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San Francisco Followed Covid Rules. Will Omicron Change the Playbook?

“This case, you know, was getting ill even before we were hearing about Omicron from South Africa,” Kris Ehresmann, infectious disease director for the Minnesota Department of Health, told reporters on Thursday.

Omicron carries more than 50 genetic mutations that in theory may make it both more contagious and less vulnerable to the body’s immune defenses than previous variants. Available vaccines may still offer substantial protection against severe illness and death following infection with the variant, but much remains unknown.

Most of the mutations are on the virus’s spike protein, which the existing vaccines target. Federal officials are asking vaccinated people to get booster shots and the makers of the two most effective vaccines, Pfizer-BioNTech and Moderna, are preparing to reformulate their shots, if needed.

But it remains unclear whether Omicron will change the anti-coronavirus playbook. If the new variant turns out to be more transmissible than, say, the Delta variant, officials said, health guidance may stiffen — more vigilance about masking indoors, sterner requirements for boosters.

“It’s worth re-asking the question, ‘I’ve started to get a little less careful than I was — is that the right thing?’” said Dr. Bob Wachter, a professor and chair of the department of medicine at University of California, San Francisco. “If, psychologically, you need a month to get prepared to move backwards, you should get ready for the possibility.”

That could be tough. The options government officials have to control the spread of the virus have proved to be politically limited in this country, even where communities have been open to restrictions. California’s health measures saved countless lives, for instance, but also helped fuel a recall effort against Gov. Gavin Newsom this year.

In the rural north end of the state, the Butte County town of Oroville recently declared itself a “constitutional republic” in a mostly symbolic move to protest pandemic mandates. Just 49 percent of the county’s residents are fully vaccinated, with more than double the cases per 100,000 people than in San Francisco.

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