Omicron is Here but Delta Still RULES!
Omicron numbers and data
The first case of COVID-19 caused by the Omicron variant was discovered in California on December 1, 2021. This first case was in an individual who had just returned from travel in South Africa. At this time, eight days later, this mutation has been identified in over twenty states and thirty countries. With the emergence of every variant the same three questions will be asked. How easily does it spread (contagiousness)? How severe is the illness that it causes (virulence)? Does previous COVID-19 infection and/or vaccination prevent one from becoming severely ill or dying from the new variant? The still evolving answers at this time are that Omicron, which is a highly mutated strain, is more transmissible that the highly contagious Delta variant. This trend is being seen in South Africa and Great Britain. The cautionary note is that the US COVID-19 experience has lagged the UK by a month. Secondly, the fifty or so Americans who are known to have been infected by this new strain have generally experienced mild symptoms.
Another data set which points to less severity is that in spite rampant spread in South Africa, fewer infected patients require high-level care and the hospital stays are shorter than before. Answering the question regarding the protection afforded by prior COVID-19 infection and vaccination continues to emerge. There do appear to be more re-infections and breakthrough infections caused by Omicron. Yet indications are that previous vaccination is associated with less severe involvement when this variant hits. Pfizer-BioNTech reports that both a two and a three-dose regimen provided protection against severe disease although the third dose increased antibody levels 25 times. So overall as Dr. Fauci says the “profile of the disease...might be less severe.”
In spite of financial markets being rattled and travel bands being implemented because of Omicron, the Delta variant is surging and remains a difficult problem. The US death toll is nearly 795,000 and we are losing close to 1300 Americans a day. This represents a 12% increase over the last two weeks. The National Guard has been activated to provide backup to strained healthcare systems in three states including Michigan, our neighbor to the north. Clearly forgetting about Delta is at our own peril particularly since the impending cold weather is likely to make it worse.
There are especially important updates regarding treating and preventing the spread of this COVID-19 virus. The CDC has approved the Pfizer vaccine boosters for teenagers in the 16- & 17-year-old age group. This means that three million US teens will be eligible to receive safe and effective boosters. The booster should be given six months after the completion of their initial Pfizer series. Current studies are assessing the safety and efficacy in 12-15- year-old adolescents. Secondly, on the treatment front is the expanded use of monoclonal antibodies. Recall that monoclonal antibodies are laboratory made proteins that act like the body’s immune system to fight off disease such as viruses. The FDA issued a revised Emergency Use Authorization (EUA) for a monoclonal antibody cocktail (two drugs at the same time) to allow usage for all pediatric patients, including newborns, who are at high risk of severe COVID-19 or death. This drug combination was previously authorized for pediatric patients 12 years of age and older weighing at least 40 kilograms. This new authorization is for the treatment of these younger children with mild to moderate disease as well as for post-exposure prevention of COVID-19, provided that the child is at high-risk of severe disease or death from the virus. Lastly on the news front is a new EUA for pre-exposure usage of a long-acting monoclonal antibody for individuals who are moderately to severely immunocompromised or those with a history of a severe allergic reaction to vaccines.
All of the above is fine and good, but none of these replace the benefits of vaccinations. All too often families of extremely ill unvaccinated patients and those unvaccinated patients who have gotten critically ill, yet fortunate enough to recover, experience a “Hard head makes a soft behind moment” after they narrowly escape a preventable COVID-19 death. We would all be better off if everyone gets vaccinated!
