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Potential Rapid Increase of Omicron Variant Infections in the United States

December 30, 2021

The Centers for Disease Control and Prevention (CDC) has identified the potential for a rapid increase in infections of the new variant of SARS-CoV-2, the Omicron variant, in the United States. Plausible scenarios include steep epidemic trajectories that would require expedient public health action to prevent severe impacts on the health of individuals and the healthcare system. The CDC Center for Forecasting and Outbreak Analysis developed this finding as a synthesis of scenario models conducted by U.S. government, academic, and international partners. The models assess the range of plausible scenarios for the epidemic trajectory based on what is currently known about the Omicron variant. Recent case data of the Omicron variant from South Africa, Botswana, the United Kingdom, and elsewhere are consistent with the faster scenarios that were modeled.

Findings

Infections with the recently identified Omicron variant of SARS-CoV-2, the virus that causes COVID-19, are exponentially increasing in multiple countries. Increases in infections are most likely due to a combination of two factors: increased transmissibility and the ability of the variant to evade immunity conferred by past infection or vaccination (i.e., immune evasion). Though the precise contribution of each of the two factors remains unknown, a substantial degree of immune evasion is likely as has been demonstrated in early vitro studies.

CDC has collaborated with partners to model scenarios of the epidemic trajectory in the U.S. that simultaneously consider transmissibility and immune evasion. Results from scenario analysis indicate that current increases in Omicron cases are likely to lead to a national surge in the coming weeks with peak daily numbers of new infections that could exceed previous peaks; these scenarios may be realized as soon as January. In scenarios with lower immune evasion, a surge is still likely, but the peak could be lower and begin as late as April 2022. Projected large surges in cases indicate surges of hospital demand even if the severity is reduced, because of the large number of anticipated cases occurring in a short period of time.

Background

Since its identification in November 2021, the Omicron variant has been reported in South Africa, Botswana, and numerous countries where it is driving rapid epidemic growth. In the U.S., the variant has been found in the majority U.S. states. The Omicron variant is increasing in the percent of circulating SARS-CoV-2 viruses in the United States. S-gene Target Failure (STGF) is a market for identifying Omicron cases. Preliminary analysis of SGTF data from testing completed through a national chain of pharmacies also observes regional increases in this proxy measure of the Omicron variant. Modeling of both genomic surveillance and SGTF data predict that Omicron will become the most common variant nationally by December 25, 2021, with some regions exceeding this threshold earlier. Furthermore, multiple large clusters of Omicron variant cases have demonstrated the rapid spread of the virus. Upcoming holiday gatherings may further accelerate these trends.

The rapid growth rate in Omicron infections is believed to result from a combination of increased transmissibility and the ability to evade immunity conferred by past infection or vaccination (i.e., immune evasion). Data from laboratory experiments and epidemiologic investigations suggest a greater role for immune evasion than increased transmissibility; immunity conferred by prior infection or vaccination is likely to be reduced compared with Delta, but not completely overcome. Data also shows that vaccinated people who either receive a booster dose or who were also previously infected are likely to have stronger protection against Omicron.

The clinical severity profile of Omicron infection will strongly influence its impact on future U.S. hospitalizations and deaths. At present, early data suggest Omicron infection might be less severe than infection with prior variants; however, reliable data on clinical severity remains limited. Even if the proportion of infections associated with severe outcomes is lower than with previous variants, given the likely increase in number of infections, the absolute numbers of people with severe outcomes could be substantial. In addition, demand for ambulatory care, supportive care for treatment of mild cases, and infection control requirements, quarantining/isolation of exposed/infected workforce could also stress the healthcare system. These stresses likely will be in addition to the ongoing Delta variant infections and rising burden of illness caused by other respiratory pathogens, such as influenza, which have begun circulating at greater frequencies.

