The Business of Empathy: How Pharmacists Can Improve Performance By Improving The Human Connection

Covid-19 highlighted the value pharmacists provide in disease management and prevention, but it hasn’t been an easy road. Patients relied on their pharmacies for more services and support than before; however, the increased demand has stretched the capacity of many pharmacies. When patients don’t receive the support they need, medication adherence suffers, which directly impacts pharmacy performance. It’s a difficult cycle to break during a critical time for pharmacy business.

Pharmacies can build on the positive momentum gained during the pandemic to improve patient engagement and, relatedly, medication adherence. A familiar face close to home can help ease patients’ anxiety as they cope with a new diagnosis. Empathic support can also make a positive impact on medication adherence—a key metric for patients’ health and for pharmacy business success. But pharmacies will need an empathetic helping hand to provide this support.

Medication adherence is one of the key indicators of pharmacy performance. Unfortunately, pharmacies have a high barrier to overcome because about half of patients do not take their medications as prescribed. This lack of adherence leads to about $500 billion in avoidable healthcare costs and contributes to up to 25% of hospitalizations each year.

Nonadherence is infrequently caused by simple forgetfulness. Patients stop or never start taking a medication for many reasons, including:

  • They can’t afford it.
  • They don’t understand the directions.
  • They don’t see the need for the medication.
  • They’re afraid of the side effects.
  • They are worried, scared, anxious, confused.

Regardless of the cause, the outcome is the same: potentially compromised patient health and lost pharmacy revenue.

Who owns the problem of adherence?

Everyone owns the problem of adherence. Understanding that adherence is a complex problem, all healthcare providers must come together to solve the problem. Tackling adherence requires a fundamental understanding of the human factors behind the problem and the solution.

Pharmacist-provided care requires empathy and genuine human connection. Practicing empathy leads to innumerable benefits for patients, including better medication adherence, fewer hospital admissions, and lower stress—the latter of which ties to numerous health improvements.

Improving patient engagement is key to improving medication adherence, and thus improving pharmacy performance and profitability. Engagement beings with prescribers who start the dialogue around the benefits and risks of a prescribed medication, the possible side effects, and the cost.

Pharmacists must continue that conversation to help ensure that patients fill prescriptions and take medications as prescribed. Given staffing shortages, it’s not an easy ask. A lower-cost, empathic support program would help fill the gap.

Another important reason to focus on patient engagement: it ties to payment for pharmacy services. The Pharmacy Quality Alliance advocates for pharmacist-provided care as part of healthcare’s shift to value-based payment models. Operating models based on financially sustainable, pharmacist-provided care lead to improved medication adherence, PQA reports.

To improve business performance, pharmacies must also focus on patient satisfaction—an important factor in retaining existing customers and acquiring new ones. Pharmacies can improve both engagement and satisfaction with a subtle shift in philosophy, from patient-centric to empathetic care.

What is empathy in pharmacy? 

Empathy is the ability or capacity to understand or feel the patient’s situation, perspectives, and feelings. In other words, it’s the capacity to put yourself in someone else’s shoes. It’s a human connection that instills confidence and builds trust between two individuals.

Empathic care improves patient satisfaction. Here’s an example: a pharmacy customer is fuming because her prescription is delayed. The pharmacy tech understands the customer isn’t angry at her. She’s scared because she doesn’t know what will happen if she misses a dose of her medication. Rather than shut down emotionally and finish the transaction as quickly as possible, the pharmacy tech explains the reason for the delay. She relays the patient’s concerns to the pharmacist, who provides a missed medication protocol. The pharmacy tech also puts the prescription on an auto-refill plan to prevent future delays.

By practicing empathic care, pharmacies achieve better rapport with their patients, engender trust, and establish loyal customers. Loyalty manifests in a number of ways – from glowing reviews, to customer retention, new customer acquisition, higher quality ratings, and increased payment for services – all of which help booth the pharmacy’s business.

