How Omicron variant could affect University protocols

Since the onset of the pandemic, SARS-CoV-2 has been a moving target. As the virus that causes COVID-19 has constantly mutated, new variants have emerged that raised concerns they may be more contagious or deadly, or less responsive to existing vaccines or treatments. The most significant of those so far was the Delta variant, which appears to be more transmissible. Yesterday, the World Health Organization said the newly discovered Omicron variant poses a high risk for infection surges.

Throughout the pandemic, Harvard has been advised by leading national and global public health and medical experts on policy and protocols, and the University has maintained very low COVID rates. The University Coronavirus Advisory Group and the University COVID Monitoring Committee are two of the advisory panels convened by Provost Alan M. Garber. The Gazette spoke with committee members Sandra Bliss Nelson, assistant professor of medicine at Harvard Medical School and infectious diseases physician at Massachusetts General Hospital; Michael Springer, associate professor of systems biology at HMS; and Lindsey Baden, an infectious diseases specialist at Brigham and Women’s Hospital and professor of medicine at HMS, to learn more about where the community is now with regard to COVID, and what effect the Omicron variant could have on protocols.

Q&A

Lindsey Baden, Sandra Bliss Nelson, and Michael Springer

GAZETTE: Let’s begin by taking stock of where we currently are with regard to COVID-19 on Harvard’s campus.

SPRINGER: The first thing to say is that our community has done a stellar job of limiting the transmission of COVID-19 on campus. Ninety-seven percent of our community has been vaccinated, and thanks to distancing and mask-wearing, and our comprehensive testing and contact tracing programs, while we have seen several localized events throughout the semester, we have not seen any major episodes of community transmission. In fact, there was no evidence for transmission in classroom settings, and we also didn’t see evidence for significant clusters related to academic work. Most of the cases that we did see came from large-scale, off-campus social gatherings where individuals weren’t masked, and to a lesser degree, through travel.

BADEN: To build on what Michael said, compared to a year ago, we now understand the virus better. We understand how it’s transmitted, and we’ve developed countermeasures across the board based on this knowledge. This is a virus that’s in our communities, globally, nationally, across the commonwealth, and in our city, and in our own daily interactions. It’s not possible, of course, to eliminate the virus completely; our goal has been to minimize the risk of acquisition and transmission of the virus if acquisition were to occur, as well as severe illness from the virus. And our community has done a good job of following the countermeasures we’ve asked them to follow toward doing just that.

NELSON: To that point, what we are seeing until now represents a stage in the pandemic with a more transmissible variant in Delta, but in a highly vaccinated population. While there have been cases on campus, fortunately there has been very little serious illness. In the absence of vaccination, the story might have been different.

GAZETTE: Speaking of the emergence of new forms of the virus, the World Health Organization yesterday labeled the Omicron variant as high risk for transmission. What does this mean for the Harvard community at this time, and the University’s outlook moving forward?

SPRINGER: I — like so many members of the community — am anxious to get back to normal, and until last week there was a credible and, I think, safe path for getting there in steps over the next semester. Now, with Omicron, we need to wait and assess until we learn more about its ability to evade the vaccine and, especially, the risk it poses for serious disease among the vaccinated.

BADEN: One of the most important themes to remember about dealing with a pandemic is that it’s a dynamic process. We continue to adapt based on what we learn. For example, as students have returned from Thanksgiving vacation, we’ve asked them to increase their testing cadence, based on what we’ve learned about the potential for increased transmission during travel and social gatherings. We’re also reassessing which activities are masked, or unmasked, based on the changing nature of the virus and its variants. Science will continue to inform our decision-making — in real time.

NELSON: I agree completely with both Lindsey and Michael, and I would add that it may be a month or two until we fully understand the impact of the Omicron variant, as scientists and health professionals study the effects in those who have acquired it.

In the meantime, we have also begun to think about how we can minimize the social harms associated with the mitigation measures that are in place and begin to allow something that looks a little bit more like a return to normal in the coming months, in case in turns out that the Omicron variant isn’t as serious as some reports are suggesting it might be.

GAZETTE: Do we have an idea yet what potential easing of restrictions could look like, or does that remain to be seen?

NELSON: I think it is reasonable to assert that this will not be a one-size-fits-all process. For example, we might suggest an early step would be to de-mask. But that doesn’t mean that we would say everybody should unmask in all settings. It will likely need to be more targeted, based on risk for severe illness, and the levels at which transmission may occur in certain areas. And we would likely advise that we move slowly and cautiously in relaxing the mitigations that are in place, and then we’d monitor the response very carefully. But again, we will see where we are in the coming weeks and months.

GAZETTE: You’ve mentioned that the Harvard community has done a remarkable job of participating in measures to keep our COVID rates low. As we enter the winter months, and more people move inside, and as we begin to wrestle with Omicron and other variants that could follow, is there anything else you would hope community members would do, beyond the mask-wearing, testing, and practicing of physical distancing and healthy habits like handwashing that so many of us are already engaged in?

SPRINGER: We still have work to do to change the mindset so that, when you feel sick, you should be staying home, and that in fact it’s acceptable to miss class, or work, in these situations. To date, as mentioned, we’ve seen very little transmission of COVID in an academic setting, but it’s possible this could change as new variants emerge. And this extends beyond COVID; the transmission of a number of potentially deadly communicable diseases like RSV (respiratory syncytial virus) and the flu can be drastically reduced, as well.

I’d also ask people to remember that even if you don’t have a pre-existing condition, someone you work or study with may. Many of our faculty and staff members are older; many other community members may be immunocompromised. So, let’s continue to follow the policies that are in place, but let’s also be sure to stay home when we’re not feeling well. And this is on all of us; we need to help our community understand that it’s OK to miss class or work when we’re not feeling well. We need to find ways to not penalize people staying home in these situations.

NELSON: Michael and I have also been engaged in a discussion around benefits to using rapid tests to supplement the University’s PCR [polymerase chain reaction] testing. It’s a wonderful thing that Harvard has done: The University has almost obviated the need to use rapid testing, because PCR testing is already done on a very frequent basis.

Still, when away from campus, even community members who are engaged in the University’s testing protocols can be proactive around their gatherings, especially when going home for the winter break, and use rapid testing to provide an extra measure of comfort. At my Thanksgiving gathering of about 20 people, for example, we all took rapid tests prior to spending unmasked time together indoors. The use of targeted rapid tests, like the use of routine screening tests, can only help to further reduce risk.

SPRINGER:  Also, you should continue to assess your risks, and if you feel like you’ve potentially been in a risky situation and you’re on campus, even if it’s off-cycle from your normal testing cadence, you can put in an additional PCR test if you feel that’s going to help you feel comfortable getting back into the community.

GAZETTE: Anything else you’d like to add?

BADEN:  I’d ask community members to please bear with us and continue to participate in the dynamic nature of the guidance based upon what information emerges around the virus. At this time, I’d strongly recommend that individuals get a booster shot.

What occurred with Delta over the summer required all of us to recalibrate what we were planning to do, and it’s possible the Omicron variant could also require us to adapt. We have already seen the Alpha, Beta, Delta, and Omicron variants, and there will be more. The key is to adapt as we go along, and ensure that measures to prevent severe illness remain in place.