Bassett's Dr. Suthanya Sornprom On What You Need to Know about Omicron

The below editorial has been contributed by Suthanya Sornprom, MD, MPH, attending physician in Infectious Diseases at Bassett Healthcare Network. 

Since it was first identified in November 2021, COVID-19's Omicron variant has become the dominant variant in more than 125 countries, including the U.S. Here's a rundown of the good, the bad, and the still unknown. 

How did we get here? Viruses and Variants

First, a quick review. 

A virus produces billions of copies of itself inside your body during an infection. Your immune system has to overcome this flood of copies to eliminate the virus. A faster and stronger immune response reduces the infection time and its consequences. 

Every so often, a virus makes an error when copying itself and the genetic code is slightly different. Sometimes these genetic differences change how the virus works. Those changes are included when that virus copies itself - and if that new version persists, it is a new variant. 

We classify variants based on the threat they pose to people. So far, COVID-19 variants have only risen to a Variant of Concern (VOC) level. A VOC is different from the original virus in ways that endanger us and that make us change our approach. 

What is new with Omicron?

Omicron is a VOC. The fact that it has spread around the world so fast and become dominant makes it clear that something about it is different. But what? Even trickier: why? Researchers have been piecing this together quickly but cautiously. Here are some current working theories about Omicron:

• It becomes transmissible more quickly than earlier variants. The original COVID-19 virus took several days to incubate in a host's body, which means it could take days after a person was infected to actually show symptoms. The Delta variant - another VOC - reduced that time to four days. Omicron becomes transmissible after just two or three. 
   
• Omicron's first symptoms are often respiratory. In 2020, body aches, fever, and a loss of taste or smell were the tell-tale signs of COVID-19. In contrast, Omicron often starts with a cough or sore throat.
   
• Being vaccinated significantly reduces your risk of hospitalization and death, but is less effective at preventing symptoms altogether. With Omicron, we're seeing far more "breakthrough" cases among vaccinated people than with Delta or the original COVID-19 virus. However, being vaccinated still significantly strengthens your body's immune response. Vaccinated Omicron patients are much less likely to have severe symptoms, be hospitalized, or die. Booster shots offer even further protection. 
   
• Most of our treatments and other tools still work. PCR (or polymerase chain reaction swab) tests, at-home antigen tests, antiviral drugs, care plans, vaccines, and other tools for fighting COVID-19 all still work. The only major exception is monoclonal antibody therapy, but new varieties of those are becoming available that are more effective against Omicron. 
   
• Omicron is still dangerous. Omicron may be less dangerous than previous variants, but it is still dangerous - especially if you're unvaccinated, older, or have a weakened immune system. We also don't yet know the long-term effects of a COVID-19 infection. 

So what do we do now?

The key to overcoming Omicron is to keep vigilant with what we are already doing to stay safe. However, there are some subtle but important differences to note.

• Masks are more important than ever - but up your game. Whereas earlier forms of COVID-19 were carried through the air by droplets, persistent coughing has made Omicron even more intensely airborne. This makes cloth masks much less effective. N95 and KN95 masks are best. 
   
• Take any cough or other symptom seriously. The shorter incubation period and the early cough mean we have more responsibility to avoid exposing others. If you feel ill, don't push yourself. Avoid unnecessary contact until you can get a COVID-19 test. 
   
• If you need a test but have no symptoms or very mild symptoms, visit your own trusted practitioner or find a state testing site near you. Between breakthrough cases and the high transmission rate, our hospitals are strained. Save the emergency department for those who need true emergency care. Need to find a state testing site? Click here. 
   
• Get vaccinated AND boosted. Variants form more easily when a virus runs unchecked. A vaccine protects you from a severe case and reduces the chance that the pandemic will continue to be prolonged. 

Finally, keep learning! I very purposely referred to my points above as "current working theories." Dedicated doctors, researchers, and scientists are diligently adding to our understanding of COVID-19 almost as fast as the virus changes. Don't take this column as the final word - I don't. Be prepared for whatever comes next.