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What doctors wish patients knew about the COVID-19 Omicron variant

What doctors wish patients knew about the COVID-19 Omicron variant

Since its discovery, the Omicron variant has shown that it is more transferable compared to other variants. The speed of the spread of the SARS-CoV-2 Omicron variant around the world has left many patients with more questions than answers. An infectious disease specialist tries to clear up some of the confusion surrounding Omicron.

The AMAs What doctors wish patients knew™ series provides doctors with a platform to share what they want patients to understand about today’s headlines, especially during the COVID-19 pandemic.

In this episode, AMA member Stephen Parodi, MD, an infectious disease physician, took the time to discuss what patients should know about the COVID-19 Omicron variant. dr. Parodi is an associate executive director at The Permanente Medical Group, a member of the AMA Health System Program. He is also part of the Section AMA Integrated Physician Practices.

“Our first best information came from South Africa to give us the first clues that Omicron might be quite contagious — more contagious than any other variants we’ve ever seen,” said Dr. parodies. That enabled the World Health Organization “to determine that it was indeed a variant of concern.”

“In the US, our first case was discovered — it seems a long time ago and yet it wasn’t that long ago — December 1st,” he said. “As of January 1, 95% of reported cases in the US are the Omicron variant. It is in all states and is now the dominant species.”

“The way a dominant strain is defined is that the virus is either more transmissible, more contagious, more likely to cause serious illness, or if it is likely to escape our immune system – either because of a previous natural infection or because of vaccination.” All those things would be factors that would make it a variant of concern,” said Dr. Parodi. “The biggest reason it’s a variant of concern is because of how transmissible and contagious it is.”

“From a United States standpoint, there are a number of reasons why it is concerning,” he said. “One is that, of course, we have people who still haven’t been vaccinated, so they continue to be at risk, as in the past with the other variants, of getting quite sick and being hospitalized.” “We see many of our hospitals filling up with people who have COVID-19 infection and are in an ICU or need mechanical ventilation,” said Dr. parodies. “But the second part of this is that it’s so transmissible that a lot of people get infected at once.”

“For our healthcare staff, we have a lot of people calling in sick, so that makes it more complicated to staff our emergency rooms, our hospitals or outpatient clinics,” said Dr. parodies. “But it also affects other essential services.

“There are reports from fire departments, police forces, airlines and others who are also having trouble finding staff,” he added. “All those things lead us to see this as a variant of care, but also as a societal impact that we need to address collectively.”

The Omicron variant is estimated to be “one and a half to two times more transmissible than Delta,” said Dr. parodies. “And to put it in full context, it’s four times more transmissible than the original strains circulating at the start of the pandemic, which explains why it moved to a dominant strain in the United States within just four weeks of initial detection.” went.”

“We know that the time you’re around a person who has Omicron is shorter in terms of exposure than the time you actually show symptoms,” he said. “Originally, it could take “five to six days or even” up to 14 days for a person to show symptoms after becoming infected.

“That time seems to be shorter, about two to three days after exposure to developing symptoms,” added Dr. Parody of it.

“There are also more reports of breakthroughs with Omicron if you have been vaccinated and if you have received a booster vaccination,” said Dr. parodies. “And that’s related to what we think are multiple mutations on that spike protein that allow it to escape full protection from the vaccines.

“But what the vaccines seem to be very good at is still resisting serious illness and disease, which means hospitalization and death,” he added. “So many of the people who have been vaccinated or given a boost are essentially reporting very little to no symptoms, or they are basically saying it feels like a cold.”

To discover what doctors want patients to know about breakthrough COVID infections.

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“It seems to have more of an immune-escaping ability,” said Dr. parodies. This means that “if you have been previously infected with a strain or variant – including the Delta variant – that does not appear to be particularly protective against re-infection with Omicron.

“In fact, the UK reports that up to 10 to 15% of the cases they detect with Omicron are actually reinfections,” he added, noting that “these are people who had previous infections with other variants, and they’re actually coming back.” down with Omicron now.”

