The U.S. is about to be hit by a huge wave of infections from the COVID-19 omicron variant. Though it’s unclear yet whether omicron is naturally less severe than, say, the delta variant, South African and British case data shows just how quickly it spreads, with significant vaccine evasion and widespread anecdotal reports of COVID-19 reinfections.

UK recorded daily cases, for example, have risen quickly to their highest level in the pandemic, despite not counting any reinfections as new cases. These numbers vastly understate true daily infections, because not all those infected test and therefore get processed as cases.

Four days ago, the British health minister said the government there believed new omicron infections were running at around 200,000 per day (equivalent to nearly a million infections per day for a population the size of the U.S.) And things are getting worse: omicron-specific infections are doubling in London every 1.5 days. One epidemiologist thinks England is just 5 days away from lab capacity for test results being completely maxed out, making such calculations impossible.

Already, there are pockets of rapidly rising COVID-19 cases in the U.S. that suggest omicron is taking off here alongside delta infections. Confirmed new COVID-19 cases across New England are surging. Cornell University saw its caseloads explode over the past week despite its population being 97 percent vaccinated. According to those on the ground the vast majority are mild cases, with fever and headache. This week the NFL, which mandates players get vaccinated (94.6 percent have done so), NHL (all but 4 players vaccinated), and the NBA (99 percent vaccinated) all reported large numbers of players testing positive, raising the possibility of cancelled matches. Again, most infections were asymptomatic and the rest had only mild symptoms. But these are very young populations. The speed of spread of this variant will be much more problematic once it reaches less vaccinated segments of the population or vulnerable, elderly groups.

With such a rapid transmission of the virus, even if this variant really is less severe, significant economic and public health problems will develop. As cases rise, Americans will engage in less face-to-face activity. And with more people isolating because of illness, positive test results, or encountering those who are infected, some businesses will voluntarily close, as they have in the UK. Major sports matches will get cancelled, schools will be disrupted, and shortages and delays will pile up again.

Although data suggests that cases in South Africa have for now peaked, with medics anecdotally reporting milder symptoms and shorter hospital stays among those affected, it is not clear yet how transferable or enduring those lessons will prove. South Africa has a younger population, is in summer, and recently had a very large delta wave that afflicted vulnerable populations. The growing consensus seems to be that omicron may, at best, only be moderately milder than previous variants. Hospitalizations always lag infections, much more so if the spread of the variant occurs in younger populations first. And some early data suggests that omicron increases the chance of someone double vaccinated and infected requiring hospitalization by 6 times.

Piece this all together and the sheer number of infections we could face here would likely lead to significantly more pressure on American hospitals, particularly when the virus reaches unvaccinated pockets of society. Even aside from the death and suffering this will produce, high case numbers could disrupt the operation of “essential” industries due to labor shortages as people isolate.

What are the implications for COVID-19 policy? Once infections start rising, there’s a risk governors will simply reach for the old playbooks. But the UK experience suggests that mask mandates are little more than a band aid, given the variant’s high transmissibility. Cornell’s experience, and that of the professional sports leagues, suggests the case for vaccine passports has never been weaker. Moreover, the case for vaccine mandates, already on shaky ground for moral and practical reasons, grows even shakier. While boosted vaccination remains the best personal defense against serious infection or death, omicron’s evident transmissibility among the vaccinated weakens the communitarian argument for compelling the vaccine hesitant.

‘Suppression’ in the form of spring 2020-style stay-at-home orders, nonessential business closures, and school closures are unlikely to be effective, even in theory. Given how easily this variant appears to spread, ‘flattening the curve’ today will just lead to a bounce back in infections after reopening, even more so than has happened in the past. Prolonged lockdowns with no end goal to avoid this would create untold social harm.

Public health experts think the current mRNA vaccine boosters work well to protect most people from severe omicron infection. That, plus a phenomenon called “original antigenic sin” or immune imprinting, make the development of an omicron-specific vaccine currently unnecessary and possibly unhelpful. It’s therefore not clear what holding back this wave via society-wide suppression measures would even achieve. With mounting evidence of COVID-19 animal reservoirs, it is absurd to reimpose policies that, for the past two years, assumed the virus would go away once nearly everyone was vaccinated. The virus is endemic. Policy must confront that reality.

