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As we head into the holidays and gather with family and friends, we face uncertainty and caution for the second year in a row, even as we weary of dealing with the pandemic.
Public health officials around the country have voiced concerns about rising Omicron infections, worried about hospital capacity while the Delta variant is still in play. Universities have moved exams online, offices delayed back to work dates and some cities have reimposed mask mandates.
So, how worried should you be and what can you do?
Dr. Celine Gounder, a leading infectious diseases specialist, shared ideas on how to process the risk of infection, at a webinar entitled “Covering Coronavirus: What We Know So Far About Omicron,” hosted by the USC Annenberg Center for Health Journalism
How worried should we be?
As numbers escalate across the country, Dr. Gounder suspects they will continue to spike over the next couple of weeks. We already have 1300 COVID19 deaths per day in the United States as the country heads into a winter surge of the seasonal flu. The Delta mutation is still around and it’s not clear right now, which variant will come to dominate this winter.
“We anticipate an increase in hospitalizations, an increase in deaths, and an increasing burden on the health care system over the next couple of months,” said Dr. Gounder, an internist and epidemiologist who previously served on the Biden-Harris Transition COVID-19 Advisory Board.
While many have been calling Omicron relatively mild, Dr. Gounder cautioned against that assumption. “Simply because it is in a more transmissible infectious variant, statistically there is a higher probability of severe disease, hospitalization and death.”
Is Omicron immune evasive?
Dr. Gounder explained that our bodies produce antibodies after an infection or vaccine that help kill the virus in subsequent exposures. But sometimes, a virus can mutate in a way that escapes detection by those antibodies. Evidence so far points to Omicron evading this detection better than previous variants and has hence been seen as having immune evasiveness.
But “that’s where giving that additional dose of vaccine is helpful,” added Dr. Gounder, “that in the short term, you are able to increase the numbers of antibodies, bump up the numbers so that you can override that relative immune evasivness.”
It’s why the Biden administration is recommending boosters for everyone.
Is Omicron more contagious?
Omicron might be more contagious because studies have detected its presence in the upper airways rather than in the lower lungs (compared to Delta and older variants) which makes it “more infectious because it is more easily breathed out into the environment.”
Should the current vaccines be modified for Omicron?
Dr. Gounder points out that modifying current vaccines for Omicron has some downsides, such as reducing its efficacy against other variants still in circulation, affecting vaccine supply production and complicating mass vaccination efforts.
She explained, “The way our immune system works, it actually makes guesses at how pathogens, viruses etc might evolve, and how to stay ahead of the virus.” That third dose of vaccine, could give our immune systems a hint that it needs to increase the range of variants recognized.
Do boosters help?
Public health officials design a strategy depending on the outcome they are targeting – whether that is preventing all Covid infections, preventing severe disease, hospitalization and death or preventing Long Covid.
The Biden administration’s public health strategy of boosters for everyone to stop Covid infections is a challenge that “frankly sets them up for failure,” said Dr. Gounder, because it’s impossible “to prevent all infections through these vaccines.”
Omicron has a very short incubation period of 2-3 days, vs 3-4 days for Delta. Incubation period is the time from exposure to symptom onset or when the infection really takes off. And this matters because “it’s really a race between your immune system and the virus,” she explained, which is why frequent boosters will be more effective. Also, our immune response is stronger at preventing severe disease in our lungs rather than combatting a respiratory virus.
What are the risks for Long Covid?
Some people suffer from Long Covid and while much is unknown, there are some hypotheses. There are parts of the body – so called immune privileged sites like the brain for example, which the immune system cannot reach. Long Covid symptoms could be triggered by an ongoing replication of Sars Cov2 in an immune privileged site, lingering virus fragments or a Sars Cov2 infection leading to an autoimmune response that turns the immune system against your body.
But the risk of Long Covid is lower, said Dr. Gounder “if you are vaccinated and have a breakthrough infection.”
What should you do if you belong to a vulnerable group?
Dr. Gounder recommends that people in a high risk category “absolutely should get fully vaccinated and get that third dose but understand that you are still at risk, particularly with Omicron of a breakthrough infection.” She recommends layering protection which include masks (specifically N95s and if not, kn-95 or the kf-94), opening doors and windows, rapid testing, and meeting family and friends outdoors, whenever possible. Ventilation and hepa air filtration units would also help.
The Biden administration has announced that insurance companies will reimburse people for purchasing rapid tests, but the cost still remains high for people purchasing rapid tests for the holidays, because it’s not happening soon enough.
Due to Omicron’s 2-3 day incubation period, Dr.Gounder recommended testing every day if meeting family. “Use the rapid tests to decide if you are going to take off masks during the holidays. If you test in the morning, and if you are all negative, you can take off your masks.”
It will make you safer while understanding that with the coronavirus, nothing is perfectly safe.
Anjana Nagarajan-Butaney is a Bay Area resident with experience in educational non-profits, community building, networking, and content development and was Community Director for an online platform. She is interested in how to strengthen communities by building connections to politics, science & technology, gender equality and public education.
Edited by Meera Kymal, contributing editor at India Currents