How to provide a more human experience through technology

While most pharmacies strive to provide attentive, empathic customer service, they’re also stretched thin. A recent National Pharmacy Technician Association survey found almost all (91.4%) pharmacy techs experienced burnout caused by unmanageable workloads. Another survey found most (80%) pharmacies have trouble finding pharmacists.

Technology that’s easy to implement and nonintrusive to workflow can lighten some of the load for busy pharmacies. Low-code process automation software can take on mundane repetitive tasks, including measuring medication, filling orders, inventory management, and notifying patients that their prescriptions are ready for pickup. Automating these tasks frees up staff to focus on higher-value activities, such as genuine patient communication.

Some pharmacists are using digital tools to provide supportive services to Medicare providers. Pharmacists can conduct virtual consultations to discuss new prescriptions, provide medication therapy and chronic care management, and other services “incident to” healthcare providers.

Research, however, shows that patients want to be seen, heard, and met where they are emotionally. Not “messaged” or “app’d” repeatedly, but actually heard. The very notion of health has evolved in the last few years, with a vernacular shift from “patient” to “person” as one example.

Technology can support a more meaningful human connection. Based on the data, would a patient need a follow-up call the day after she picks up her prescription? Would they appreciate a check-in call if they haven’t picked up a prescription after a few days? This type of simple check-in may open the door to deeper conversations about cost, administration, or side effects.  It may also provide the space for a patient to express their worries, concerns, or confusions about their treatment. Or it may simply trigger a patient’s memory.

Studies have shown that empathic, positive communication is associated with improved patient satisfaction and quality of life compared to usual care. An Accenture survey of nearly 1,800 patients found that the most important factor in creating a positive experience was a provider “who explains the patient’s condition and treatment clearly,” (55%) followed closely by “a provider who listens, understands patient’s needs, and provides emotional support” (52%).

Pharmacies can be instrumental in instilling positive behavior changes in the patients they serve.  Behavior is the result of our motivation, ability, and prompt.  When pharmacies engage on a human level with patient support programs, patients become more fully engaged in their treatment, leading to potentially significant health benefits. The human-to-human connection relieves patients from isolation,  gives them confidence in their recommended treatment, and ensures that humans remain first in the digital/AI age.

Empathy is Good Business

Developing meaningful relationships with patients creates an emotional bond that helps patients make lasting change—including taking their medications as prescribed. Empathy activates and moves patients from emotion to action. When that action includes more prescriptions filled and refills as directed by physicians, that’s good empathy-derived business.

Michael Oleksiw

By: Michael Oleksiw

Michael is a leader in technology development and product data on a global scale for over 20 years solving specific business and societal problems through innovation.

Source: The business of empathy: How pharmacists can improve performance by improving the human connection – MedCity News

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CDC Approves COVID-19 Vaccines For Children Under 5

U.S. health advisers on Saturday recommended COVID-19 vaccines for infants, toddlers and preschoolers — the last group without the shots.The advisers to the Centers for Disease Control and Prevention unanimously decided that coronavirus vaccines should be opened to children as young as 6 months. On Saturday afternoon, CDC Director Rochelle Walensky signed off on the panel’s recommendation.

“Together, with science leading the charge, we have taken another important step forward in our nation’s fight against COVID-19,” Walensky said in a statement. “We know millions of parents and caregivers are eager to get their young children vaccinated, and with today’s decision, they can. I encourage parents and caregivers with questions to talk to their doctor, nurse, or local pharmacist to learn more about the benefits of vaccinations and the importance of protecting their children by getting them vaccinated.”

HHS Secretary Xavier Becerra released a statement calling the CDC’s move a “major milestone.”

“Thanks to the FDA and CDC’s rigorous, comprehensive, and independent review of the data, and their strict commitment to following the science, we are reaching another major milestone in our efforts to protect more children, their families, and our communities as we work to end the pandemic,” Becerra said. “We are following the data and science as we make sure all Americans are eligible and have access to COVID-19 vaccines and boosters to prevent severe disease and save lives. Based on CDC and FDA actions, we now know that vaccination for our children 6 months through 5 years old is safe and effective and we are ready to get millions of children vaccinated.”

