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(NEW YORK) — As health officials expected, the United States has now confirmed several cases of the omicron variant, which was first identified in Botswana and has since been detected in at least 35 counties.

The World Health Organization declared omicron a variant of concern on Friday. Earlier this week, the agency said the overall global risk is “very high” due to the variant’s large number of mutations, including on the spike protein of the virus, though there are still many unknowns, including information on its transmissibility, severity and impact on immunity.

Here’s what we know so far about the variant in the U.S.

First states to detect cases

The first three cases of the omicron variant identified in the U.S. were detected in fully vaccinated Americans with recent travel histories. All three people experienced mild symptoms, health officials said.

The first case was detected in California in an individual who had returned from South Africa on Nov. 22. The person, who was not yet eligible for a booster dose, sought COVID-19 testing a few days upon returning to San Francisco after developing symptoms, and genomic sequencing testing confirmed the case to be omicron on Wednesday, health officials said. All close contacts have been contacted and have tested negative.

Colorado confirmed a case of the omicron variant Thursday in a woman from Arapahoe County who had recently traveled to southern Africa. State epidemiologists had flagged the testing specimen for genome sequencing due to the recent travel history. The resident was eligible for a booster but had not yet received it, health officials said.

Through its regular surveillance of COVID-19 case specimens, Minnesota detected an omicron case Thursday in a Hennepin County resident who had recently traveled to New York City to attend the Anime NYC 2021 convention from Nov. 19 to 21. The man, who had received a booster dose in early November, developed mild symptoms on Nov. 22 and sought testing on Nov. 24. It seems likely that the transmission occurred at the NYC convention, but that is not certain, health officials said. His symptoms have since resolved. A close contact tested positive for COVID-19, though tests to confirm if that is also omicron have yet to be conducted, health officials said.

Thursday evening, New York Gov. Kathy Hochul announced that at least four cases of the omicron variant had been detected in the state. They included a 67-year-old, fully vaccinated woman in Suffolk County who recently traveled from South Africa, and then three residents in New York City. A fifth case is also suspected to be omicron, Hochul said. All cases are mild.

A second California case was also announced Thursday evening, in a fully vaccinated Los Angeles County resident who had returned from South Africa on Nov. 22, health officials said. The infection “is most likely travel-related,” the Los Angeles County Department of Public Health said.

The detected cases illustrate the need to seek out testing based on travel history and symptoms, as well as the importance of sharing travel history with public health officials, health experts said. The Centers for Disease Control and Prevention currently advises that people who recently traveled internationally should get tested three to five days upon their return regardless of symptoms or vaccination status. NYC officials have also encouraged all attendees of the Anime NYC 2021 convention, estimated to be around 53,000, to get tested immediately and take precautions such as social distancing.

No cause for panic

Health experts have said the presence of the omicron variant in the U.S. is not surprising, and while concerning, it is not a reason to panic.

“At this point, I’m not terribly alarmed,” Colorado Gov. Jared Polis told reporters Thursday during a briefing on the omicron case.

The governor said that if community transmission is occurring in Colorado, it’s very small because no omicron variant has been discovered in wastewater analysis yet. Roughly 15% of all positive COVID-19 tests are sequenced in Colorado.

San Francisco Department of Public Health Director Dr. Grant Colfax told reporters during a briefing yesterday that the case was “not a cause for us to panic” and that the city “is prepared” for this.

Leaders in New York and Minnesota had similar messages.

“We’re ready for it. This is not surprising,” New York Gov. Kathy Hochul said during an on-camera briefing earlier Thursday.

“This news is concerning, but it is not a surprise,” Minnesota Gov. Tim Walz said in a statement. “We know that this virus is highly infectious and moves quickly throughout the world.”

Minnesota Department of Health Commissioner Jan Malcolm echoed that sentiment during a briefing Thursday, saying omicron is something to take seriously but “not a reason to panic.”

“We’re at a stage where there is still a lot we need to learn about omicron,” she said.

Officials in the cities and states where the variant has been detected have said they don’t plan to make any changes to health orders at this time.

Impact on travelers

White House chief medical adviser Dr. Anthony Fauci told reporters Wednesday he doesn’t think a domestic flight policy for testing or vaccination due to omicron is necessary right now but said it’s always something under consideration.

