This is a bi-weekly Q and A column written by Dr. Lydia S. Segal. M.D. in conjunction with Chaffee County Public Health. This column is focused on questions readers have about COVID-19 news and sciences. As Segal points out, ‘Everything I write today is valid for today. COVID-19 news and science are rapidly evolving, assume updates will be made”
QUESTION: What is going on with Omicron?
ANSWER: Omicron, the COVID -19 variant that was announced by the World Health Organization, WHO, at the end of November as being a variant of concern, is still new to scientists and doctors. More data is needed to understand this variant better and this data can only be gathered after more people get sick and more lab testing is done. Only then can the three most important questions be answered regarding this variant: what is the level of transmissibility/contagiousness; what is the level of severity, meaning are people experiencing Omicron as a mild cold or are they more likely to be hospitalized and/or die; and finally, do vaccines or previous infection provide protection against this variant known as an immune escape.
QUESTION: What do we know about transmission?
ANSWER: We think that Omicron is three times more transmissible than the last variant, Delta, and Delta was many times more transmissible than the original. This means that this variant can more easily be transmitted with fewer virus particles and shorter exposure so both a lower amount of virus and less exposure time is necessary for one to get this variant from another person. This explains why both England and Denmark are predicting that by the end of December, Omicron will be the dominant variant in their countries. In Scotland, the number of Omicron cases is doubling every two to three days. Keep in mind that Europe has been a harbinger of what we see in the USA.
QUESTION: What do we know about the severity of disease caused by Omicron?
ANSWER: So far Omicron looks less severe than initially thought based on the number of mutations in critical areas of the virus. However, most of the relevant data is based on a limited number of people (just several hundred) and those people are not in the U.S. So I think the answer to the severity of disease is too early to predict. But even if it may be less severe, it appears to spread more quickly, resulting in more people getting Omicron. If only a tiny percentage of those people end up with severe cases warranting hospitalizations, it will still be a substantial number. This has the potential to overwhelm hospitals that are already filled with people with COVID. It is worth noting again, that the vast majority of these hospitalized people are not vaccinated. In Chaffee County, about 90 percent of those hospitalized are NOT vaccinated.
QUESTION: What do we know about immune escape?
ANSWER: Again, we are too early in the research and in the review of clinical data about who is getting sick and which vaccine or previous infection they may have had, to make a sound analysis. Early data seems to show that vaccines are protective but only if one is also boosted. Being boosted means having three shots of either mRNA vaccines (Pfizer or Moderna) or two shots of the J & J.
QUESTION: Is one vaccine, say, Pfizer, more effective than the other two, Moderna and J & J, against this new variant?
ANSWER: Check back in a few weeks for the answer to this question. We simply do not have an answer yet to this question. As most of the data in the first two weeks has come from South Africa, and the vast majority of people there were not vaccinated, it is too early to say. England is collecting data now, and as it is looking like Omicron is vastly spreading there, we should have information in two to four weeks.
What we do know so far, is getting a booster, of whatever type, is the way to go. And if you are not vaccinated yet, get your shots.
QUESTION: What is going on with travel mandates and Omicron?
ANSWER: Travel mandates were put in place to try and slow the spread of the variant. By the time this is posted, more than half of the states and countless countries already have Omicron variant spreading. Because there is only a small percentage of positives that are tested for specific variants, we really do not know where it initially started and how much it has spread.
QUESTION: Where did this variant come from?
ANSWER: To date, it is assumed that the variant came from someone who was immunocompromised and had either latent or clinically apparent disease but they never rid themselves of the virus. And in never clearing the virus, the opportunity to mutate (as is the nature of viruses) occurred.
QUESTION: What is the safest way to celebrate the holidays during the pandemic?
ANSWER: This breaks down into two groups: are you visiting with only vaccinated family and friends? Or are you interacting with those who are unvaccinated, who may have traveled to high COVID-19 areas, or are frail and elderly and/or immunocompromised?
Currently, the recommendation is if everyone is vaccinated and there is no one who is immunocompromised, take those masks off and enjoy inside celebrations. If there are young children who are not eligible for vaccination, or others who are not vaccinated, have those people do a rapid home antigen test to make sure they are not contagious. If they are unwilling to do a home test, it is up to your level of risk tolerance as to what to do.
If you have questions you would like Dr. Segal to address in a future COVID Q and A column, please write to firstname.lastname@example.org
For more information about COVID and the vaccines, eligibility and appointments, see the links below. Pharmacies and doctors offices are getting small shipments of vaccines. Information will be posted online here and on the county public health and hospital web pages.
Pharmacies with vaccine clinics:
Salida: Safeway, Walmart and Salida Pharmacy
Buena Vista: Mt. Shavano (LaGree’s), City Market, BV Drug and Valley-Wide Health
By Lydia S. Segal, M.D., MPH