Without a doubt, by now you’ve heard of the Omicron Covid-19 variant that has spread across the world like wildfire and now accounts for roughly 95% of new Covid cases as of the first week of January 2022, according to the CDC. Positive cases in the U.S. have reached a staggering 1 MILLION cases daily. And yet at-home testing shortages, lack of reporting if at-home tests turn up positive, and that the tests may be less sensitive to the Omicron variant also point to the fact that the actual amount of positive cases is grossly unreported. One thing is clear, Omicron has saturated our country, surpassing the Delta variant. Up until a few weeks ago, the Delta variant had been dominant, but Omicron has proven formidable and it is clear that the pandemic is far from over.
Even as scientists race to understand the effects and potential long term impact of Omicron, the sands continue to shift. A new strain of Covid-19 that combines Delta and Omicron was detected in Cyprus. The combination strain has been dubbed “Deltacron,” signifying the commonalities between the strains. 25 cases have been reported and are being sequenced by GISAID. GISAID is a global science initiative and primary source established in 2008 that provides open-access to genomic data of influenza viruses and the coronavirus responsible for the COVID-19 pandemic. GISAID will track changes in the virus; you can stay current on the spread of any of the variants, here.
What is unique about Omicron?
Omicron was first detected in December 2021 and quickly spread throughout the world, now being detected on all seven continents. Unlike other variants, Omicron caught the attention of scientists across the globe because of the unusually large number of mutations. One study from Hong Kong found that Omicron infects and multiplies in cells 70 times faster than the Delta variant. So far, it looks to be roughly twice as contagious as the Delta variant, but it doesn’t appear to cause more severe illness. But, a variant that doesn’t cause a more severe illness isn’t a green-light of safety by any means.
Omicron and other variants may still infect those that are vaccinated (and breakthrough cases are an expected occurrence with any vaccine), vaccination continues to protect against severe illness and hospitalization. Despite that reassurance, the reality remains that with Omicron spreading so quickly, if even a small percentage of people that become infected with Omicron end up needing a hospital bed, that small percentage may still overwhelm our medical systems. This is a reality that is coming to fruition.
While it is a small silver lining that the variant doesn’t appear to cause more severe illness, the rate at which it spreads means that the medical community is scrambling to keep up with the increase in hospitalizations as a larger proportion of communities are being impacted. In late December 2021, the White House released a statement communicating that due to surges in cases and nursing shortages in Arizona, among other states, it is sending medical personnel to assist. The aid includes 20 paramedics from the Federal Emergency Management Agency to help transfer patients to open beds, according to a news release from the White House.
Shortages are becoming routine, patients are overwhelming offices and hospitals, resulting in medical personnel being in a position of higher risk of exposure to the more contagious Omicron variant. This also means more staff has to quarantine and recover after a positive test. As a result, hospitals across the country are requiring additional help, with some states even mobilizing the National Guard.
Vaccines and boosters protect against Omicron (and other variants).
Since the initial launch of Covid-19 vaccines, the need for boosters that provide continued protection has become clear. Moderna said it’s vaccine is 93% effective six months after the second dose. By comparison, Pfizer and BioNTech said their vaccine efficacy declined to around 84% after six months. Studies have shown that after 6 months, efficacy from the Johnson & Johnson vaccine wanes to roughly 66%. But boosters have proven to recoup any decrease in protection among all three vaccine brands.
While Omicron has been found to be elusive against initial vaccines, a new study published in the journal Cell (January 2022) shows that people who received either the Pfizer-BioNTech or Moderna two-dose COVID-19 vaccine series and then a booster achieved “potent” neutralization against omicron. The study was carried out by researchers at the Ragon Institute at Massachusetts General Hospital, MIT and Harvard. The researchers explained that while Omicron is better at getting past vaccine-created immunity, people who have breakthrough cases do have milder disease, which could be because their initial vaccination helped create long-term immunity. “Even if antibodies can’t keep us from getting infected with omicron, other aspects of the immune response may keep us from becoming very sick,” said Alejandro Balazs, who investigates how to engineer immunity against infectious diseases at the Ragon Institute and is the paper’s senior author.
Other studies have demonstrated that after a booster shot, people that initially received the Johnson & Johnson vaccine showed a significant and protective increase in antibodies, reaching levels comparable to those that received boosters after mRNA vaccines.
The CDC shares the following recommendations for vaccines and boosters:
- COVID-19 vaccines are highly effective at preventing severe illness, hospitalizations, and death.
- Scientists are currently investigating Omicron, including how protected fully vaccinated people will be against infection, hospitalization, and death.
- CDC recommends that everyone 5 years and older protect themselves from COVID-19 by getting fully vaccinated.