“These kinds of things we always talk about and consider. But right now, I’m not so sure we need testing for air travel in this country,” he said.

There are strengthened requirements for travelers coming to the U.S. amid the spread of the omicron variant. On Thursday, President Joe Biden announced that all passengers must show proof of a negative COVID-19 test within one day of flying into the U.S., regardless of their vaccination status or nationality.

“This tighter testing timetable provides an added degree of protection as scientists continue to study the omicron variant,” he said during a briefing.

Unvaccinated Americans already were required to show proof of a negative test within one day of traveling. The new rule, which goes into effect Monday, expands that one-day requirement to all vaccinated travelers coming into the U.S. from other countries. Unvaccinated nonresidents are currently barred from boarding a flight to the U.S.

Delta still dominant

Amid concerns about the omicron variant, health experts have stressed that delta is still a major issue in the U.S., where close to 100,00 new cases are diagnosed daily. Delta comprises 99.99% of new COVID-19 cases.

“I think omicron is another kind of wake-up call, and we needed another one,” Malcolm, with the Minnesota Department of Health, said. “Even though we might feel like we’re done with the pandemic, it is most certainly not done with us.”

Health officials have urged people to get vaccinated and get boosters and to continue to follow COVID-19 guidelines such as wearing a mask indoors while in public, test if you have symptoms and stay home if you’re sick.

ABC News’ chief medical correspondent, Dr. Jennifer Ashton, told David Muir on Thursday that vaccinations remain the most important tool we have in combatting COVID-19 this winter.

“Some protection is better than none, and while we learn about the many mutations that omicron has … we have to double down on what we know is going to be our best tool in the toolbox, and that is vaccination,” Ashton said.

Regarding boosters, Fauci has urged Americans who are eligible to get the shot now.

“Right now, I would not be waiting,” he said Wednesday. “People say, well, if we’re going to have a booster-specific vaccine, should we wait? If you are eligible, namely six months with a double mRNA dose, or two months with the J&J, get boosted now.”

“We may not need a variant-specific boost,” he added.

ABC News’ Matthew Fuhrman, Cheyenne Haslett and Arielle Mitropoulos contributed to this report.

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(NEW YORK) — As the U.S. Supreme Court continues to weigh whether to leave Texas’s unprecedented six-week abortion ban, SB8, in place, a new law that also restricts abortion access is going into effect in the state.

Starting Thursday, people in Texas will have a narrower window in which they can receive abortion-inducing medication, including the two most commonly used medications, mifepristone and misoprostol.

Senate Bill 4, or SB4, cuts the window in which physicians are allowed to give the medication from 10 weeks of pregnancy to seven weeks.

The new law also prohibits mailing abortion-inducing drugs, a restriction that contrasts with a federal regulation enacted in April by the Biden administration that temporarily allows the medication to be mailed during the COVID-19 pandemic.

Current Texas law already bans providers from administering medication abortion using telemedicine, according to Abigail R.A. Aiken, MD, MPH, PhD, associate professor of public affairs at the University of Texas at Austin and principal investigator with Project SANA, a research project focused on self-managed abortion in the U.S.

“We’ve seen many states be able to open up new models of care where clinic-based providers can now do medication abortion by telemedicine,” said Aiken. “I think Texas is very clear that they don’t want providers here to follow suit and be able to start doing those kinds of new models where you would do a phone consultation with a provider and then have the pills mailed to your house for use at home.”

The bill, signed into law by Gov. Greg Abbott on Sept. 24, also adds new requirements around medication abortions, including an in-person examination by a physician, a mandatory follow-up visit within 14 days and new reporting requirements for providers.

The bill also creates a state jail felony offense for “a person who intentionally, knowingly, or recklessly violates provisions relating to abortion-inducing drugs,” but exempts pregnant people on whom a medication abortion is “attempted, induced or performed,” according to the bill summary.

Though SB4 is being enacted in Texas, medication abortion is now a very common method used for abortions in the first 10 weeks of pregnancy. In 2019, 42% of all abortions in the U.S. were early medical abortions, meaning medications were taken at nine weeks or earlier after conception, according to the Centers for Disease Control and Prevention.

Medication abortions were first approved by the Food and Drug Administration in 2000. FDA guidelines advise that abortion-inducing pills are safe to use up to 70 days, or 10 weeks, after conception, though evidence shows it can be safe even later in pregnancy, according to the American College of Obstetricians and Gynecologists.