Analytic Approach

The modeled scenarios of the epidemic trajectory in the U.S. consider varying degrees of transmissibility and immune evasion: high transmissibility and low transmissibility together with high immune evasion and low immune evasion. Modeled scenarios with faster relative growth rates (of Omicron as compared to Delta) indicate that a large surge of infections could begin in the U.S. in early January 2022 and that the peak daily number of new infections could exceed previous peaks. With low immune evasion, the surge could be lower and occur as late as April 2022. Multiple modeling groups in the United States, as well as those from other countries’ public health agencies, have identified similar trends.

Recent case data of the Omicron variant from the United Kingdom and elsewhere are consistent with the faster growth scenarios which increase the plausibility of faster growth scenarios.

Scenario*Inherent transmissibility relative to DeltaImmune escape relative to all prior strains
Faster growth (Higher transmission**. Mid escape)1.5x43%
Slower growth (Higher transmission. Low escape)1.5x10%
Faster growth (Unchanged transmission. High escape)1.0x85%
Slower growth (Lower transmission. Mid escape)0.8x50%

*Parameters were chosen to span a range of apparent growth rate advantages for Omicron over Delta of ~2-3.5x in an environment where 75% of the population has immunity to infection due to vaccination or prior infection. **Relative to Delta

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/science/forecasting/mathematical-modeling-outbreak.html.

Domestic Travel During COVID-19

December 23, 2021

What You Need to Know

  • Delay travel until you are fully vaccinated.
  • Check your destination’s COVID-19 situation before traveling. State, local, and territorial governments may have travel restrictions in place.
  • Wearing a mask over your nose and mouth is required in indoor areas of public transportation (including airplanes) and indoors in U.S. transportation hubs (including airports).
  • Do not travel if you have been exposed to COVID-19, you are sick, or if you test positive for COVID-19.
  • If you are not fully vaccinated and must travel, get tested both before and after your trip.

Before You Travel

Make sure to plan ahead:

  • Check the current COVID-19 situation at your destination.
  • Make sure you understand and follow all state, local, and territorial travel restrictions, including mask wearing, proof of vaccination, testing, or quarantine requirements.
    • For up-to-date information and travel guidance, check the state or territorial and local health department’s website where you are, along your route, and where you are going.
  • If traveling by air, check if your airline requires any testing, vaccination, or other documents.
  • Prepare to be flexible during your trip as restrictions and policies may change during your travel.

Do NOT Travel If…

  • You have been exposed to COVID-19 unless you are fully vaccinated or revered from COVID-19 in the past 90 days.
  • You are sick.
  • You tested positive for COVID-19 and haven’t ended isolation (even if you are fully vaccinated).
  • You are waiting for results of a COVID-19 test. If you test comes back positive while you are at your destination, you will need to isolate and postpone your return until it’s safe for you to end isolation. Your travel companions may need to self-quaranti

During Travel

Masks: Wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and train stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like an open deck area of a ferry or the uncovered top deck of a bus).

Protect Yourself and Others: Follow all state and local health recommendations and requirements at your destination, including wearing a mask and staying 6 feet (2 meters) apart from others. Travelers 2 years of age or older should wear masks in indoor public places if they are not fully vaccinated, if they are fully vaccinated and in an area with substantial or high COVID-19 transmission, or if they are fully vaccinated and with weakened immune systems.

  • If you are not fully vaccinated and aged 2 years or older, you should wear a mask in indoor public places.
  • In general, you do not need to wear a mask in outdoor settings.
    • In areas with high numbers of COVID-19 cases, consider wearing a mask in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.
  • Wash your hands often or use hand sanitizer (with at least 60% alcohol).

After Travel

  • ALL Travelers
    • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
    • Follow all state and local recommendations or requirements after travel.
  • If you are NOT Fully Vaccinated
    • Self-quarantine and get tested after travel:
      • Get tested with a viral test 3-5 days after returning from travel.
        • Check for COVID-19 testing locations near you.
      • Stay home and self-quarantine for a full 7 days after travel, even if you test negative at 3-5 days.
      • If you don’t get tested, stay home and self-quarantine for 10 days after travel.

