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'Winter of Severe Illness, Death' for the Unvaccinated, White House Warns

— Fully vaccinated individuals must still get boosted for optimal protection, says Fauci

MedpageToday
A screenshot from this White House COVID-Response Team briefing

Unvaccinated people are needlessly dying from COVID-19, and the situation is likely to worsen as the more transmissible Omicron variant tightens its grip on the U.S., the White House COVID-19 Response Team said on Friday.

Jeffrey Zients, the response team coordinator, urged unvaccinated Americans to do their part to prevent Omicron outbreaks. "For the vaccinated, you've done the right thing, and we will get through this," he said.

"For the unvaccinated," Zients warned, "you're looking at a winter of severe illness and death for yourselves, your families, and the hospitals you may soon overwhelm."

A total of 160,000 unvaccinated people have "needlessly lost their lives" since June, he said. That number will continue to go up unless unvaccinated people take the necessary steps to protect themselves and their families, he said, advocating for both vaccination and mask-wearing in public indoor settings.

Zients underscored that vaccines do work against Omicron. While breakthrough infections are possible for the vaccinated, those infections are more likely to be asymptomatic or mild, he noted.

"This is not a moment to panic, because we know how to protect people and we have the tools to do it," Zients said. "The more people get vaccinated, the less severe this Omicron outbreak will be."

During the briefing, CDC Director Rochelle Walensky, MD, MPH, shared that Omicron cases have been confirmed in 39 states and over 75 countries. While the Delta variant continues to "circulate widely" stateside, "Omicron is increasing rapidly and we expect it to become the dominant strain in the United States ... in the coming weeks," she said.

Anthony Fauci, MD, chief medical advisor to President Biden, underscored the importance of getting boosted. While mortality is already low in people who are vaccinated, "it goes down to practically negligible values" following a booster dose, he said.

He cited one that found that among people 50 years or older who received a booster 5 months after their second dose of the Pfizer-BioNTech vaccine, mortality rates were 90% lower compared to those who did not receive a booster.

Fauci also highlighted real-world data from the U.K. suggesting that two doses of the Pfizer/BioNTech vaccine were much less protective against Omicron infection -- offering just under 40% protection against the variant at about 25 weeks -- compared with Delta. A booster restored vaccine effectiveness against symptomatic infection to more than 70% in that study. "Optimum protection is fully vaccinated plus a boost," he said.

Even for vaccinated and boosted individuals, it is important to practice additional prevention measures -- from indoor masking in public settings, improved ventilation, testing -- as more crowding occurs over the holidays, Walensky stressed.

'Test to Stay' School Policy

The CDC Director also highlighted new research on so-called test to stay (TTS) policies that can help even unvaccinated children avoid missing school due to a COVID-19 exposure.

This approach focuses on increased testing of close contacts -- at least twice during the 7 days following a COVID-19 exposure -- and allowing children who meet certain criteria to stay in school rather than quarantine if they continue to test negative.

In Los Angeles County, where one in five public schools adopted a TTS strategy, the ratio of COVID-19 infections among students in TTS districts compared with non-TTS districts remained unchanged during the policy rollout, according to an encouraging by Walensky and published in Morbidity and Mortality Weekly Report (MMWR).

Study authors added that non-TTS schools in Los Angeles lost approximately 92,455 in-person school days to quarantine during the study period, compared with zero at TTS schools.

A separate MMWR report from 90 TTS schools in , boasted a secondary transmission rate of just 1.5% among 1,035 students and staff, who had 8,152 in-person school days saved by TTS.

In both studies, Walensky stressed, masks were "consistently and correctly" worn and close contacts of any positive cases were monitored for symptoms and directed to stay home if they became ill.

Under TTS, schools are expected to promote vaccination for eligible students and staff; keep indoor masking for anyone over age 2; maintain 3 feet of distance between students; in addition to keeping up ventilation, handwashing, and encouraging anyone who's sick to stay home.

The CDC updated its to incorporate the new research, and is currently working to update materials to help advise parents and schools about this "promising and now proven practice," Walensky said.

She noted that the safety data for coronavirus vaccines continue to be favorable for children age 5-11 years. Side effects such as pain at the injection site, fever, tiredness, and headaches indicate that the body is building its immune response to SARS-COV-2.

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    Shannon Firth has been reporting on health policy as 鶹ý's Washington correspondent since 2014. She is also a member of the site's Enterprise & Investigative Reporting team.