The Biden administration was considering severe air travel restrictions out of concern for the Omicron variant of the virus, but they couldn’t make the logistics of legality of some of them work. New restrictions were expected to be announced on Thursday, and now we know what they’re actually doing.
- Requiring a negative test within one day of travel (rather than three) to enter the U.S. by air
- Extending the transportation mask mandate two months to March 18
- Requiring insurers to cover the cost of at-home rapid tests (new rules to be published by January 15)
Before news spread of the Omicron variant I predicted an extension of the mask mandate, that it would only sunset sometime prior to midterm elections 11 months from now. So an extension of the mask mandate isn’t surprising, but of course there’s no such requirement for large indoor gatherings not associated with public transportation.
There will be no requirement for a second Covid test 3-5 days after arrival into the U.S. While the CDC has been handing out such tests at a handful of airports to passengers arriving from Southern Africa, they have no process in place to ensure that people actually take those tests, or that they quarantine if testing positive. And there will be no requirement for mandatory quarantine on arrival, either, as some in the administration were pushing for.
We still mostly know only about the makeup of the Omicron variant, the number of mutations it has and what some of those mutations have meant in other variants. And we’ve seen a spike in cases in South Africa, where the variant was first identified, though we don’t know how many of those cases are Omicron versus a Delta spike after the country relaxed Covid restrictions.
It’s still not clear how much more transmissible this new variant is, whether it’s more or less virulent, and the extent to which it evades vaccination or immunity from prior infection. Despite this uncertainty it seems that transmissibility may not be as bad as initially feared, but it does seem (still speculative) to overcome immunity from prior infection with the Delta variant. Nonetheless anecdotal evidence which I’ve been skeptical so far is mounting about less severe disease and continued protection from vaccines especially after boosting.
The problem of course is that by the time we have answers to these questions it’s too late to do anything. Indeed, it may already be too late – the variant is being identified all over the world, and has been identified in the U.S. where we do less to sequence variants than many other countries. And the bigger problem is that these steps do little to stop or slow transmission of the virus here.
Requiring insurance to pay for testing isn’t as effective as removing barriers to the availability of cheap tests (self-tests often cost 10x here compared to parts of Europe). Pre-travel use of rapid tests identifies current infectiousness but doesn’t identify pre-infectious travelers. And these measures ignore rapid spread within the community already. Vaccinated travelers testing negative are far less likely to spread the virus than the median American in a bar.
We need widely available cheap tests, boosters, variant-specific and multivariant boosters, and immediate approval of small molecule inhibitors along with clinical guidance for already-available repurposed drugs like fluvoxamine.