7 Reasons Why You Want To Avoid Getting Infected with the Omicron Variant
Thursday, December 30, 2021
There has been much discussion about the possibility of the COVID Omicron variant causing less severe illness than Delta. There is still a great deal that is unknown - it has been less than two months since it was first identified. These are seven reasons why you probably want to avoid getting infected with Omicron.
1. Omicron does not appear intrinsically much less severe than Delta
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTWhile it is already clear Omicron is much more transmissible and has greater immune escape (resistance to vaccines and antibody therapies) than the Delta variant, the definitive answer on virulence will take more time to determine. Some observations to date have reported fewer hospitalizations and deaths compared with the Delta variant. This ‘milder’ premise has been picked up by many who seek rationalizations to avoid the lockdowns and other restrictions of previous waves.
However, Omicron’s lowered risk of hospitalization appears to be due in large part to immunity in those populations. Many of the infected already had protection against severe disease, either because of previous infections or vaccinations. Omicron might be a ‘milder’ infection than Delta – but only if you have been vaccinated, or have antibodies from recent prior COVID.
Compared with the U.S., the population of South Africa is younger and has had more exposure to prior COVID infections. Both of these factors lessen the severity of illness. Younger people generally have less severe illness than older, and the antibodies from prior infections, while not providing ‘immunity’ against Omicron, seem to reduce the severity of illness.
Experiences in Europe are more relevant indicators for what might be expected in the U.S., because of closer similarities in population age, general health, vaccination rates, and prior exposure to COVID.
"We find no evidence (for both risk of hospitalization attendance and symptom status) of Omicron having different severity from Delta," commented a recent report from the Imperial College London COVID19 Response Team.
The danger of COVID now is more the number of people infected than virulence compared with Delta. Delta was more virulent than Alpha, and Alpha was more virulent than the original strain. Omicron and Delta cannot be compared only by adding up the numbers of cases and hospitalizations for each over a short time. Omicron cases are growing much faster than they did for Delta, and it takes time for people to become seriously ill or die. To accurately assess the severity of Omicron what must be done is to compare the numbers of cases that end up as hospitalizations or death. Mortality is often assessed as death within 28 days of diagnosis (and can happen much later), and most Omicron cases started less than 28 days ago. It would seem wise to not wait for the final analysis before deciding to take precautions.
Overall, it seems that Omicron’s effects will not be as mild as hoped.
“The transmissibility alone is such a big factor, just in terms of how quickly outbreaks can grow. Even if just a small fraction of Omicron cases go on to severe disease, that’s still a lot of cases,” said Dr. Natalie Dean, a biostatistician at Emory University.
2. Reinfection is a much higher risk with Omicron
Antibodies from prior COVID infection may reduce the severity of illness from Omicron, but previous exposure does not provide ‘immunity’ or protection from infection. On the contrary, reinfection is over five times more likely with Omicron. Prior infection by other variants provides little protection.
"Controlling for vaccine status, age, sex, ethnicity, asymptomatic status, region and specimen date, Omicron was associated with a 5.4-fold higher risk of reinfection compared with Delta," said a recent report from the Imperial College London COVID19 Response Team.
The first Omicron death in the U.S. was a reinfection, someone who previously had COVID.
3. A ‘mild’ case of Omicron isn’t necessarily easy
A mild or even asymptomatic infection with COVID can still be problematic. One of the many things being learned about COVID is the wide range of possible symptoms and disease severity. ‘Mild’ COVID can still be a lengthy, challenging, unpleasant ordeal with long-term consequences.
‘Mild’ symptoms often include fever, chills, shortness of breath, nausea, headache, vomiting, sore throat, muscle pains, extreme fatigue, diarrhea, and loss of taste or smell. Secondary pneumonia can also happen.
Some people will also have lung damage after recovering from the acute infection, called “post-COVID fibrosis”, literally holes in the lungs. This lung damage might be permanent and life-long and result in coughing, shortness of breath, and a need for supplemental oxygen.
A 20-year-old COVID survivor needed a lung transplant because of post-COVID fibrosis.
4. A hospital bed might not be available for you if you get infected
Rhode Island’s heroic doctors, nurses, and healthcare system are facing tremendous pressures with insufficient resources to meet surging COVID cases. As of December 27, 295 COVID patients were hospitalized, more than double the number a month ago. 131 out of 140 ICU beds – 94% of capacity – are filled. You might not be able to count on easily getting a bed if you get infected and need to be hospitalized.
On December 14, 2021, Dr. Nadine Himelfarb, President of the Rhode Island Chapter of the American College of Emergency Physicians, wrote an urgent letter to Governor McKee and Dr. Alexander-Scott of the Rhode Island Department of Health. In this letter, she makes some staggering statements on the precarious state of our healthcare system.
