Dr. Jessica Kiss, a family medicine doctor in Southern California, has answered countless questions about COVID-19 under her TikTok handle @AskDrMom during the pandemic. But one of the most surprising came on Jan. 3, which also happened to be a record-breaking day for new U.S. cases: “Should you deliberately get Omicron?”
While most people have spent the last two years desperately trying to avoid COVID-19, some are now apparently contemplating doing the opposite. Their perverse logic mirrors that behind chickenpox parties, at which parents would purposely expose their kids to the virus to get the infection “out of the way” and kickstart immunity.
But as Kiss said on TikTok, “It wasn’t a good idea then, and it’s not now.”
Omicron is so contagious that many people, both vaccinated and unvaccinated, will get infected during this wave. On Jan. 3, more than a million people in the U.S. were diagnosed with COVID-19, leading some experts and members of the public to conclude that it may be impossible to hide from the virus forever. Breakthrough infections have become common, and for those who are fully vaccinated and boosted, they’re likely to be fairly mild.
But actively trying to get infected isn’t wise for anyone, experts say. It’s an unnecessary gamble for fully vaccinated people, and for those who aren’t vaccinated, it’s like playing “Russian roulette with an automatic handgun,” says Dr. Laolu Fayanju, regional medical director for Oak Street Health in Ohio.
There are several problems with this approach, says Akiko Iwasaki, an immunobiologist at the Yale University School of Medicine who studies viral immunity. First, there’s no way to predict how serious a case of COVID-19 will be. Second, vaccines and boosters already provide strong protection. And third, every infection can set off a domino effect, affecting other people in potentially devastating ways.
“The risk-to-benefit calculation here is very clear to me,” Iwasaki says. “The risk is so much higher than whatever benefit you might reap.”
So far, data suggest that people infected by the Omicron variant are less likely to be hospitalized than people infected by previous strains of COVID-19, and those who are admitted for care don’t seem to get as sick as patients in earlier waves. That seems to be because Omicron is less likely to cause severe lung damage.
But even if Omicron is on the whole milder than other variants, it will still be catastrophic for some people. On Jan. 3 alone, more than 1,400 people in the U.S. died from COVID-19 and more than 100,000 were hospitalized with the virus. Unvaccinated, elderly and medically vulnerable people are at the highest risk, but there’s no 100% guarantee for anyone. There’s also no way to know if you’re exposing yourself to the Omicron variant versus the still-circulating and more-severe Delta variant, since consumer tests do not differentiate between different strains.
Another concern is Long COVID, the name for symptoms including fatigue, brain fog, trouble breathing and more that last long after an acute COVID-19 infection subsides. Even mild cases can lead to Long COVID. And while studies have shown that vaccination significantly reduces the risk of getting Long COVID after an infection, it is still possible to develop the condition after a breakthrough case.
“People don’t know if they’re going to [be one] of the folks who are able to endure an infection with few long-term consequences,” Fayanju says. There’s no reason to intentionally take that risk, he says.
But what about the idea that recovering from COVID-19 can provide “super immunity” for those who are fully vaccinated? It’s true that each encounter with COVID-19 likely confers some level of natural immunity, and mixing those defenses with vaccination seems to provide a stronger-still response. The U.S. Centers for Disease Control and Prevention has confirmed that “vaccinating previously infected individuals significantly enhances their immune response and effectively reduces the risk of subsequent infection.”
Other studies suggest that people who get sick after they’re vaccinated also see immune perks. A recent research letter found that a small group of fully vaccinated (but unboosted) people experienced an antibody surge after recovering from breakthrough infections, and another small, not-yet-peer-reviewed study found that both vaccinated and unvaccinated people who had an Omicron infection also gained some protection against the Delta variant.
These benefits are silver linings for people who accidentally get sick, but Iwasaki says it’s unnecessary to seek out infection for an immune bump; you can get similar benefits from vaccines and a booster, which are proven to be safe and effective. Plus, natural immunity wanes over time, and there’s no guarantee that getting Omicron will protect you from the next unknown variant that could be around the corner. “We know that the booster induces quite robust antibodies, even against Omicron,” Iwasaki says. “Why not get your immunity that way?”
One of the most important reasons not to intentionally get COVID-19 is the burden it places on vulnerable individuals and our slammed health care workers. Each person who gets sick with COVID-19 can infect others, including those who are medically vulnerable, too young to be vaccinated or otherwise unprotected. If some people deliberately get sick, potentially setting off a chain of transmission, “it has the potential to just explode the number of people who are ill and then swamp our already overwhelmed and overburdened health care system,” Fayanju says.
Thinking of that situation getting worse because people want to get sick, he says, “puts a chill up my spine.”
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Contributor: Jamie Ducharme