In most cases in a medication abortion, mifepristone is taken first to stop the pregnancy from growing. Then, a second pill, misoprostol, is then taken to empty the uterus.

Of the two medications, mifepristone is more restricted by the FDA. Since 2011, the agency has applied a risk evaluation and mitigation strategy to mifepristone, preventing it from being distributed at pharmacies or delivered by mail like other prescription drugs.

It must be ordered, prescribed and dispensed by a health care provider who meets certain qualifications, and may only be distributed in clinics, medical offices, and hospitals by a certified health care provider, according to FDA guidelines.

The FDA’s rules, combined with state restrictions like the one in Texas, have the effect of not only limiting when, where and how people can get abortions, but also potentially misguiding people on the safety of medication abortion, according to Dr. Bhavik Kumar, a staff physician at Planned Parenthood Center for Choice in Houston.

“What’s important to note is that the medication used in medication abortion has been used in this country for 21 years and it is extremely safe,” said Kumar. “We’ve learned a lot since it was first introduced and can use it in different ways that are more patient-centered, more evidence-informed and really optimizes science and medicine so that patients get the care that they need.”

Speaking of the new law now in effect in Texas, he added, “What Senate Bill 4 is doing is inserting itself squarely into my relationship with my patients and telling me how to practice medicine, and it’s not in the best interest of my patients. It’s actually causing more harm to my patients and it’s taking options away from them.”

Abortion rights advocates say SB4 also has the likelihood of signaling to other states that further restrictions on medication abortion can be put in place.

In South Dakota in September — the same month SB4 was signed into law in Texas — Gov. Kristi Noem, a Republican, issued an executive order directing the state’s Department of Health to establish rules requiring that abortion-inducing drugs only be prescribed and dispensed by a state-licensed physician after an in-person examination. Noem said she also plans to pass legislation next year that makes “these and other protocols permanent.”

Across the country, more than 30 states require clinicians who administer medication abortion to be physicians, while 19 states require the clinician providing a medication abortion to be physically present when the medication is administered, according to the Guttmacher Institute.

“I think we have to see this is another continuation of the trajectory of trying to really make abortion a right on paper only in the United States,” said Aiken. “It’s another way of placing barriers in the way of people.”

She continued, speaking of restrictive abortion laws in some states, “I think what it’s doing in reality is creating this really uneven picture where you have some states that are moving in the direction of more and more and more accessible care, but the reality in other states is completely the reverse, so we’re looking at that uneven picture where your access really depends on your zip code.”

Both Aiken and Kumar mentioned the affect laws like SB4 in Texas have on the most vulnerable populations.

Around 75% of abortion patients are low-income residents, and nearly 60% of U.S. women of reproductive age live in states where access to abortion is restricted, according to the Guttmacher Institute, a reproductive rights organization.

“It has been the case in Texas now for decades that we have seen low-income people and communities of color just bear this disproportionate brunt of negative impacts of these laws,” said Aiken. “So this is an equity issue and it’s a justice issue as well as a health care issue.”

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(OKEMOS, Mich.) — Michigan is in the midst of its fourth COVID-19 wave — and there is no end in sight, hospital officials said.

Cases and hospitalizations are rivaling levels seen in earlier parts of the pandemic, when vaccines weren’t widely available. The surge also comes at a time when non-COVID-19-related patients are being admitted, flu cases are emerging and health systems are understaffed, Brian Peters, CEO of the Michigan Health & Hospital Association, told ABC News.

Unvaccinated people continue to make up the majority of those infected with COVID-19, including severe cases of the infection. Roughly around three-quarters of COVID-19 cases, hospitalizations and deaths were in unvaccinated people from Oct. 21 to Nov. 19, according to state data.

Around 45% of the state remains unvaccinated, according to federal data.

“The situation right here in Michigan is as dire as it has ever been since the start of this pandemic,” Peters said.

Michigan reported a nearly 20% positivity rate in the past week, and every county is currently at the state’s highest risk level for transmission.

