There's still much to learn about the new omicron variant of the COVID-19 virus. We don't yet know how transmissible it is, whether it causes severe illness or how effective existing COVID-19 vaccines are against it.
At the same time, there's one thing about the omicron variant that we do know: If we don't use all our resources to get people around the world vaccinated, variants like omicron will continue to emerge, posing a health threat not only to people outside of the United States, but also to those within our borders.
The emergence of omicron is directly related to our failure to make vaccines equally available to all countries.
As of Nov. 23, just over 7% of people in low-income countries have been vaccinated with at least one dose, compared to nearly 64% in high-income countries, according to the Global Dashboard for Vaccine Equity, an initiative established by the United Nations Development Programme, the World Health Organization and Oxford University.
"COVID is a global pandemic that requires global solutions, and we cannot ignore it any longer," said Dr. Reshma Gupta, an internal medicine physician at UC Davis Health.
In just the few days since the omicron variant was first discovered in South Africa, cases of it have been detected in Africa, Europe, the Middle East and Canada. If it isn't already here in the United States, its arrival is imminent. This is entirely predictable. COVID-19 knows no borders. Wherever there are people, it will spread.
Nevertheless, vaccinations offer a proven way to slow the spread of the virus and reduce the number of hosts available.
"Broad sharing and supply of vaccinations could prevent the magnitude of viral mutations that increase the risk of spread again," Gupta said.
The Biden administration has worked with world leaders to create processes for the distribution of vaccines worldwide. It has also committed to donating more than 1 billion doses of the Pfizer/BioNTech vaccine to lower-income nations.
However, these efforts are light-years away from the goal, as ultimately the demand far exceeds the pace of donations. According to the Kaiser Family Foundation, just 245 million of those promised doses have been delivered and 26 million have been shipped, leaving over 828 million pledged vaccines yet to be distributed.
But if the sudden spread of the omicron variant teaches us anything, it's that we can no longer wait to get these vaccines abroad.
"The rise and spread of the delta and omicron variant could have been avoided had the world committed to vaccinating on a global scale," said Dr. Bhavna Lall, an internal medicine physician and professor at the University of Houston College of Medicine.
To implement such a global vaccine initiative, the United States should follow four steps.
First, the U.S. should coordinate vaccine distribution efforts with institutions that already have presences in the regions that most need the shots. These institutions include the United States Agency for International Development, non-governmental organizations and NATO.
There's precedent for success with missions like these. Starting in 2003, the United States has provided more than $85 billion in funding for HIV/AIDS treatment, prevention and research, according to the Department of State. Agencies working in more than 50 countries coordinated efforts that have saved millions of lives, mostly in low- and middle-income countries. If the U.S. can do this with HIV/AIDS, which can be spread in myriad ways, it can do it for COVID-19, which, epidemiologically speaking, is just a respiratory virus.
Second, the country should waive drug patents for COVID-19 vaccinations. Patent protections keep the manufacture of lifesaving vaccines in the hands of the drug companies that developed them. That makes economic sense for those companies. But at a certain point, public health must take priority over profits.
The Biden administration said over the summer it supports waiving patent protections on COVID-19 vaccines. News of the omicron variant, the president said, "reiterates the importance of moving on this quickly."
A World Trade Organization summit originally scheduled for this week, at which the subject of patent waivers was to be discussed, was postponed due to the risks posed by the omicron variant. Countries including the U.K., Switzerland and Germany, where some of the largest pharmaceutical companies are based, oppose the waiver.
Without such waivers, which are largely opposed by the wealthiest nations, poorer countries rely on vaccinations produced in other countries. Some of the Chinese vaccines -- which have been distributed to dozens of countries -- have been shown to have low effectiveness, the director of the Chinese Center for Disease Control and Prevention admitted in April. According to the Associated Press, China's five vaccines range from 50% to 79% effectiveness, compared to Pfizer and Moderna's 95%.
Third, the U.S. must vaccinate the world's health care workers. Just two in five health care workers globally are vaccinated, World Health Organization Director-General Tedros Adhanom Ghebreyesus said in a press conference last month. In Africa, fewer than 10% are vaccinated, he said.
It's not possible to vaccinate every person in the world right away. But it is possible to begin a mass vaccination campaign aimed at health care workers, who are needed most acutely on the front lines to fight illnesses spread by COVID-19.
What's more, because health care workers regularly come into contact with sick people, who are most susceptible to COVID-19-related illness, it's crucial to vaccinate them first.
Finally, the U.S. should reinforce masking, distancing, testing and vaccinations both in the United States and abroad. Vaccines are the most effective way to stem the spread of COVID-19. But masking and distancing are also important layers of intervention. While we wait to get vaccines to the world's most vulnerable populations, we can help stop the spread of disease by following these simple guidelines.
We are now at a crossroads. Although just 59% of the entire U.S. population is fully vaccinated, nearly 75% of Americans over age 5 have received at least one COVID-19 vaccination dose.
That's not the case across the world. And the lack of vaccinations, in short, is why the omicron variant is spreading.
But omicron shouldn't signal our surrender to COVID-19. Instead, it should lead us to redouble our efforts to stomp it out by getting life-saving vaccines to every corner of the globe.