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Coronavirus Updates, News

What You Should Know About the Omicron COVID-19 Variant

Just a few months after the delta variant caused an increase in COVID-19 cases, the omicron variant is rapidly becoming the dominant strain in the United States. Atrium Health vice president and enterprise chief epidemiologist, Katie Passaretti, MD, and Atrium Health Wake Forest Baptist infectious diseases expert, Christopher Ohl, MD, share more about what we have learned.

Editor’s Note: This information is current as of April 7, 2022.

All viruses mutate (or change) over time, and COVID-19 is no exception. When a mutation changes how the virus behaves – for example, making it more contagious – the new version is known as a variant or strain. Throughout the COVID-19 pandemic, we have seen multiple variants of the virus, including the highly contagious delta variant. Now, the omicron variant is spreading even more rapidly across the United States. Atrium Health vice president and enterprise chief epidemiologist, Dr. Katie Passaretti and Atrium Health Wake Forest Baptist infectious diseases expert, Dr. Christopher Ohl, explain what we have learned about omicron.

Early Symptoms and Infection

The omicron variant is a fairly highly mutated variant first discovered in South Africa. It has more than 30 mutations, far more than the delta variant. Just as we saw with the delta variant, we are now seeing a subvariant of omicron. While this subvariant may be slightly more easily spread than the original strain of omicron, it’s important to note that there is currently no evidence the subvariant has any different clinical characteristics, so there is no specific change to the symptoms or severity of illness. The subvariant will similarly show up as positive or detected if present during testing for COVID-19.  

The symptoms of omicron still seem to be the same as with other COVID-19 variants: body aches, headaches, sore throat, cough. In more severe cases, pneumonia and organ difficulties may be a concern, especially in those who are not vaccinated. Omicron has been associated with a slightly lower chance of loss of taste and smell and is more often associated with fever. Compared to prior variants, omicron has a shorter incubation period than delta. In fact, the time from when you are exposed to when symptoms begin can be as short as 2-3 days.

"At the end of the day, this virus continues to mimic cold and flu symptoms and people are most contagious early in their infection – from 48 hours before symptoms begin thru the first few days of symptoms,” says Dr. Katie Passaretti, Atrium Health vice president and chief epidemiologist. “Some of the first symptoms patients report tend to be sore or scratchy throat, muscle aches or congestion. If you have these symptoms, assume you have COVID-19 and isolate yourself immediately. If you are high risk or live with someone who is high risk, get tested.”

The Demand for Testing

That advice is especially important as the demand for testing increases in our communities. The goal behind testing is to determine if you have COVID-19 in order to prevent it from spreading to anyone else. Omicron passes from person to person much more easily than other variants, especially in poorly ventilated areas. So, if you have symptoms or have been exposed to someone who tested positive, it’s important to wear a mask regardless of your vaccination status. If you’re not up to date on your COVID-19 vaccinations (including boosters), you should also quarantine from others.

While Atrium Health continues to offer COVID-19 testing at sites across the region, a new federal program has also made it easier to get at-home tests sent to your home, for free.

“It’s important to note that the tests you can do at home will just tell you if you have COVID-19 or not,” Dr. Passaretti says. “They cannot determine which variant you have. That requires specific genomic sequence testing. But the end result is the same. If you’re positive for COVID-19, no matter which variant you have, you need to take precautions immediately to keep from infecting others.”

There are also some other things you can do when testing demand rises, and one thing you definitely should not do.

“Please do not come to the emergency room solely for a COVID-19 test,” Dr. Passaretti says. “Hospital employees and resources are already being stretched thin. Please reserve the emergency room for emergency situations so that we are able to treat those who truly need immediate care. This is more than a request. It may sound dramatic, but it could be a matter of life or death.”

What About the Vaccine?

As the COVID-19 virus continues to change, and more variants are discovered, scientists and researchers are working to learn more about the virus to determine if any changes are needed to the vaccines. In fact, such work has already begun for the omicron variant. But that doesn’t mean you should wait to get vaccinated – or to get a booster shot.

“Should people bother getting vaccinated? The short answer is YES,” says Dr. Christopher Ohl, Atrium Health Wake Forest Baptist infectious diseases expert. “Even if this variant does have ways to evade some of our immune response, it’s very unlikely to evade all of it. That means the COVID-19 vaccine should continue to offer protection against severe infections due to this virus.

“While the vaccine has shown to have slightly less protection against getting any type of infection with omicron, being vaccinated and especially getting a booster are the best ways to protect you from being hospitalized or dying from COVID-19,” Dr. Passaretti says.

COVID-19 boosters are now available to everyone 12-years and older, as long as enough time has passed since your vaccination. That means at least five months for Pfizer-BioNtech and Moderna or two months for Johnson & Johnson. Additionally, a second booster is now approved for everyone ages 50 and up and for those who are immunocompromised who are at least 12-years old. Second boosters should be given at least four months after the first booster and must be an mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna). Dr. Passaretti says now is the perfect time to get a booster.

“Boosters are intended to do just what they say – give your immune system a little boost,” she explains. “We do boosters with other vaccines, and the reason is that over time the amount of protection offered by the vaccine decreases. The booster is essentially a reminder for your body that, ‘Hey this is something you still need to protect against’ and makes sure that you are maximally protected against severe illness from COVID-19.

While we’re still learning about the omicron variant, Dr. Passaretti says there will be breakthrough infections among those who are vaccinated and even in some who were boosted.

“This is all about preventing severe illness and hospitalization,” she explains. “If the whole community has a minor cold and stays out of the hospital, that’s manageable.”

“I think the vaccine will still largely prevent hospitalizations. And if you’ve been boosted, it’ll do even more to protect you,” Dr. Ohl says. “But even if you have been vaccinated and you’ve received your booster, I wouldn’t change what we are doing. Masks still work. Avoiding large crowds and groups of people is still worthwhile. I still wear my mask indoors.”

Dr. Passaretti agrees and says those behaviors are going to be extremely important, even as we are starting to see some relief from this latest surge.

“We are starting to see the number of cases coming down slightly, but the massive impact of omicron has taken a toll,” she says. “The state reported a record number of COVID-19 hospitalizations, and it has hit our health care resources hard. So even as we start to see less cases, we need to continue to do the most to we can to protect those who are most susceptible – people who are elderly, immunocompromised or unvaccinated. And we must protect our health care workers so that they can take care of others.”

The Bottom Line

For Dr. Passaretti and Dr. Ohl, the bottom line when it comes to protecting yourself against the omicron variant is no different than what they’ve been repeating for months: get vaccinated, get boosted, wear your mask, stay home if you are sick and keep your distance.

“Stay home when you’re sick, wear a mask indoors and get vaccinated. And when it’s your time, get boosted. It’s the best protection you can give yourself and your loved ones,” Dr. Passaretti says.

“Vaccinations still work and protect you,” Dr. Ohl says. “And the more people we vaccinate and then give a booster to, the harder it will be for that virus to transmit from one person to another. The less transmission that occurs, the less chance the virus has to mutate.”

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