Omicron variant: The U.S. travel ban ‘makes no sense at all,’ doctor says

Brigham and Women's Hospital Emergency Medicine Physician Dr. Jeremy Faust discusses his opinions on the effectiveness of Dr. Fauci's travel ban recommendations and how variants impact vaccination efforts.

Video transcript

AKIKO FUJITA: Let's bring in Dr. Jeremy Faust. He is Brigham and Women's Hospital emergency medicine physician and Bulletin.com's writer of insider medicine. Doctor, just give me a sense of how you're looking at this right now. What's your biggest concern with omicron?

JEREMY FAUST: Thanks for having me. With omicron, the big concern really comes down to, is it more contagious? And does it cause worse disease? And for those of us who are vaccinated, do our vaccines hold up? I think right now, we know none of that. I think the number of mutations can sound very scary. But that is laboratory information.

We are light years away from having the technology to say, based on a mutation sequence, that we know what that means in terms of a clinical response. We just do not have that technological know-how yet, but we do have a lot of other technological know-how that is going to help us in this moment, regardless of what happens. That includes understanding quickly if our vaccines are going to hold up and also making quick changes to the vaccine if necessary.

JARED BLIKRE: And doctor, good to be with you here. Can you give us a timetable for finding out exactly some of this information that we're talking about? So many unknowns here. President Biden has said it's going to be a minimum of two weeks. But realistically, how long will this take?

JEREMY FAUST: I'm hearing different things. And I really go to the source right now. I agree, we don't know where this came from. But we do know where it is. And one of the places is in South Africa. And in talking to my colleagues on the ground there, they have been through this too many times. And so, they're sort of saying, look, we know there's a case spike right now. We see those numbers. We don't expect our hospitals to really feel that or notice that yet. But they're really bracing for the next 7, 10, 14 days.

But that being said, if this were a variant that had a characteristic, such as it was actually faster to cause very deadly disease, I think we'd start to know that right away. So I expect to keep on hearing anecdotal reports. But we won't have really great data for a couple of weeks on the aspect of, is it causing worse disease and breakthrough?

ANJALEE KHEMLANI: Dr. Faust, Anjalee here. I'm so glad you brought up that part about the vaccines and the breakthrough. I want to know, where it stands right now when we talk about global vaccinations, do you see that as playing a role in sort of why we're here, getting news of a new variant? And what needs to be done specifically to help prevent maybe the next variant?

JEREMY FAUST: Yeah, thank you for that question because it's so essential. The way that mutations arise is through infections. And we know that the vaccines temporarily seem to stop infections, at least for several months. We see that efficacy is fantastic. And then even once you have the sort of settled in period where you might still-- you do still have protection against severe disease, hospitalization, and death months and, who knows, years out, we also believe that the vaccine gives us-- our body a chance to defeat the virus quicker. And that's good because that means less spread and less mutations.

So I do think that boosting the older population is an essential move when you see the numbers that you saw in terms of breakthrough, severe illness, and death. You know, the vaccines were working great, but we want them to work even better. So, fine, that's great. But in terms of getting our eye off the prize, in terms of not boosting-- boosting the young and healthy, rather than trying to really focus on vaccinating people all over the world and even in this country who aren't yet having-- haven't received even a single dose yet. So I think those are the priorities in terms of stopping the morbidity, the severity of the disease. And also, it does decrease future moments like this.

ANJALEE KHEMLANI: Do you anticipate that we'll have to do anything in terms of even focused targeted lockdowns or anything like that, just restrictions on people? Because we've already implemented the travel ban, which has had some controversy attached to it. Are we going to see any movement like that here in the US like we're seeing over in Europe?

JEREMY FAUST: I think the travel ban makes no sense at all. I have to say, I disagree with what Dr. Fauci said on the Sunday morning shows. This is a very porous travel ban. I'm sorry, if omicron is a problem, having a ban that goes into effect three days after you announce it that doesn't apply to US passport holders, that doesn't apply to permanent lawful US residents, as if you and I couldn't carry it home with us, that doesn't make any sense.

So, look, travel bans slow things down if they actually work. So Japan is restricting all visitors. They might actually be able to slow this down. The question is, slow it down to do what? And if you're trying to flatten the curve to keep your hospitals from overflowing, that's one thing, but quite frankly, the vaccines I think are doing that already. So we wouldn't be buying time to do that.

What I think people don't want to hear is that a total and complete travel ban would only be so that we could have time to make new vaccines. And that would be something that we think that could happen in 100, 120 days, perhaps, a great technological achievement. But I do think that when you think about what are you trying to slow down, spread of a virus. But again, to what end? So I think that, you know, in 2020, we were trying to get tests. We were trying to get therapeutics. Now, if you were to really try to keep a virus out, it's because, quite frankly, you think that something's wrong with your strategy, and you need to revamp it completely.

AKIKO FUJITA: Yeah, and Dr. Fauci seemed to allude to that saying, look, in many ways, we're just trying to buy time here. What would be a more effective strategy if we're talking about trying to control this? To what extent can what we're seeing right now be contained if, in fact, there is more vaccine distribution, especially in developing countries that have really been sort of raising their hand here, saying, look, you may have boosters in the US and Europe, but we're still waiting for our first shot.

JEREMY FAUST: That's correct. And I think that this is a really important reminder, this moment, to the unvaccinated, who can choose to become vaccinated in this country. So that's one thing that anyone can do who hasn't been sure. This variant, even if it's just another one of the same variants, that's terrible because it's another wave, and it punishes the unvaccinated. I think that we need to redouble our efforts on that track on the first doses.

Look, there actually was a really good rollout of the vaccine for older people in this country, including excellent collaboration between nursing homes, long-term care facilities. And a lot of that actually has ceased to happen smoothly. So we don't have the same rates of vaccination in nursing homes that we did in January and February because of turnover. So we need to focus on that.

We also need to realize that, again, blaming the country that first reported it is a very, very bad idea, because the thing that you could do to stop these things is to know about them very early and to act upon them. Well, if you're South Africa and the lesson you might take is, well, wait a second, why would I want to announce this when I could just wait a week, and maybe Belgium will be blamed? And so, then, we lost a week.

So we need, as a community, to not punish the transparency. We need to increase our sequencing ability. But I think this moment is showing us all we're so uncertain. Sequencing is not everything. So we need to get those sequences. And then the work of studying the clinical impact can begin. So I think getting a headstart is important, but that doesn't mean that you know everything about what those mutations really imply.

AKIKO FUJITA: Yeah, that's a good point and a good reminder, doctor, for all of us to kind of catch our breath, to say let's just hold on here and wait for the science to follow. Dr. Jeremy Faust, Brigham and Women's Hospital emergency medicine physician, always good to have you on the show. And our thanks to Anjalee Khemlani as well for joining in on the conversation.