“We, a collective group of emergency physicians, are terrified for the future of health care in this state...Imagine patients dying while waiting to be seen by a doctor who is 50 feet away and, because of lack of staff and thus capacity, simply unable to treat them. This is a true tragedy that is currently unfolding for citizens of Rhode Island,” she writes.
“The lack of policy and action from the Rhode Island Department of Health and state leadership to address this health care capacity crisis are putting our citizens at risk,” she adds,
Rhode Island is facing the most critical hospital staff shortages of any state in the country.
With hospitals strained to capacity, the prospect of having to recover from COVID at home might not be easy. The persistent fatigue, additional stresses for families with children, feeling weak and having to deal with all the debilitating symptoms of even a mild case on your own could be grueling.
5. Long COVID is a risk even after a ‘mild’ case and can lead to long-term or permanent disease or disability
The long term problems after a COVID infection, ‘Long COVID’, is another aspect of the disease of which much is still unknown and being intensively studied. Brown University School of Public Health has launched a Long COVID initiative to study this major health problem.
As more research is done two trends seem to be emerging: first, ‘mild’ or even asymptomatic cases can lead to Long COVID, and second, Long COVID is more common than many may have thought.
A recent report in the Journal of the American Medical Association, a meta analysis of over 250,000 COVID survivors, found that 54% - over half - had at least one persistent health problem more than 6 months after their initial infection.
A recent study by the University of Arizona of people who had mild COVID and were not hospitalized for their infections, found that 77% had persistent health problems more than two months after their initial infections.
For those with serious infections requiring hospitalization, it can be worse. Another study followed hospitalized COVID patients found that 92% - nearly everyone – had at least one persistent health problem one year later.
6. If you get infected the virus will spread throughout your body and persist for a very long time
A major study just submitted for publication in the scientific journal Nature shows that the COVID-19 virus spreads to almost every organ and tissue in the body, especially the brain and heart, and persists there for over 7 months.
This study conducted by the National Institutes of Health performed autopsies of people, from ages 6 to 91, who died up to 230 days after having a COVID infection. The investigators found that the virus effectively penetrates and reproduces in almost every organ and tissue in the body – even in patients who had mild or even asymptomatic infections. The highest concentrations were found in the lungs, but also, especially in the brain and heart. The virus causes long-term systemic infection and persists for a very long time.
The longest time point studied was 230 days after infection – it’s not known how long after that the virus may still stay in the body. Some viruses, such as HIV, are never completely cleared from the body. It’s not known if this might also be the case with COVID.
This work helps explain why Long COVID happens in people who have mild or even asymptomatic disease. If you get infected with Omicron – which is increasingly likely given its high transmissibility and the extreme level of infection risk in Rhode Island – the virus can be in your body for a very long time.
7. Living in Rhode Island means an extremely high risk of getting infected
Rhode Island’s rate of new COVID infections has reached an all-time high for the state – even worse than when we were the most highly infected place in the world this past January. On Monday, December 27, 2,839 Rhode Islanders were confirmed with a new COVID infection, an all-time one-day high – about one every 30 seconds. Also spiking to an all-time high in Rhode Island are cases in children age 5-18 and especially age 5-9.
Since the start of the pandemic, Rhode Island has often had higher infection rates and more new cases than not only other New England states but many in the country. Living here means being exposed to a higher risk of COVID infection than most other states, as well as now a more beleaguered healthcare system.
Since March 1, 2020, Rhode Island has been in a state of High, Very High, or Extreme level of infection risk 76% of the time, 472 out of 622 days. For only 22 days were we at a ‘Low’ level of infection risk – just 3% of the time. The pandemic has been brutal and catastrophic for all states, but some have managed it better than others. Compare Rhode Island’s 76% of the time spent at a greater than ‘High’ level of infection risk with leaders such as Vermont at 44% and Maine at 48% of the time.
Even if there turns out to be a higher percentage of mild cases with Omicron, because of the enormously increased contagiousness we can expect a terrible toll in illnesses, deaths, and pressures on our already over-burdened doctors, nurses, and healthcare systems. One person infected with Omicron can rapidly spiral into multiple infections and across generations - a child can infect their parents that could then result in the death of a grandparent. With the dramatically increased transmissibility of Omicron, your personal chances of getting infected, hospitalized, or dying, go up.
The latest data show that those who are unvaccinated are 60 times more likely to end up in an Intensive Care Unit than someone who is vaccinated. With only a handful of ICU beds left available, is it worth taking the chance that one will be waiting for you?
Living in RI means facing well-above-average risks of getting infected and limited access to emergency care - which means needing to take extra precautions if you want to avoid COVID.
Nick Landekic is a retired scientist and biotechnology executive with over 35 years of experience in the pharmaceutical industry.
