Omicron, 3 Camps, and the Limitations of Fear
One of the motivating factors for me to start this newsletter back in March of 2020 was to chronicle the COVID-19 journey so I could look back over time to remind myself what the status of the pandemic was at any given point in time and track developments. Much of the past 22 months has felt like a blur, and it’s been informative to go back and flip through some of my earlier posts to see where we’ve been and where we are now.
In reviewing old blogs and thinking about the pandemic to date, a recurring key insight is that every step of the journey has presented a scientific and sociological challenge.
As we’ve discussed previously, pandemics are not solved by science alone.
This theme emerged early on, initially with mask wearing in back in June 2020, followed by vaccine uptake a year later in the summer of 2021.
And now, almost a year after the first variants became news in January of 2021, history repeats itself again and we’re looking at a new variant around New Years as Omicron takes hold.
Given the key lesson learned above on the importance of addressing the science and sociology of each new COVID-19 development, I’ll give you my take on both based on present day information.
From a science perspective, we still don’t know much. As many smart people like Dr. Ashish Jha have previously written, when thinking about a new variant, there are three critical questions to answer:
1) Is it more transmissible?
2) Does it cause more severe disease?
3) Does it evade vaccines or reduce the effectiveness of vaccines?
It is highly likely that Omicron will not be the last variant to come our way and thinking about Omicron and future variants through the lens of these 3 questions is a rational mental model to assess risk.
Unfortunately, it is still early to answer any of these questions with 100% confidence and there’s more to learn over the coming weeks regarding Omicron.
With that caveat, I’ll keep the science part brief and leverage a succinct infographic shared by Dr. Eric Topol on the state of Omicron knowledge published 2 days ago:
In summary:
1) Is it more transmissible? – It appears so.
2) Does it cause more severe disease? – Maybe??? But, trending towards no.
3) Does it evade vaccines or reduce effectiveness of vaccines? - It appears so, but the clinical significance of this remains to be seen.
Despite the scientific murkiness, the good news is that what you can do to protect yourself is very straightforward: Get vaccinated and get a booster if you’re more than 6 months out from your last shot. This is even more important if you have other risk factors for severe illness such as increased age, obesity, chronic conditions, and being immunocompromised.
Now that we’ve covered that, let’s move on to the sociology side of this variant.
From a sociology perspective, Omicron is dominating the headlines and evoking visceral reactions from all sides on what the implications are for this new variant ranging from no big deal to Armageddon and everywhere in between.
I was struck by one tweet and one article earlier this week that I think are important to consider from a sociology perspective at this stage in the pandemic.
The tweet came from Dr. Neil Stone who posted this on Twitter a few days ago:
In retrospect, these three camps of people have existed since the beginning, I just lacked the ability to succinctly group them into three camps before seeing this tweet.
While I appreciate Dr. Stone getting the ball rolling on the 3 camps analogy, I will create my own 3 camps for the purposes of this blog:
Camp #1: The people who receive vaccinations and boosters the day they become available (or perhaps even before they’re approved!). These campers may also be continuing to take significant precautions such as wearing masks at all times indoors and significantly adjusting their normal activities to reduce their risk of exposure.
Camp #2: The people who are definitely vaccinated by now and might be boosted at this point, or at least considering it, but generally have to be nudged along a good bit to take a new action. They are potentially willing to change their behaviors but probably only temporarily and for a compelling reason(s).
Camp #3: The people who remain unvaccinated and/or are completely numb and immune to any further public health messaging regarding COVID-19. There is little anyone can say or do to motivate any form of behavior change such as getting a vaccine or taking any precautions ever.
Let me emphasize these are over-simplified and many of you reading this may not find yourself perfectly described in any of the above camps, but for the sake of simplicity and getting my sociology message across, I’ll keep it simplified to the above.
The reason I think these camps are important is to stratify people’s mindsets at this point in the pandemic to understand how best to engage/connect with them and help us all get along. Sadly, COVID-19 isn’t disappearing tomorrow and Omicron, regardless of its eventual impact, will not be the last chapter in the COVID saga. Thus, understanding our audience and best ways to engage going forward remains paramount.
Camp #1 needs no encouragement. If anything, we’re probably trying to hold them off from going and getting a 4th booster dose at this point. Chances are this camp regularly wears masks indoors and takes as many precautions as possible. They are willing to alter their normal daily activities to reduce their risk of exposure to COVID.
The key with group #1 is not to unintentionally alienate the folks in group #2 that may be willing to tolerate more risk.
Camp #2 understands the value of vaccines and has gotten the initial two doses and perhaps a booster at this point. They may or may not wear masks indoors except when mandated and are more risk-tolerant of being exposed to COVID. They are not as willing to sacrifice or adjust usual activities (eating indoors, attending large events, traveling). Essentially, they value returning to their normal routines/activities and are willing to tolerate additional exposure risk.
The key with group #2 is to be willing to adjust situationally if and when the time ever calls for it in your community based on prevalence, hospital spikes, a new variant etc to potentially modify your behavior if COVID-19 worsens.
Translated, we need those in group #2 to remain open to future calls to action and not become totally numb (more on this below) if the situation worsens.
Camp #3 is where most of our attention should be and the biggest headscratcher. I am also guessing few folks in Camp #3 are reading this blog right now. Regardless, we have to continue thinking of new ways to engage this group and move folks from Camp #3 to Camp #2.
Every convert from Camp #3 to Camp #2 is FAR more important than converting Camp #2 folks to Camp #1.
Getting as many people out of Camp #3 and into Camp #2 remains the mission-critical sociological challenge.
Conversely, it is equally important to keep folks in Camp #2 from migrating to Camp #3.
No one summed this up better than Adam Grant, an organizational psychologist, who wrote a recent piece in the New York Times about the limitations (and harm) of repeatedly appealing to fear to drive behavior change. It is well worth your 5 minutes to read and if you can’t access it, find a friend who has an NYT subscription and ask them to share with you. It’s that good. The tweet below gives you the very short abstract, but I found the entire article compelling as we think about public health messaging going forward:
I second his thoughts and worry greatly about how the messaging of fear may unintentionally move people from Camp #2 to Camp #3.
I think public health officials, doctors, influencers, and the like must use their calls to action judiciously recognizing COVID-19 is a marathon, not a sprint. We only know what we know at this point and can’t look around the corner to see what’s coming next. We all hope things only get better at this point, but we need everyone to remain on guard and open to taking additional actions in the future if needed.
We cannot overuse the element of fear to motivate behavior change as it has a diminishing half-life.
In summation:
For folks in Camp #1 – Please remain kind, patient, and non-judgemental of folks in Camp #2 who may be willing to tolerate more risk in their daily lives. We need them to stay in Camp #2 and avoid converting them to becoming numb to all COVID-related information and drifting to camp #3.
For folks in Camp #2 – Please remain kind, patient, and non-judgement of folks in Camp #1 who may be more risk-averse and want to continue taking all precautions to avoid contracting COVID-19. And, please remain open in the future to our calls to action if the situation worsens locally or with a new variant. We promise to be judicious in asking you to modify your behaviors recognizing you are willing to tolerate more risks. Please do not become totally numb / immune to future messaging.
For folks in Camp #3 – Please join us in Camp #1 or #2. We want this pandemic to end and remaining in Camp #3 slows the process of getting there, while simultaneously putting yourselves, your loved ones, and all of us at an increased risk of death. Not sure what else I can say.
Here’s hoping to a happier, healthier, and ‘boring’ 2022 on the COVID-19 front,
Harry