If Your Test is Positive

Isolate yourself to protect others from getting infected. Learn what to do and when it is safe to be around others.

If you Recently Recovered from COVID-19

You do NOT need to get tested or self-quarantine if you recovered from COVID-19 in the past 90 days. You should still follow all other travel recommendations. If you develop COVID-19 symptoms after travel, isolate and consult with a healthcare provider for testing recommendations.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html.

COVID-19 Vaccines for Older Adults

December 16, 2021

The risk of severe illness from COVID-19 increases with age. Getting a COVID-19 vaccine is an important step in helping to prevent getting sick from COVID-19.

Tips on How to Get a COVID-19 Vaccine

  • Contact your state or local health department for more information.
  • Ask a family member or friend to help with scheduling an appointment.
  • Ask your doctor, pharmacist, or community health center if they provide vaccines.

Find a COVID-19 vaccine or booster: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

What You Should Know about Vaccines

  • You can help protect yourself and the other people around you by getting vaccinated.
  • COVID-19 vaccines are safe and effective in preventing severe illness from COVID-19.
  • Depending on the kind of COVID-19 vaccine you get, you might need a second shot 3 or 4 weeks after your first shot.
  • The vaccines cannot make you sick with COVID-19.

You May Have Side Effects from the Vaccine

Some people have side effects after getting vaccinated. Common side effects include:

  • Pain, redness, or swelling where you get your shot
  • Tiredness
  • Headache
  • Muscle Pain
  • Chills
  • Fever
  • Nausea

These are normal signs that your body is building protection against COVID-19. Learn more about what to expect after getting your COVID-19 vaccine.

Booster Shots and Additional Doses

A booster shot is administered when a person has completed their initial vaccine series and protection against the virus has decreased over time. Booster shots are available to everyone ages 16 years and older who is fully vaccinated. Learn more about getting a COVID-19 vaccine booster shot.

An additional primary dose is administered when a person may not have built the same level of immunity to their initial vaccine series as someone who is not immunocompromised. Currently, moderately or severely immunocompromised people ages 18 years and older who completed their Moderna vaccine primary series should plan to get an additional primary dose 28 days after receiving their second shot. For people ages 12 years and older who completed their Pfizer-BioNTech vaccine primary series, they should also plan to get an additional primary dose 28 days after receiving their second shot.

Vaccination Card and Booster Shots

At your first vaccination appointment, you should have received a vaccination card that tells you what COVID-19 vaccine you received, the dates you received it, and where you received it. Bring this vaccination card to your booster dose vaccination appointment.

Safe, Easy, Free, and Nearby COVID-19 Vaccination

The federal government is providing the vaccine free of charge to all people living in the U.S., regardless of their immigration or health insurance status. To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/no-cost.html.

Omicron Variant: What You Need to Know

December 10, 2021

Emergence of Omicron

On November 24th, 2021, a new variant of SARS-CoV-2, B.1.1.529, was reported to the World Health Organization (WHO). This new variant was first detected in specimens collected on November 11, 2021, in Botswana and on November 14, 2021 in South Africa.

On November 26, 2021, WHO named the B.1.1.529 Omicron and classified it as a Variant of Concern (VOC). On November 30, 2021, the United States designated Omicron as a Variant of Concern, and on December 1, 2021, the first confirmed US case of Omicron was identified.

CDC had been collaborating with global public health and industry partners to learn about Omicron, as we continue to monitor its course. CDC has been using genomic surveillance throughout the course of the pandemic to track variants of SARS-CoV-2, the virus that causes COVID-19, and inform public health practice. We don’t yet know how easily it spreads, the severity of illness it causes, or how well available vaccines and medications work against it.

Despite the increased attention of Omicron, Delta continues to be the main variant circulating in the United States.