The White House also weighed in on the decision in a statement calling the CDC’s decision a “monumental step forward in our nation’s fight against the virus.””For parents all over the country, this is a day of relief and celebration,” President Biden said in the statemente. “As the first country to protect our youngest children with COVID-19 vaccines, my Administration has been planning and preparing for this moment for months, effectively securing doses and offering safe and highly effective mRNA vaccines for all children as young as six months old.

“While the Food and Drug Administration OKs vaccines, it’s the CDC that decides who should get them. The government has been gearing up for the start of the shots early next week, with millions of doses ordered for distribution to doctors, hospitals and community health clinics around the country. Roughly 18 million kids will be eligible, but it remains to be seen how many will ultimately get the vaccines. Less than a third of children ages 5 to 11 have done so since vaccination opened up to them last November.

Two brands — Pfizer and Moderna — got the green light Friday from the FDA. The vaccines use the same technology but are being offered at different dose sizes and number of shots for the youngest kids.

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Pfizer’s vaccine is for 6 months through 4 years. The dose is one-tenth of the adult dose, and three shots are needed. The first two are given three weeks apart, and the last at least two months later. Moderna’s is two shots, each a quarter of its adult dose, given about four weeks apart for kids 6 months through 5. The FDA also approved a third dose, at least a month after the second shot, for kids with immune conditions that make them more vulnerable to serious illness.

Two doses of Moderna appeared to be only about 40% effective at preventing milder infections at a time when the omicron variant was causing most COVID-19 illnesses. Pfizer presented study information suggesting the company saw 80% with its three shots. But the Pfizer data was so limited — and based on such a small number of cases — that experts and federal officials say they don’t feel there is a reliable estimate yet.

Hospitalizations surged during the omicron wave. Since the start of the pandemic, about 480 children under age 5 are counted among the nation’s more than 1 million COVID-19 deaths, federal data show. “It is worth vaccinating, even though the number of deaths are relatively rare, because these deaths are preventable through vaccination,” said Dr. Matthew Daley, a Kaiser Permanente Colorado researcher who sits on the advisory committee.

U.S. officials expect most shots to take place at pediatricians’ offices. Many parents may be more comfortable getting the vaccine for their kids at their regular doctor, White House COVID-19 coordinator Dr. Ashish Jha said. He predicted the pace of vaccination to be far slower than it was for older populations.

Pediatricians, other primary care physicians and children’s hospitals are planning to provide the vaccines. Limited drugstores will offer them for at least some of the under-5 group. U.S. officials expect most shots to take place at pediatricians’ offices. Many parents may be more comfortable getting the vaccine for their kids at their regular doctor, White House COVID-19 coordinator Dr. Ashish Jha said. He predicted the pace of vaccination to be far slower than it was for older populations.

“We’re going see vaccinations ramp up over weeks and even potentially over a couple of months,” Jha said. It’s common for little kids to get more than one vaccine during a doctor’s visit. In studies of the Moderna and Pfizer shots in infants and toddlers, other vaccinations were not given at the same time so there is no data on potential side effects when that happens. But problems have not been identified in older children or adults when COVID-19 shots and other vaccinations were given together, and the CDC is advising that it’s safe for younger children as well.

About three-quarters of children of all ages are estimated to have been infected at some point. For older ages, the CDC has recommended vaccination anyway to lower the chances of reinfection.Experts have noted re-infections among previously infected people and say the highest levels of protection occur in those who were both vaccinated and previously infected. The CDC has said people may consider waiting about three months after an infection to be vaccinated.

Source: CDC approves COVID-19 vaccines for children under 5 | Fox Business

Related contents:

Fourth Shot Protects Against Severe Omicron Outcomes; COVID May Increase Risk of Rare Eye Blood Clots

The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Fourth vaccine dose protects vs Omicron for at least a month

A fourth dose of the COVID-19 vaccine from Pfizer and BioNTech provided significant added protection against severe disease, hospitalization and death for at least a month in older individuals, according to a study conducted when the Omicron variant was dominant.

