The Rapid Advance of Omicron

Healthcare facilities are rapidly becoming overwhelmed with an influx of new patients who have contracted the highly contagious COVID variant.

If you’re confused by the ever-changing Centers for Disease Control and Prevention (CDC) recommendations regarding the Omicron variant of COVID-19, you’re not alone. Even healthcare workers are. Omicron behaves very differently from all the previous Greek-alphabet named variants. It’s the new king of the hill. Ninety-five percent of new COVID-19 infections in the U.S. are currently being caused by it.

What do we know about Omicron?

• It’s so new that our knowledge about it is regularly changing. It started in South Africa in November. Its newness is causing much of the confusion.
• We tried to lock the barn door after the horse was out by banning air travel from African countries, only to find just days later that Omicron was already widespread here.
• Its presenting symptoms tend to be a little different than previous variants.
• It’s crazily contagious. In fact, it’s one of the most transmissible viruses ever identified.
• It loved the holiday season, because families and friends gathered around the country. The Thanksgiving break, followed by Christmas and New Year’s, was the perfect human fuel.
• And it’s a master at vaccine evasion. Even fully vaccinated and boosted individuals can still catch this virus and pass it along.

Controlling exploding Omicron cases here has been hampered by testing challenges. Good luck scheduling a PCR test. And even if you can get one, getting the results after 72+ hours is worthless. This variant has a shorter incubation period than its predecessors, as short as 1-2 days, so the best tests, though imperfect, are rapid antigen tests, with results in 15-30 minutes. Getting home antigen test kits is also a challenge. They seem to disappear off drugstore shelves as soon as they are stocked.

Difficulty in getting tested is harming everybody. Otherwise-well patients are showing up in ERs to get tested. That’s a terrible idea. Waiting in a crowded ER increases your risk of catching this virus, while overwhelming already burnt-out doctors and nurses who are struggling to take care of sick patients. Healthcare facilities are being stretched beyond their limits, resulting in the rationing of care, in some places.

But it’s not all gloom and doom. Omicron isn’t Delta. Omicron results in milder disease than previous variants…provided that you are fully vaccinated. Unless you have a significantly compromised immune system, hospitalizations and deaths from Omicron are highly unlikely if you are vaccinated and boosted. These vaccines work, despite some degree of vaccine evasion.

Unless you live like a hermit, it will be difficult to avoid catching Omicron over the next few months. It’s that contagious. So, this is what I think we should do in the short run:

1. Get vaccinated, even if you’ve had COVID-19. You can get it again and still become really sick. And, if you are fully vaccinated, get your Pfizer or Moderna booster shot as soon as possible. It doesn’t matter which one. I’d recommend a flu shot, too. The flu took a long vacation over the past two winters, but it’s back. Emergency departments are beginning to report cases of “Flurona,” the flu plus COVID-19. Vaccinations will lower your risk.
2. Although mask mandates are rare in most of the U.S., be smart and considerate: wear a face mask when indoors in public places. They protect others and also protect you. All masks are not equal! The best is an N95, followed by a KN95, then a surgical mask, and lastly a cloth one. Any mask is better than no mask at all, and consider double-masking for added protection if you only have the inferior masks.
3. Avoid indoor restaurant dining whenever possible. Eat outside, get takeout, or cook at home.
4. Plan ahead and order some home antigen test kits so you have them when you need them. You and your friends or family can reduce your risk of catching and spreading COVID-19 by all testing before gathering.

As for the long run, Omicron won’t be the last variant. COVID-19 will likely never disappear. It will become endemic, just like the flu, with seasonal outbreaks. Booster shots and periodic public health recommendations to wear face masks are unlikely to go away anytime soon.

We can learn to live with this new normal.