2 Boston researchers urge CDC to encourage short-term restrictions in areas of high omicron spread

Two Harvard-affiliated researchers are calling for faster, more targeted action against the omicron variant of the coronavirus.

They've sent a memorandum to CDC Director Dr. Rochelle Walensky, asking her to give states and municipalities guidance on how to implement what they're calling "circuit breakers." Those are short-term restrictions on high-risk activities, meant to disrupt and slow down the transmission of the virus. That, in turn, would allow hospitals to continue taking care of not only COVID patients, but people with other acute conditions, they argue.

Dr. Jeremy Faust co-wrote the memo to the CDC along with epidemiologist Bill Hanage. Faust is an emergency physician at Brigham and Women's Hospital in Boston and an instructor in health policy at Harvard Medical School.

Faust told WBUR's All Things Considered host Lisa Mullins that with "circuit breakers," mayors or governors would take action when it looked like hospitalizations in their city or state would become so high that systems would soon be overwhelmed.

On why he considers this urgent:

Dr. Jeremy Faust: "The urgency is that there are some places that need this information right now because they might be on the brink. And we cannot afford to not give them that information so they can act in time. Not every place needs to do this. And so, I don't want people to think that we are advising or advocating a circuit breaker system-wide in every place. We can actually tell a jurisdiction, 'Look, you are now a few days away from a big problem. You should consider the circuit breaker.' "

On the specifics of the "circuit breaker" approach:

"The basic idea is short-term changes in our activities — things like indoor dining capacity, eliminating indoor dining in some places, or [canceling] concerts or performances for a few days ... or doing work from home when that's possible. Non-essential work from home is always best in these situations. ... We can't stop the spread of this virus. This policy doesn't try to do that. But what we do try to do is say, 'What are some things we can all take collectively, for just even a few days or a week, that will change the tide so that downstream, the hospitals aren't falling apart from the insides?' "

On why he believes the omicron variant calls for this kind of action:

"This variant is so extravagantly contagious that we can't wait around. We have to anticipate what's coming. So we have, on the one hand, an advantage. We have an immune population. We have a population that's vaccinated — and boosted in some places. And we know that that means that the numbers of cases today doesn't mean the same thing that it did a year ago. But unfortunately, omicron is so contagious that it will find the people who are not protected. And so we can project the kinds of hospitalizations that we'll see in a week. And the idea is that if we take collective action, you can change the trend."

On how restrictions for just a short time could have a significant impact:

"It has to be several days, at least, but it doesn't have to be so much longer, actually, if you think about it. This virus is highly contagious in very short windows. Probably 10 days is the contagious window for this virus; but it's really the most contagious early. If we can actually stop that from occurring for just a few days, the impact is actually quite amazing. It's not necessarily linear; it can be sort of exponential. So a small change in activity can eliminate a huge amount of spread."

On how this might play out in a particular area:

"We can imagine a city that has 100 available hospital beds. If we find out that there are 1,000 new COVID cases today, and maybe 2% of those are going to need to be hospitalized, that means that 20 people are going to need a hospital bed in a few days from now. So if you do that for five, six, seven days ... that's 100 beds that you filled up. So that would be sort of the threshold being approached."

On the current situation in Massachusetts:

"Basically, if you look at it in Massachusetts, we have about [12% to 15%] of our beds are available right now. And ... based on past numbers, we would have to have more than 10,000 new coronavirus cases per day for five, 10 days to get to a place where I would start to worry about the hospital capacity being an issue. We're not there right now. We're at about 5,000, on average, per day. But we could easily get to 10,000, and if we got well above that for five to 10 days, given our current hospital capacity, we would start to then see the kind of overflow that we're trying to prevent."

On how much he thinks people would cooperate with this call for temporarily buckling down:

"I don't know, and I'm sure it will depend on regions, and we'll see. But one thing that I think people are tired of is losing. No one gets tired of winning. So I think that if we do something that has an achievable goal and we achieve that, then that actually puts fuel in the tank, as opposed to extending. In the initial shutdown period, we did that for a long time, and I'm not sure that anyone really knows or appreciates what that accomplished. So my hope is that by providing something that is actually achievable in a short period of time, that we're actually giving people something to do that they can feel good about, rather than this big sense of, 'Why am I doing this again, and how long will it last?' "