The estimated effectiveness of the fourth dose during days 7 to 30 after it was administered compared with a third dose given at least fourth months earlier was 45% against infection, 55% for symptomatic disease, 68% for hospitalization, 62% for severe disease and 74% for death, the research team reported on Wednesday in The New England Journal of Medicine.

The study compared 182,122 individuals aged 60 and older who received a fourth dose and 182,122 very similar people who had received a third dose but not a fourth.

“The results of our real-world study suggest that a fourth vaccine dose is, at least initially, effective against the Omicron variant,” the researchers said. “Additional follow-up will allow further assessment of the protection provided by the fourth dose over time.”

A recently published study that looked only at rates of breakthrough infections and serious illness after the fourth dose found that efficacy waned quickly versus infection but held steady versus severe illness.

COVID-19 may increase risk for rare eye clots. Patients with COVID-19 may have an increased risk of rare vision-threatening blood clots in the eye for months afterward, new findings suggest.

Because SARS-CoV-2 infections increase the risk of blood vessel obstructions at other sites in the body, researchers studied nearly half a million COVID-19 patients to see whether they would develop clots in the veins or arteries of the retina, the nerve tissue at the back of the eye that receives images and sends them to the brain.

Over the next six months, 65 patients had a retinal vein occlusion. While that number is low, it reflects a statistically significant 54% increase compared with pre-COVID infection rates, according to a report published on Thursday in JAMA Ophthalmology.

Retinal artery clots were 35% more common after COVID-19 than before, but that difference might have been due to chance. The clots most often occurred in patients with other conditions that increased their risk of blood vessel problems, such as diabetes, high blood pressure, and high cholesterol.

By: Nancy Lapid

Source: Fourth shot protects against severe Omicron outcomes; COVID may increase risk of rare eye blood clots

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Critics:

By: Mary Van Beusekom

Compared with a third vaccine dose, a fourth dose of the Pfizer/BioNTech COVID-19 vaccine lowered the risk of infection, symptomatic infection, hospitalization, severe illness, and death 52% to 76%—depending on the measure—amid the Omicron surge among older adults.

Protection against infection waned, however, after 5 weeks, but not protection against severe COVID-19. The findings were published yesterday in the New England Journal of Medicine.

Seven to 30 days after the fourth COVID-19 dose, vaccine effectiveness (VE) relative to the third dose was estimated at 45% against infection (95% confidence interval [CI], 44% to 47%), 55% against symptomatic illness (95% CI, 53% to 58%), 68% against COVID-19 hospitalization (95% CI, 59% to 74%), 62% against severe disease (95% CI, 50% to 74%), and 74% against death (95% CI, 50% to 90%).

Fourteen to 30 days after the fourth dose, VE was 52% (95% CI, 49% to 54%) against infection, 61% (95% CI, 58% to 64%) against symptomatic illness, 72% (95% CI, 63% to 79%) against hospitalization, 64% (95% CI, 48% to 77%) against severe disease, and 76% (95% CI, 48% to 91%) against death.

In the fourth week after the fourth dose, the adjusted infection rate was lower by a factor of 2.0 (95% CI, 1.9 to 2.1) than that in the three-dose group and lower by a factor of 1.8 (95% CI, 1.7 to 1.9) than that among controls.

The difference in absolute risk for COVID-19 hospitalization 7 to 30 days after a fourth vaccine dose, relative to a third, was 180.1 per 100,000 people (95% CI, 142.8 to 211.9), while it was 68.8 cases per 100,000 (95% CI, 48.5 to 91.9) for severe disease. A sensitivity analyses of VE against infection had similar results as those in the primary analysis.

Starting in the fifth week after the fourth dose, the rate ratio (RR) for infection began to fall. The adjusted rate of infection in the eighth week after the fourth dose was comparable to that of internal controls. The RR for the three-dose group relative to the four-dose group was 1.1, while the rate ratio for the internal control group, compared with the four-dose groups, was 1.0.

