I’ll admit it. Last week, amid a flurry of COVID-19 infections among people I know and as at-home coronavirus tests became impossible to find, I was regretting the tongue-in-cheek tone in which I wrote last month about the newly circulating omicron variant.

A framed copy of that column my friends got me for my birthday was beginning to feel like a cursed object, a proverbial monkey’s paw whose fingers curled with every bit of news about omicron’s impact: record-shattering caseloads across the United States and the looming threat that rising transmission would place undue strain on our health care system. It’s done a little more than harsh my vibe, to re-use the cringeworthy phraseology I used in my last column.

Omicron has made it around the world in fewer than 80 days — just over a month, in fact, since it was first discovered by South African scientists. The speed with which it has pervaded nearly every corner of the globe is hard to fathom, but also totally apropos considering this virus’s unpredictable trajectory.

On Monday, the City of San Antonio revealed a weekend spike in cases. Nearly 4,000 positive COVID-19 results were returned Monday, following similar caseloads on Saturday and Sunday. You’d have to go all the way back to 2020’s summer surge to find a higher case total than the 3,894 we saw on Monday. On July 16, 2020, Bexar County recorded 5,501 cases, but that number was greatly inflated by a laboratory backlog — so it’s very possible the count reported Monday is Bexar County’s highest daily caseload of the pandemic.

One in four people who sought testing in Bexar County last week tested positive, and the San Antonio Metropolitan Health District has upgraded the local COVID-19 risk level to “severe.” COVID-19 hospitalizations have doubled in just a week, and a greater proportion of those patients are children (22 as of Monday) than I remember seeing throughout the pandemic. 

Already feeling the crunch, local hospital officials urged residents last week not to go to the emergency room if they are experiencing mild symptoms. Help should be on the way for local health care facilities struggling to staff up amid the new wave in hospitalizations.

“We announced last Friday with University Health, the county’s hospital district, that we were going into a critical situation with hospitals,” Bexar County Judge Nelson Wolff said in a news release. “We have asked for 400 nurses and will be asking for more. People need to help us avoid filling up our hospitals by taking precautions such as masking up, sanitation and avoiding gatherings.”

Although at least one model is predicting Bexar County will have as many as 300,000 new COVID-19 cases and 5,000 additional deaths by the end of March, there is too much uncertainty around omicron at the moment to truly project with confidence. On the flip side of that model, omicron’s output could wind up being as low as 50,000 new cases and 500 deaths. 

The scientist behind that model, the University of Texas at San Antonio’s Juan B. Gutiérrez, says he’ll have an updated forecast later this month.

In the weeks since Gutiérrez published that modeling, a few key discoveries have been made about omicron. The first is that it causes mostly mild disease. As cases surge throughout the U.S., hospitalizations and deaths are projected to be low relative to previous peaks. Scientists think that has something to do with omicron’s lessened ability to replicate deep into the respiratory system than prior strains.

Where delta, for example, thrived in the lungs, omicron doesn’t seem to replicate there as easily and instead largely affects the cells in the upper respiratory tract, such as the nose and throat. It’s why you’re seeing people who contract the omicron variant exhibit mostly cold-like symptoms: runny nose, sore throat and sneezing, among others.

Although omicron appears to be a milder form of disease, it also is better able to evade antibodies from prior infections and vaccination than previous variants. Specifically, those who have had the full vaccine program of either one Johnson & Johnson dose or two doses of the mRNA vaccines (Pfizer and Moderna) are still getting sick. 

There are breakthrough cases among those who have had their booster dose as well, but people with the third shot have 25 times more antibody protection than people with two doses, according to recent studies.

Bexar County has only a 15% booster vaccination rate among residents ages 16 to 49, according to data from the Texas Department of State Health Services.

This has caused local epidemiologist Cherise Rohr-Allegrini to worry. 

“That’s a concern because even though [omicron] is less bad, you still have a lot of susceptible people,” Rohr-Allegrini said.

With a milder variant quickly becoming the dominant strain and vaccinated people still contracting COVID-19, some public health professionals fear that fewer people, especially younger healthy adults, will line up to get jabbed.

But Rohr-Allegrini reminded that the advent of the vaccine was never going to eradicate the virus in one fell swoop, especially when much of the world has little access to COVID-19 immunizations. Still, vaccines will ultimately “help us end the pandemic,” she said.

So make it your New Year’s resolution to get boosted if you haven’t already. It’ll be your easiest accomplishment of the year and, from a global perspective, perhaps your most consequential.

JJ Velasquez

JJ Velasquez is a columnist at the San Antonio Report. A former reporter and editor at the SA Report, he currently works as a project manager for New York City-based Advance Local.