- CDC recommends that everyone ages 16 years and older get a booster shot after completing their primary COVID-19 vaccination series. You are eligible for a booster at 5 months after completing Pfizer-BioNTech primary series, 6 months after completing Moderna primary series, and 2 months after the initial J&J/Janssen vaccine. Individuals ages 16-17 are only eligible for the Pfizer-BioNTech COVID-19 vaccine.
Masking
Another layer of protection continues to be the simple act of masking. The Pima County Board of Supervisors voted 3-2 on December 21st, 2021, to reinstate a mask mandate as COVID-19 transmission remains high throughout the county. The mandate will remain in place until Feb. 28, 2022, pending COVID-19 case and hospitalization counts at that time. Pima County residents will be required to wear a mask at indoor public places when continuously maintaining a 6-foot distance from others isn’t possible.
- CDC continues to recommend wearing a mask in public indoor settings in areas of substantial or high community transmission, regardless of vaccination status.
- CDC provides advice about masks for people who want to learn more about what type of mask is right for them depending on their circumstances.
The good news?
There is hope that despite the overwhelming rise of Omicron cases, that this will follow patterns as during other moments in the pandemic. Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, suggested the Omicron surge in the U.S. may be visualized more as an “ice pick,” versus the “waves” seen previously in the pandemic, with a dramatic rise and fall in cases similar to South Africa, which has passed its Omicron surge.
“I do think in places that we are seeing this really steep incline, that we may well see also a precipitous decline,” Walensky said during a briefing.
But we are not there yet. And even with a precipitous drop in positives, once hospitalized, it takes the human body far longer to recover, causing a disparate impact on our healthcare system. It’s imperative we all do what we can do stay safe and healthy. If not acute, stay home, quarantine, hydrate and eat healthy. Vaccinate. And continue vigilant protection with social distancing and wear a mask at all time when indoors.
We are all exhausted, frustrated and ready for this to end. We know so much more than we did when this started two years ago. We have proven ways to stay safe and diminish exposure. We no longer have to wipe down our mail or groceries. We have vaccines that do prevent severe disease and hospitalizations in fully vaccinated people. After losing almost a million souls to this infection that is a life changer. We know we are safe if we wear masks that cover our nose and mouth to keep our droplets to ourselves and can be in the same room unmasked with those who are vaccinated. We have more access to testing and can quarantine less time (5-10 days depending on your vaccine status). We’ll discuss these new and yes, controversial, recommendations along with an update on the antiviral pills newly authorized, next Monday.
Please, I’m asking everyone, for their safety and health as well as the community’s, to adhere to all these protective measures now. The last thing you want to hear when you call 911 is that the wait is an hour or more before an ambulance can arrive. Or spend a day in the emergency room before anyone can assess your needs. Together we can get through this.
Sources:
-https://www.yalemedicine.org/news/johnson-and-johnson-covid-booster
-https://www.usatoday.com/story/news/health/2022/01/07/covid-boosters-pfizer-moderna-omicron/9123578002/
-https://www.washingtonpost.com/health/interactive/2022/omicron-comparison-cases-deaths-hospitalizations/
-https://www.cnbc.com/2022/01/04/us-counts-over-1-million-new-daily-covid-cases-in-global-record-.html
-https://www.nbcnews.com/health/health-news/omicron-cases-fall-just-quickly-rose-cdc-says-rcna11356
-https://www.cnbc.com/amp/2022/01/08/cyprus-reportedly-discovers-a-covid-variant-that-combines-omicron-and-delta.html
-https://tucson.com/news/local/nursing-shortages-compounding-southern-arizona-health-care-crisis/article_9e742c4c-46f9-11ec-a674-ff0e14b9ea6b.html
-https://www.jnj.com/johnson-johnson-announces-real-world-evidence-and-phase-3-data-confirming-strong-and-long-lasting-protection-of-single-shot-covid-19-vaccine-in-the-u-s
-https://www.cnn.com/2022/01/05/health/us-coronavirus-wednesday/index.html
-https://www.med.hku.hk/en/news/press/20211215-omicron-sars-cov-2-infection
-https://www.nbcchicago.com/news/coronavirus/vaccine-efficacy-data-shows-how-shots-protect-against-omicron-covid-variant/2716776/
-https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html
-https://www.cbsnews.com/news/covid-omicron-variant-95-percent-cases/
-https://tucson.com/news/local/pima-county-masks-required-for-indoor-public-spaces/article_2cb19f1e-61e7-11ec-9893-83d8b13ac1b6.amp.html
-https://www.gisaid.org/
-https://www.aamc.org/news-insights/so-you-got-jj-vaccine-here-s-what-you-should-know-about-delta-variant-boosters-and-more