also exposes and widens other deep divisions in our society related to our values, beliefs related to personal freedoms versus community responsibility, and respect for scientific thinking and evidence.
Given the reluctance of Congress to reauthorize additional Covid-19 funding, there are several areas that such an analysis will likely highlight as critical for strengthening our preparedness and our capacity to cope and respond and need further funding.
First, strengthen our surveillance systems for new SARS CoV-2 mutations. Surveillance methods need updating from a passive to active mode that target high-risk and vulnerable groups in near real time. We need to implement genetic sequencing on a reasonable percentage of SARS CoV-2 infections to rapidly identify variants of concern.
Our surveillance systems should implement active multidimensional methods including regular PCR testing, wastewater monitoring, and disease monitoring in congregant educational and work locations such as schools and colleges and universities, in high-risk jobs such as police and first responders, and in work locations such as meat packing-plants.
The Colorado Department of Public Health and the State have done outstanding work in this area, recognizing the limitations of our fragmented county-based public health system. There needs to be a community-wide consortium to access federal funds and mobilize the financial and logistic assets of the state health department, local private foundations, private diagnostic laboratories, and our research universities.
Second, strengthen our public-health capacity to test with rapid results and carry out contact tracing as soon as new more dangerous SARS CoV-2 variants are introduced and before there is widespread community transmission. Again, this will require a consortium approach that must go beyond the capacity of the health department to carry out all the needed testing.
We also will need to have adequate monitoring and quality-control measures in place at the county level to ensure that testing is well done.
Third, establish a planning process that involves all the key players related to the financing, acquisition, inventory, distribution and monitoring for supplies, vaccines, and medications. We have a complex health-care delivery system especially for diagnostics, vaccines and therapeutics that includes public and private health insurance plans, hospitals, health clinics, private physician offices, urgent-care centers, state and county health departments, and pharmacies. These entities need to be coordinated and, if possible, integrated into a seamless system that can respond efficiently and fairly.
Fourth, establish a working group with the key government and community players to assist and monitor the federal-state response to ensure it is equitable with respect to race, ethnicity, income, and vulnerability. Many people in Colorado, especially the elderly and those without internet access, were disadvantaged with respect to being vaccinated or having access to monoclonal antibody therapy.
Community engagement is needed to develop communication methods and messaging to reach communities distrustful of our traditional health care system and/ or our government. Having an effective strategy to communicate with non English-speaking families and immigrants, regardless of their immigration status, to reduce community transmission is essential.
Now is the time to strengthen our preparedness. As Benjamin Franklin once said: “Failing to plan is planning to fail.”
Stephen Berman, M.D., is professor of Pediatrics and Public Health, University of Colorado, and director of the Center for Global Health at the Colorado School of Public Health.
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