Where has Omicron been Detected in the United States

CDC is working with state and local public health officials to monitor the spread of Omicron. This map shows the states that have detected at least one case of COVID-19 illness caused by the Omicron variant. Omicron will be included in variant surveillance data on CDC’s COVID Data Tracker when it can be reliably estimated at a low frequency.

What We Know about Omicron

Infection and Spread

  • How easily does Omicron spread? The Omicron variant likely will spread more easily than the original SARS-CoV-2 virus and how easily Omicron spreads compared to Delta remains unknown. CDC expects that anyone with Omicron infection can spread the virus to others, even if they are vaccinated or don’t have symptoms.
  • Will Omicron cause more severe illness? More data are needed to know if Omicron infections, and especially reinfection and breakthrough infections in people who are fully vaccinated, cause more severe illness or death than infection with other variants.
  • Will vaccines work against Omicron? Current vaccines are expected to protect against severe illness, hospitalizations, and deaths due to infection with the Omicron variant. However, breakthrough infections in people who are fully vaccinated are likely to occur. With other variants, like Delta, vaccines have remained effective at preventing severe illness, hospitalization, and death. The recent emergence of Omicron further emphasizes the importance of vaccination and boosters.
  • Will treatments work against Omicron? Scientists are working to determine how well existing treatments for COVID-19 work. Based on the changed genetic make-up of Omicron, some treatments are likely to remain effective while others may be less effective.

We have the Tools to Fight Omicron

Vaccines remain the best public health measure to protect people from COVID-19, slow transmission, and reduce the likelihood of new variants emerging. COVID-19 vaccines are highly effective at preventing severe illness, hospitalizations, and death. Scientists are currently investigating Omicron, including how protected fully vaccinated people will be against infection, hospitalization, and death. CDC recommends that everyone 5 years and older protect themselves from COVID-19 by getting fully vaccinated. CDC recommends that everyone ages 18 years and older should get a booster shot at least two months after their initial J&J/Janssen vaccine or six months after completing their primary COVID-19 vaccination series of Pfizer-BioNTech or Moderna.

Masks offer protection against all variants. CDC continues to recommend wearing a mask in public indoor settings in areas of substantial or high community transmission, regardless of vaccination status. CDC provides advice about masks for people who want to learn more about what type of mask is right for them depending on their circumstances.

Tests can tell you if you are currently infected with COVID-19. Two types of tests are used to test for current infection: nucleic acid amplifications tests (NAATS) and antigen tests. NAAT and antigen tests can only tell you if you have a current infection. Individuals can use the COVID-19 Viral Testing Tool to help determine what kind of test to seek. Additional tests would be needed to determine if your infection was caused by Omicron. Visit your statetribal, local, or territorial health department’s website to look for the latest local information on testing.

Self-tests can be used at home or anywhere, are easy to use, and produce rapid results. If your self-test has a positive result, stay home or isolate for 10 days, wear a mask if you have contact with others, and call your healthcare provider. If you have any questions about your self-test result, call your healthcare provider or public health department.

Until we know more about the risk of Omicron, it is important to use all tools available to protect yourself and others.

What CDC is Doing to Learn about Omicron

Virus Characteristics

CDC scientists are working with partners to gather data and virus samples that can be studied to answer important questions about the Omicron variant. Scientific experiments have already started. CDC will provide updates as soon as possible.

Variant Surveillance

In the United States, CDC uses genomic surveillance to track variants of SARS-CoV-2, the virus that causes COVID-19 to more quickly identify and act upon these findings to best protect the public’s health. CDC established multiple ways to connect and share genomic sequence data being produced by CDC, public health laboratories, and commercial diagnostic laboratories within publicly accessible databases maintained by the National Center for Biotechnology Information (NCBI) and the Global Initiative on Sharing Avian Influenza Data (GISAID). If a variant is circulating at 0.1% frequency, there is a >99% chance that it will be detected in CDC’s national genomic surveillance.

