The Omicron messaging dilemma

Why public health experts believe communications around Omicron need to toe the line between too much concern and just enough.

Health officials want clearer messaging from the federal government on the Omicron variant. (Photo credit: Getty Images).
Health officials want clearer messaging from the federal government on the Omicron variant. (Photo credit: Getty Images).

Over the long Thanksgiving weekend, more Americans traveled to see family than they had during the entirety of the COVID-19 pandemic. But that brief taste of something approaching normalcy vanished the day after the holiday, when Omicron was dubbed a “variant of concern.”

Now that the first U.S. case has been identified – it happened in California on Wednesday – public health officials are scrambling to communicate the risk the new variant poses to both vaccinated and unvaccinated groups. Which represents quite the challenge, because epidemiologists believe anything resembling a definitive answer is more than a week away.

In a press briefing on Tuesday, President Joe Biden stressed that the variant was a “cause for concern, not a cause for panic.” He emphasized again that the nation had access to the best vaccines, medicines and scientists, adding for good measure that the best protection remains vaccination and, if possible, a booster.

Biden also pledged that the federal government would work with vaccine makers in the event that Omicron poses an upgraded threat, even though most public health officials believe that  existing vaccines will likely protect against severe illness and death.

Still, overall messaging about Omicron remains confusing. With terms like “immune evasion” being tossed around and the federal government once again enacting travel restrictions, the public has many questions. Will I be okay if I haven’t yet received my booster shot? Should I quarantine? Am I safe indoors without masks if I’m vaccinated?

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, wants more definitive answers from public health officials.

“The communication has been relatively poor, in the sense that they’re having difficulty conveying that it’s something to take seriously but also not to panic about,” he said. “Much of the rhetoric and actions from the federal government harken back to the early days of the pandemic, as if we’re as helpless now in November 2021 as we were in March 2020. We’ve gained so much knowledge about this virus since then.”

Some of that initial fear, Adalja noted, has been fueled by the reintroduction of travel restrictions, even before scientists know whether Omicron is more transmissible or likely to evade vaccines.

Then there’s the reality that the Biden administration, the Centers for Disease Control and Prevention and the Food and Drug Administration have struggled to communicate clearly over the course of the pandemic. This summer, public health experts called on the CDC to improve its communications strategy after the agency came under fire for flip-flopping on its masking guidance. Similarly mixed messages were conveyed when the Biden administration clashed with Food and Drug Administration scientists over whether booster shots were needed for the general public.

Is the pattern of mixed messaging repeating itself with Omicron? Adalja argued that a fractured focus on booster shots, travel restrictions and holiday plans takes away from the single most important message the government needs to convey: that vaccination prevents severe illness, hospitalization and death.

“There’s something missing in their communications,” Adalja said. “It’s not the lack of boosters that make Omicron a threat; it’s the unvaccinated who make it a threat. There’s been such a strong emphasis on boosters that we’ve lost sight of the main goal: that first and second doses, not third doses, are the most important.”

The confusion stems from a larger, overarching problem, Adalja pointed out. The U.S. has not made clear its goal when it comes to battling the pandemic. Is it to eradicate the virus as soon as possible or to manage it as it transforms from epidemic to endemic, similar to the yearly flu or other respiratory illnesses?

“They’ve moved the goalpost from preventing severe disease to preventing all disease,” Adalja said. “When you’re making public health guidance and shifting it in the middle, it’s very confusing.” For his part, Adalja believes the U.S. communication goal should center around harm reduction.

But Dr. Leana Wen, a professor of health policy and management at George Washington University, believes that caution around Omicron and future variants is the best route. While emphasizing that initial vaccination is important, she said the administration should include booster shots, robust testing, travel restrictions, quarantining and contact tracing protocols as part of its overall Omicron messaging.

“For understandable reasons, people are confused,” Wen noted. “I wish the Biden administration did a better job of clarifying its travel restrictions. Why not also implement mandatory quarantine and post-arrival testing for all international travelers?”

“They’ve been smart to use an abundance of caution,” Wen continued. “To say there’s a lot that we don’t know, to get the unvaccinated vaccinated, to get boosters to people, these are exactly the things they should be saying.”

When it comes to Omicron, the good news is that the U.S. certainly isn’t starting from square one. As CDC director Rochelle Walensky has pointed out, “We have far more tools to fight the variant than we had at this time last year.”

This story first appeared on mmm-online.com. 

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