The RRs comparing controls with fourth-dose recipients were larger and lasted longer for severe disease. In the fourth week after the fourth dose, the adjusted rate of severe disease was lower by a factor of 3.5 than in three-dose recipients and a factor of 2.3 than in internal controls.

The adjusted rate of severe illness in the fourth week after the fourth dose was 1.6 cases per 100,000 person-days, compared with 5.5 cases per 100,000 in three-dose recipients and 3.6 cases per 100,000 in internal controls. The adjusted rate differences were 3.9 fewer cases per 100,000 person-days and 2.1 fewer cases per 100,000 than the three-dose group and internal controls, respectively.

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Pandemic Endgame: What ‘Endemic’ Covid Means—And When We May Get There

Nearly two years into the pandemic, weary politicians and governments are pushing to treat Covid-19 like any other problematic but manageable illness like the seasonal flu, but experts warn the approach could be premature and paints an overly optimistic picture of what “living with Covid” actually means.

Despite the contagious omicron variant driving huge waves of infections, countries including the U.K., Denmark and Sweden have dropped almost all pandemic restrictions as leaders stress we must “learn to live” with the virus and transition from treating Covid-19 as a pandemic illness to an endemic one.

But “with few exceptions, politicians do not understand the meaning or significance of endemicity,” warns Dr. John Swartzberg, an infectious disease expert at the University of California at Berkeley school of public health, who told Forbes endemic means the “stable or constant presence of a disease” within a set area.

Dr. Aris Katzourakis, an evolutionary virologist at the University of Oxford, expressed a similar degree of uncertainty and told Forbes that while he couldn’t say how soon we might reach it, “it’s not going to be in 2022.”

Endemic doesn’t mean mild or infrequent disease either, both experts caution—”endemic means that it is with us to stay,” Halloran said—and many of the world’s biggest killers like malaria, tuberculosis and HIV are endemic.

What We Don’t Know

What endemic Covid would mean for our everyday lives. This would depend on “what level the endemicity arrives at,” Swartzberg said, meaning how common the disease will be. If Covid were to be endemic at a very high level, “we will be limited in our options,” he explained, and may have to keep on using social restrictions and non-pharmaceutical interventions like masks.

At a very low level, “life will return toward the pre-pandemic state.” We have some control over the level of endemicity through vaccination, Swartzberg said, which would also reduce the chance of a new variant emerging.

Key Background

Calls to just live with the coronavirus have been prevalent since the pandemic began and many—including a not-insignificant number of politicians at the highest levels of office like former President Donald Trump and Brazil’s Jair Bolsonaro—controversially compared it to seasonal flu to illustrate the point.

Though symptoms between the two diseases are similar, the comparison misleadingly downplayed the severity of the coronavirus and showed ignorance of the death toll influenza exacts every year (up to 650,000 people worldwide).

Calls to treat Covid-19 as a more predictable and regular illness grew in popularity as restrictions continued into a second year of the pandemic and vaccines were rolled out and gained new momentum with the rapid spread of the delta and then the omicron variant. Though the latter variant caused higher rates of infection—which reached record levels in many countries—there were relatively low levels of hospitalization and deaths compared to previous waves.

In addition to parts of Europe, leaders in many states are renewing the push to return to normal, with a number of governors feeling it’s time to treat Covid as endemic.

Chief Critic

Tedros Adhanom Ghebreyesus, the leader of the World Health Organization, warned last week against countries lifting restrictions and claiming victory over the virus prematurely. “This virus is dangerous, and it continues to evolve before our very eyes,” he said. Continued restrictions are vital to stop transmission of the virus, he added, in response to countries relaxing measures.

What To Watch For

“Stealth” omicron BA.2. A close relative of the omicron variant—known as BA.2 and called “stealth omicron” by some scientists—is more infectious than the original omicron variant and is rapidly overtaking it in some parts of the world. It does not appear to cause more serious disease, as with the original variant, though experts warn it could lead to more hospitalizations and deaths with more people getting infected.