“For those people who are over it but haven’t been vaccinated yet, Omicron is a signal that the coronavirus isn’t done with you yet,” said Dr Parodi. “You have to get that vaccination, because it’s been clearly shown that unvaccinated people are at a very high risk of getting super sick and possibly dying.”

“There’s now a fair amount of data that suggests you significantly reduce your chances of getting infected if you’re boosted,” he said. “And that if you have a breakthrough infection, even with boosting, you’re much less likely to be hospitalized or die from Omicron.”

“The main message from Omicron is that it’s still important to get the vaccines,” said Dr. parodies. “If you haven’t gotten a series yet, you should, and if you’re five months off your mRNA vaccination against Pfizer or Moderna, you should get a booster. And if you’re two months away from the J&J shot, you should get a booster.

However, the CDC recommends that individuals receive an mRNA COVID-19 vaccine rather than Johnson & Johnson’s COVID-19 vaccine.

read about what doctors wish patients knew about COVID-19 vaccine boosters.

“Omicron, especially in the vaccinated and boosted populations, appears to cause less severe disease,” said Dr. parodies. “So if you got the vaccine or a booster, the chances of being hospitalized are much smaller.

“Many people report cold symptoms,” he added, noting that “data for the unvaccinated population is still emerging, but we remain concerned that those individuals are still at high risk of hospitalization.” .”

“The other thing that may have been lost with this wave is that there are long-term effects of COVID-19 on up to 50% of people who become infected,” said Dr. parodies. “They get long-term complications and sometimes it can be as simple as losing your scent for a while, which isn’t benign.

“Your smell is actually important to taste, which is important for food, which is important for your own mental health,” he added, noting that there are also “long-term effects on the brain and nervous system.”

To discover what doctors wish patients knew about long-term COVID.

“One of the newer monoclonal antibodies is effective against Omicron, but some of the older monoclonal antibodies are not as effective,” said Dr. parodies. “A few of the new oral drugs are also effective against Omicron.

“The treatments just approved by the Food and Drug Administration are largely used for outpatient or outpatient treatment to prevent complications and avoid hospitalizations,” he added, noting that “they are effective for those purposes.”

“One challenge with the new oral therapies is that they are currently in short supply,” said Dr. parodies. “The U.S. government is doing its best to distribute the offerings that we have available, and they are assigning that to the various local health jurisdictions.”

Related Coverage:

What Doctors Wish Patients Knew About the Johnson & Johnson Vaccine

“As tired as we are with the pandemic, we still have to realize that we have to wear a mask to live with it and to try to move on,” said Dr Parodi.

As for the type of mask to wear while Omicron continues to spread, Dr. Parodi to upgrade from a cloth mask to an N95. But if that’s not feasible, double masking is good too.

“In 2020, when there was a general shortage of masks, having a cloth mask was better than having none at all,” said Dr. parodies. “Now that we have surgical grade and isolation grade masks available, I would at the very least recommend using one.

“They are more effective at filtering than the cloth masks, but KN95s are now more readily available and they do offer an extra level of protection,” he added.

Find out how you clear your patients’ confusion about which masks work best.

“In general, most of the tests that take place don’t specifically look at the type of variant a person is infected with,” said Dr. parodies. This depends on the state because “a number of states are actively monitoring, looking for what kind of variants are circulating.”

“On a population basis, physicians, clinicians and health care systems submit samples to the state,” he said. “And then the state will carry out a group of samples to find the type of variant.

“For example, we can see that up to 95% of infections now appear to be Omicron related,” added Dr. Parody of it.

To discover what doctors want patients to know about which COVID-19 test is best.

“Omicron just moves so fast. That’s why it feels like everything in terms of guidance, recommendations, all of which seems to be moving very quickly,” said Dr. Parodi. being able to share or feel sorry for is okay.

“It was critical to be able to have those open conversations about the impact that COVID-19 has had, how we are resilient together, and how the response to each wave has been different,” he added.

The AMA has developed frequently asked questions about COVID-19 vaccination related to safety, assignment and distribution, administration and more. There are two frequently asked questions, one meant to be answered questions from patients (PDF), and one more to tackle COVID-19 vaccine questions from doctors (PDF).