If the early data is accurate on Omicron's immune evasion we may see a pretty disjointed Omicron wave given still significant gaps on first/second doses and a lot of state variance on booster uptake, especially by age. And there's massive variance in regards to prior infection with places like Hawaii and Vermont without many infections this pandemic.
This graph tries to roughly extrapolate population immunity by state by assuming a 1:4 case ascertainment.
The math of viral pandemics is harsh. While a ~23% reduction in vaccine effectiveness against severe disease doesn't seem like much if the underlying case load is sufficiently high that can mean a lot of new severe cases. And if they all happen quickly that can put acute strain on health systems. This is an unfortunate time for a new wave as we are still dealing with Delta, RSV, and emerging seasonal Flu. There's also a lot of postponed hospital care now being done.
Even if we don't see many coronavirus deaths, this Omicron wave could be quite disruptive.