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I am a London-based reporter for Forbes covering breaking news. Previously, I have worked as a reporter for a specialist legal publication covering big data and as a freelance journalist and policy analyst covering science, tech and health. I have a master’s degree in Biological Natural Sciences and a master’s degree in the History and Philosophy of Science from the University of Cambridge. Follow me on Twitter @theroberthart or email me at rhart@forbes.com 

Source: Pandemic Endgame: What ‘Endemic’ Covid Means—And When We May Get There

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Critics:

Europe is entering the “plausible endgame” of the coronavirus pandemic, a director of the World Health Organization has said. Dr Hans Kluge, WHO regional director for Europe, said the region had recorded 12 million new COVID-19 cases in the last week, with 30% of all cases since the pandemic began being reported this year.

But he said “for now, the number of deaths across the region is starting to plateau”. He said there is an “opportunity to take control of transmission” because many are immune to Omicron through either natural infection or vaccination.

Dr Kluge said there is a “favourable seasonal pause as we move out of winter”, while the “lower severity of the Omicron variant” is also helping. “This context, that we have not experienced so far in this pandemic, leaves us with the possibility for a long period of tranquillity and a much higher level of population defence against any resurge in transmission, even with a more virulent variant,” he said.

“This period of higher protection should be seen as a ceasefire that could bring us enduring peace.”

More contents:

Don’t Treat Covid Like Flu, WHO Says, As Nations Ditch Restrictions And Live With Virus (Forbes)

COVID-19: endemic doesn’t mean harmless (Nature)

We’re Thinking About Endemicity All Wrong (Atlantic)

Pfizer sees revenues double to $81bn thanks to COVID-19 vaccine

COVID-19: Hundreds of thousands probably died due to ‘bad behaviour’ from politicians over AstraZeneca vaccine, says Oxford scientist

Sir Keir Starmer in the clear over claim he broke lockdown with office beer

How Omicron Upended What We Thought We Knew About Natural Immunity

After dizzily swelling for weeks, COVID-19 cases seem to be leveling off in New York and Chicago. In the greater Boston area, the amount of SARS-CoV-2 found in wastewater is going down as quickly as it had gone up. The hard part isn’t over yet, but the omicron wave is starting to break and roll back out to sea. Soon we’ll see if any treasures are left behind in the tide pool.

Between Dec. 1 and Jan. 17, at least 18 million Americans contracted COVID. Data suggests that the vast majority of those cases were in unvaccinated people, but plenty of people who got their primary series of the vaccine also caught the immunity-evading omicron variant. By the time this wave is over, American bodies will know this virus like never before. But will the survivors gain anything from having had the disease? After all, there will be more variants in the future. Could the hard-earned immunity we’ve gained from omicron help fight them off? Could this wave be the last?

On Monday, White House chief medical adviser Anthony Fauci said it’s too soon to answer these questions. Scientists we spoke to agreed. But they also said the reason these questions were so difficult to answer was because of an issue that hasn’t always gotten much attention in the public sphere:

The immunity provided by a COVID infection itself. Scientists have learned a lot about this “natural immunity” since the pandemic began. But omicron has upended many of those expectations, and the more we learn about this variant, the less clear it is what we should expect for the future of the virus and our immunity to it.

Scientists have been studying infection-induced immunity since COVID first emerged. In fact, it was the only kind of immunity anyone could really study at that point, said John Moore, a professor of microbiology and immunology at Cornell University’s Weill Cornell Medical College. And while there are now many more studies on vaccine-induced immunity thanks to clinical trials and easily trackable vaccinated populations like medical staff, there’s a lot that can be said about natural immunity, pre-omicron, with a reasonable amount of certainty.

One important takeaway from all that pre-omicron research: Infection-induced immunity and vaccine-induced immunity are pretty similar. On the whole, studies found that the efficacy of infection-induced immunity was about the same as what you’d get from a two-dose mRNA vaccine, and sometimes higher.