For more information, please visit https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html.

Improving Ventilation in Your Home

December 3, 2021

Staying home with only members of your household is the best way to keep SARS-CoV-2 (the virus that causes COVID-19) particles out of your home. However, if a visitor needs to be in your home, improving ventilation (airflow) can help prevent virus particles from accumulating in the air in your home. Good ventilation, along with other preventive actions, like staying 6 feet apart and wearing masks, can help prevent you from getting and spreading COVID-19.

Interactive Ventilation Tool

Use this tool to learn how you can decrease the level of COVID-19 virus particles during and after a guest visits your home. Get started.

Below are ways you can improve ventilation in your home. Use as many ways as you can (open windows, use air filters, and turn on fans) to help clear out virus particles in your home faster.

Bring as much fresh air into your home as possible. Bringing fresh, outdoor air into your home helps keep virus particles from accumulating inside.

  • If it’s safe to do so, open doors and windows as much as you can to bring in fresh, outdoor air. While it’s better to open them wide, even having a window cracked open slightly can help.
  • If you can, open multiple doors and windows to allow more fresh air to move inside.
  • Do not open windows and doors if doing so is unsafe for you or others (for example, presence of young children and pets, risk of falling, triggering asthma symptoms, high levels of outdoor pollution).
  • If opening windows or doors is unsafe, consider other approaches for reducing virus particles in the air, such as using air filtration and bathroom and stove exhaust fans.
  • Use fans to move virus particles in the air from inside your home to outside. Consider using a window exhaust fan if you have one. Be sure it is placed safely and securely in the window. Another option is to place a fan as close as possible to an open window or door, blowing outside. Don’t leave fans unattended with young children.

Filter the Air in Your Home

f your home has a central heating, ventilation, and air conditioning system, (HVAC, a system with air ducts that go throughout the home) that has a filter, do the following to help trap virus particles:

  • In home where the HVAC fan operation can be controlled by a thermostat, set the fan to the “on” position instead of “auto” when you have visitors. This allows the fan to run continuously, even if heating or air conditioning is not on.
  • Use pleated filters – they are more efficient than ordinary furnace filters and can be found in hardware stores. They should be installed initially within the HVAC system by a professional, if possible. If that is not possible, carefully follow manufacturer’s instructions to replace the filter yourself.
  • Make sure the filter fits properly in the unit.
  • Change your filter every three months or according to the manufacturer’s instructions.
  • Ideally, have the ventilation system inspected and adjusted by a professional every year to make sure it is operating efficiently.

Turn on the Exhaust Fan in Your Bathroom and Kitchen

Exhaust fans above your stovetop and in your bathroom that vent outdoors can help move air outside. Although some stove exhaust fans don’t send their air to the outside, they can still improve airflow and keep virus particles from being concentrated in one place.

  • Keep the exhaust fan turned on over your stovetop and in your bathroom if you have visitors in your home.
  • Keep the exhaust fans turned on for an hour after your visitors leave to help remove virus particles that might be in the air.

Use Fans to Improve Airflow

  • Place a fan as close as possible to an open window blowing outside. This helps get rid of virus particles in your home by blowing air outside. Even without an open window, fans can imrpove airflow.
  • Point fans away from people. Pointing fans toward people can possibly cause contaminated air to flow directly at them.
  • Use ceiling fans to help improve airflow in the home whether or not windows are open.

Limit the Number of Visitors in Your Home and the Time Spent Inside

The more people inside your home, and the longer they stay, the more virus particles can accumulate.

  • List the numbers of visitors in your home.
  • Try to gather in large rooms or areas where you can stay at least 6 feet apart.
  • Be sure that everyone wears a mask while visitors are in your home. This includes visitors as well as the people who usually live in your home.
  • Keep visits as short as possible.
  • Follow additional recommendations for hosting gatherings.

To learn more information and alternative methods for ventilating your home, please visit

https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html.