So what can be done? At a personal and business level a lot of people have and will change their behavior to avoid infection or spreading the virus. In the run up to the holidays, individuals might start to prioritize what social gatherings they attend, lest an infection caught at one meeting means they can’t attend more important events later. Given healthcare pressures, people might avoid unnecessary trips to hospitals, or activities that might heighten that possibility, such as extreme sports or other risky activities.

In the policy space, there’s some obvious low-hanging fruit. Boosters reduce the omicron risk. Yet today just 42.2 percent of Americans over 50 have received three shots. Public health messaging should urge their take-up and reiterate the risks associated with non-vaccination, especially among the elderly and obese. Where possible, shots should be administered outdoors or in very well-ventilated spaces, to avoid vaccine sites becoming inadvertent hotbeds of infection.

There should also be more urgency in getting supplies of antivirals to the public. The FDA should immediately approve Pfizer’s Anti-COVID-19 pill Paxlovid and Merck’s molnupiravir and consider purchase agreements to ensure mass production.

Effective antivirals are difficult to develop. Analogous to antibiotics that kill bacteria, antivirals kill viruses. Merck’s pill, if taken early, snuffs out 30 percent of cases by causing lethal mutations in the replicating virus. It was submitted for FDA approval on October 11. The U.K approved its use November 4. Even after an advisory panel recommended its approval, FDA regulators have yet to decide. Paxlovid inhibits an enzyme the virus needs to replicate within the host cell. It is 89 percent effective—against omicron as well—in clinical trials; so effective that the FDA-overseen trial was interrupted because it became unethical to deny the drug to participants in the placebo arm. Pfizer asked for approval November 20. From the FDA so far: “crickets.” With it clearly established that vaccines don’t provide 100 percent protection and the omicron virus spreading staggeringly quickly, the FDA should move post haste to get these COVID killers out to the population.

By the time omicron sweeps widely through the population it might not make much difference, but the FDA should approve more rapid tests to lower their cost and broaden their availability, with better guidance about how to use them at home and in business settings. For those with very mild symptoms, at–home tests are a clear improvement on “seeing how you feel” or taking your own temperature for avoiding transmission to others. Those in client-facing in-person roles that encounter large numbers of people should be advised to use rapid tests regularly. Obviously, those who work or live among vulnerable people, especially caregivers in elder homes, should test frequently too.

Beyond that, until we are much more confident about this variant being less lethal or have antivirals widely available for vulnerable, elderly populations, it might be worth providing guidance that these groups consider shielding — i.e. socially distancing — for a short period. Given the high transmissibility of this variant, a sharp wave among the non-vulnerable population could quickly mitigate risks for these groups after the infected in less vulnerable populations have recovered.

This sort of “focused protection” is obviously very difficult to achieve in hospitals and made less sense in 2020 when vaccines were soon to be made available. But with the prospect of a sharp wave anyway and vaccines already available, protection targeted at those still vulnerable makes more sense today. The authors of the ‘focused protection’ plan were right that more could be done to protect nursing homes, in particular. Deliveries of N‑95 masks and rapid tests, as well as funds to facilitate live-in care or reduce the number of staff working at multiple homes, are still sensible ideas.

Finally, state governors should avoid using laws to ban measures that businesses might voluntarily adopt to mitigate risk or to reassure their customers. As more information comes in about this variant, entrepreneurs, companies, and hospitals will experiment with new ways to adjust to the new context. They can do so more effectively if politicians avoid meddling in their conduct.

In short, the policies and guidance above amounts to finding new ways to live with an adapted virus. Living with the virus means being smart, acting quickly to this altered threat, and taking sensible steps to mitigate risks that do not have costs that obviously exceed the benefits. Living with the virus does not mean pretending there’s no pandemic or that the omicron variant has not changed the situation. It requires rediscovering how to pursue happiness in a world full of ever-changing risks.