For example, research from the U.K., in which a few hundred thousand participants were followed in a large-scale longitudinal survey, found that prior to May 16, having had two doses of the vaccine (regardless of the type) reduced the risk of testing positive by 79 percent, while being unvaccinated and having had a previous infection reduced the risk by 65 percent. After the delta variant became dominant,1 vaccination became less effective, reducing the risk by 67 percent, while a previous infection reduced the risk by 71 percent.

Likewise, both kinds of immunity seemed to wane over time — though Moore said infection-induced immunity might take longer to decline because a vaccination happens nearly all at once, while an infection takes longer to go through a process of growing, declining and finally being cleared from the body. “But it’s also not radically different [from antibody titers to vaccination]. It’s not measured in years, but months,” he said.

This is why some countries, including the member states of the European Union, treat documented recovery from COVID-19 as functionally the same as vaccination in their “vaccine passport” systems.

Still, vaccine-induced immunity is a better choice, not because it produces a stronger immunity, but because it enables you to get the immunity without the side effects and risks that come along with illness — like a greater risk of stillbirth if you’re pregnant, or long COVID, hospitalization and death in general.

The pre-omicron research also indicated another downside to natural immunity: namely, that it can be more variable. All immunity differs from person to person and holds up better against some variants than others. But infection-induced immunity can also be more or less effective depending on how severe your case of COVID was, explained John Dennehy, a professor of biology at the City University of New York’s Graduate Center.

Since the earliest studies, scientists have found evidence that more severe illnesses produce a higher antibody response, while mild cases end up producing much less.

Then came omicron. The public desire for information on omicron is moving faster than science can produce, but we do know that this variant escapes natural immunity as easily as it does vaccine immunity. Omicron carries a lot of mutations that make it able to evade antibodies — and it doesn’t really matter how you got those antibodies in the first place, said Jeffrey Klausner, a professor of medicine in the Division of Infectious Diseases at UCLA’s David Geffen School of Medicine.

Beyond that, the picture is murky. For example, we know milder infections have, with past strains, produced less effective immunity. If a hallmark of omicron is milder infections — and that’s the main reason why there’s so much chatter that it might just be better to get this variant and get some natural immunity — how much immunity can anyone really expect to come out of those mild infections with?

“We’re going to know for sure in a few weeks because a ton of preprint is coming out about it, but I don’t know the answer today,” Moore said. It’s information journalists can come back and update you on later, but it makes informed speculation hard now. (Meanwhile, keep an eye on our COVID-19 research tracker.)

The same holds true when you start trying to parse out what vaccinated people can expect from a breakthrough case of omicron. The combination of vaccine and infection-induced immunity has been shown to produce a hybrid that is probably more effective than either type alone — but, again, that research came from pre-omicron studies. Is a breakthrough case as good as a booster?

If you’re going to get a booster after you’ve had a breakthrough case, how long should you wait? Those are questions scientists don’t have the answers to yet, partly because there’s no clear through line of what to expect once you’re dealing with omicron.

“Maybe your readers are right in being confused, because we don’t really know how long-lasting the immunity you get from omicron will be,” said David Thomas, the director of the Division of Infectious Diseases at Johns Hopkins Medicine.

Which brings us to the biggest question of all: Will the many infections, reinfections and breakthrough infections associated with omicron maybe — finally — put us in a better position for a well-protected, safer society? Maybe even a society that doesn’t have any more big waves crashing on its head?

Theoretically, yes, Klausner told me. And he’s optimistic that it will. Thomas and Dennehy, on the other hand, were more cautious. After all, Dennehy pointed out, there’s no guarantee that future strains will be related to omicron. If omicron is different enough from delta that it evades immunity from that previous variant, what happens if a future variant comes along that’s evolved from delta and not omicron? It’s not unreasonable to expect a whole new wave.

And what does Moore think? He was just ready to take a pause from speculation and get some data before anyone starts making decisions for themselves or for society. “I’m fed up with winging answers to reporters like yourself, because I don’t know the answer,” he said. “None of us know for sure.”

Maggie Koerth

By:

Maggie Koerth is a senior science writer for FiveThirtyEight.

Source: How Omicron Upended What We Thought We Knew About Natural Immunity | FiveThirtyEight

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