The U.S. reported a new daily record for COVID-19 cases, even as CDC guidelines on quarantining after a positive test were eased this week, recommending five days isolation, instead of then the previous ten-day recommendation.
Dr. James McDeavitt is executive vice president and dean of clinical affairs at Baylor College of Medicine. He says indoor holiday gatherings are a bad idea right now, given the extreme transmissibility of the omicron variant of COVID-19.
Listen to the interview above or read the transcript below.
This transcript has been edited lightly for clarity:
Texas Standard: What can we deduce from this most current spike?
Dr. James McDeavitt: Well, it’s a pretty stunning spike. And, to put it in perspective a little bit, I have been following the numbers closely in Harris County and surrounding counties. As recently as a month ago on a per 100,000 population basis, we were down to about 36 cases, which is approaching low levels of disease burden. We’re now, the most recent data, no longer 36 — we’re at 652 daily cases on a 100,000 population basis. And what that means, practically, is if I’m sitting in a restaurant today, compared to a month ago, the person sitting to my left, to my right is almost 20 times more likely to be carrying and spreading coronavirus as they were a month ago.
The visual that just popped into my head is someone who is traveling by air over the holidays. What are you telling folks to do right now?
Well, I still think it’s relatively safe. Now, the difference with omicron and the prior variants, including delta, is the sort of the good news is that it appears to be perhaps a little bit less virulent. So it’s not causing as severe disease, particularly in people that are vaccinated and boosted. But the downside is, it’s much more infectious and it’s spreading much more easily than the delta variant. So the fact that we haven’t had outbreaks in airplanes today, gives me a little bit of optimism. But it’s more infectious, so I would be cautious. I think when you’re on the plane, you should keep your mask on at all times. I would double mask if using a cloth mask, I’d consider wearing an N95 on a plane now. And when you sit down, turn your air on and have it pointing straight down in front of you to help to improve circulation. The planes are pretty well designed. And I would forego the snacks and the pretzels and just leave your mask on as much as possible when you’re on the plane and be careful in the airport as well.
Let’s talk about the CDC rule change on reducing isolation for people who test positive but have no symptoms from 10 days to five. I know that was intended to help relieve labor shortages like what the airlines and health care industry have been experiencing. Do you have a concern, however, that this might backfire? Especially since the CDC is not recommending that people get tested before returning to the workplace?
I think what CDC recommends is rational at this point. Omicron is a little bit different. It appears the incubation period is a little bit shorter, whereas with the prior variants, it was seven days to two weeks before maybe you’d show symptoms. It looks like you tend to develop symptoms in the first several days of an exposure with omicron. I think the 10 days, they’d already backed down to seven, was probably a little conservative as we started looking at our actual experience with the virus. So I’m actually pretty comfortable with the five day target. And I agree the criteria should not be getting a negative test because we have shown, repeatedly, that very healthy people that are not actively shedding a virus can have a positive, particularly a positive PCR test for weeks and sometimes months after the infection. So that’s not the right endpoint. The right endpoint is a time-based strategy.
Is this, as you see it, a concession to economic realities? Or does this make sense from the standpoint of sound medical guidance?
I think it’s probably a combination of both. And public policy is messy and it is based in science and it is based on practicality. The unique characteristic of this wave is that it’s been a very rapid rise. But the bigger issue is that there’s been incredible spread. I mean, I’m sure you know people that have been very careful through the whole pandemic, taking all kinds of precautions who now have COVID-19. The big problem that’s causing is that people are calling out for health reasons, they’re not coming to work, at record numbers. That’s the biggest problem with this wave is that we’re losing our workforce.
Doctor, are you concerned about health care worker shortages?
It is absolutely more of a problem now. Every hospital system I’ve talked to, every hospital system in the Texas Medical Center, every single one of them is experiencing shortages, are experiencing record level of callouts — more than they’ve seen at any other point in the pandemic. And it’s affecting operations. Now, the people calling out are all vaccinated and most them are boosted. They’re not getting sick, they have the sniffles. It’s an annoyance, but they’re still unable to come to work.
With New Year’s just ahead, should people be backing off of their New Year’s plans in your opinion?
I’m pretty aggressive in terms of thinking we should be open and getting back to life as normal. I have to say, I don’t think this is the right time together and I’ve written about how to gather safely extensively in the past. I just think we’re at a difficult time. This virus is too infectious, again, in Houston, 20 times as likely to run into somebody — it’s just the wrong time to gather with a group of people in a closed, indoor space and celebrate.