Omicron could be peaking in the US — but experts urge caution

A downtick in COVID-19 cases is raising hopes that the omicron wave has peaked in the United States.

To be sure, new case numbers remain high and hospitals are still overwhelmed in many areas. But, especially in the earliest hard-hit states like New York and Massachusetts, cases are clearly declining, and experts say cases appear to have peaked on a national basis as well.

The U.S. seven-day average of new cases fell from about 798,000 on Jan. 15 to about 744,000 on Jan. 19, according to Centers for Disease Control and Prevention (CDC) data, the first downturn since mid-December, when the highly transmissible omicron variant took hold and cases began a rapid spike.

"I think we've turned the corner," said Monica Gandhi, an infectious disease expert at the University of California-San Francisco.

While cases may be falling nationally and in early hit states, experts caution that the U.S. is a large country and some areas, such as Western states like Montana and Wyoming, may take longer to peak.

They also caution that hospitalizations and deaths are lagging indicators - meaning they could continue to rise for a few weeks after cases begin to fall. There are a record 160,000 people hospitalized with the virus, according to a New York Times tracker, and about 2,000 people dying every day from it.

"It's wall-to-wall stretchers; we have no capacity left at the hospital," Robert Jansen, the chief medical officer at Grady Hospital in Atlanta, said at a media briefing this week.

In a few weeks, once hospitalizations have time to fall as well, the U.S. could be in a much better place.

"By mid-February, there are going to be many areas that honestly seem strangely normal," said David Rubin, director of the PolicyLab at Children's Hospital of Philadelphia.

CDC Director Rochelle Walensky noted during a press briefing Friday that "overall nationally the case numbers are coming down, which I consider an optimistic trend."

The possible national peak in omicron cases comes as the Biden administration has begun rolling out additional measures that experts have been pushing for months, like free N95 masks and a website to order free rapid tests.

Those tools could finally become more widespread after the worst of the omicron wave has already passed.

"There's a metaphor here which involves horses and stable doors," said William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. "It should have been done way in the past."

Gandhi said once the omicron wave passes, the country could enter a more "endemic" phase of the virus, in which it continues to exist but no longer poses a crisis affecting every day life, and widespread masking and testing among the general public are no longer needed.

Because so many people will have been infected with omicron, on top of the immunity provided by vaccines and boosters, the population will have far greater immunity coming out of this wave. Experts still stress that it is far better to never be infected at all, and get immunity through vaccines and boosters, rather than getting sick.

Anthony Fauci, the government's top infectious disease expert, said that whether there is another major spike from a new variant in the future will depend on to what extent the next variant can evade the immunity many Americans have built up.

He said the worst-case scenario is "a variant that's so different that it eludes the accumulation of the immune protection that we've gotten from vaccinations and from prior infections."

"I hope that doesn't happen; I can't give you a statistic of what the chance of that happening [is], but we have to be prepared for it," he added. "So we hope for the best and prepare for the worst."

Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, wrote in The Lancet this week that more than 50 percent of the world could be infected with the omicron variant by the end of March.

The combination of this immunity, plus vaccines that can be adapted to new variants and new antiviral treatments, will lead to a new phase of the virus, he writes.

"The era of extraordinary measures by government and societies to control SARS-CoV-2 transmission will be over," he writes. "After the omicron wave, COVID-19 will return but the pandemic will not."

Experts have been calling for months, though, for greater efforts to vaccinate the world, as the best way to ensure that a new dangerous variant that can elude immunity does not emerge.

More than 80 Democratic lawmakers last month called for $17 billion for global vaccinations and other efforts to fight the virus around the world in a coming government funding package.

The fact that the omicron variant tends to cause less severe disease on average also helped avoid an even greater crisis that would have occurred if it was as severe as the delta variant.

"Had Omicron been Delta and had we had fewer vaccinations we'd be seeing 8,000 deaths/day, may be more," tweeted Ashish Jha, dean of the Brown University School of Public Health, who noted cases nationally have now "likely peaked."

"As [the] Omicron surge ebbs and life returns back to more of a normal let's use that time to prepare to more effectively manage future variants and surges," he added.