Michigan is not alone in seeing COVID-19 cases and hospitalizations increase due to the delta variant, especially as colder weather has approached, people have gathered indoors more and pandemic fatigue has long set in. Though the duration of this surge, and the speed with which cases have “skyrocketed” in the past three weeks, is alarming, Dr. Darryl Elmouchi, president of Spectrum Health West Michigan, which operates 14 hospitals, told ABC News.

“If you look at most other states, and all the surges we’ve had, usually you start at a low point and you go up really quickly, and then you come down pretty quickly,” he said. “What happened for us is we went up gradually enough, but we went up high enough, with [positivity rates] in the teens, that when we shot up, we shot up from that baseline.”

“This has far surpassed anything we’ve seen before — both in how long it’s been going on, and now its seemingly never-ending peak,” he added. “We just don’t know when the end will be, and we’re very worried it will have a very long tail.”

Michigan reported its second-highest number of COVID-19 cases and case rates in the past week, according to the state’s latest weekly coronavirus report, released Tuesday. That follows records set in both cases and case rates the previous week. Hospitalized COVID-19 patients also increased 13% during the past week, the report found.

“I felt like probably the surge we had last fall was going to be the worst we’ve ever seen. I never would have guessed that we would be in yet another surge and that it would be the worst surge yet,” Sandra Gilman, a nurse and hospital supervisor for Spectrum Health, told ABC News.

At Spectrum Health West Michigan, unvaccinated COVID-19 patients are generally about nine years younger and only have two comorbidities, as opposed to four, when compared to vaccinated patients, “meaning that they’re younger and healthier when they’re coming in,” Elmouchi said.

“That tells us the importance of being vaccinated,” he said. “And that’s what’s so heartbreaking for our teams, is that they see all these people that are so sick, being on the ventilator and even dying, and they know it’s preventable. It’s heart-wrenching.”

Due to a mix of early nursing retirements, pandemic burnout and a “rising tide of violence” against health care staff, Michigan hospitals are treating the latest surge in COVID-19 patients amid a staffing shortage, according to Peters. There are approximately 875 fewer staffed hospital beds in Michigan than in November 2020, he said.

“That is incredibly concerning, because there’s not a rapid or easy solution to that problem,” Peters said.

Amid the staffing strain, this week, the Department of Defense temporarily deployed nearly four dozen medical personnel, including registered nurses, doctors and respiratory therapists, to two hospital systems in the state.

The help is welcome, though more is needed, Peters said, especially as the pandemic only worsened an existing health care workforce shortage. Among other measures, his organization is advocating for a $650 million special appropriation in the state legislature that would provide payments to health care staff to encourage them to stay in their jobs, as well as offer incentives for training programs to increase the number of workers in the pipeline, he said.

For now, hospital capacity remains a concern throughout the state, where every region, from urban to rural, is a “hotspot,” Peters said.

At Spectrum Health West Michigan, the intensive care units are operating at 147% of their traditional capacity, Elmouchi said.

Statewide, hospitals are operating at almost 85% occupancy, according to state data.

In recent weeks, some hospitals have had to divert patients to other hospitals and delay elective procedures, Peters said.

“That doesn’t necessarily create a quality-of-care problem as much as it can be a convenience problem,” he said. “But what we’re very fearful of, is that if these COVID numbers don’t level off and decline, you’re going to start seeing real access challenges, where literally there’s no more capacity to care for patients, COVID or otherwise, in certain communities.”

“We’re doing everything we possibly can to avoid that outcome, but without the public’s help, that’s our future,” he added.

Health officials are urging residents to get vaccinated and receive booster shots and to mask up indoors in public settings to help alleviate the surge — especially amid concerns and questions around the transmissibility and mutations of the new omicron variant, which was first detected in the U.S. Wednesday in California.

“Ensuring that as many Michiganders as possible are vaccinated remains the best protection we have against COVID-19 — including variants of concern,” Dr. Natasha Bagdasarian, Michigan’s chief medical executive, said in a statement this week.

Peters said he has been encouraged by the continued increase in vaccinations in the state, including among newly eligible pediatric populations, but “those numbers aren’t growing rapidly enough.”

“[Omicron] is yet another reason for the public to get vaccinated now without waiting any longer,” he said. “I fear that there are so many Michiganders, and I’m sure it’s true outside of Michigan as well, but who believe that the pandemic is largely over. And nothing could be further from the truth.”

ABC News’ Arielle Mitropoulos contributed to this report.

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