The Omicron Variant

Transcription:

Melanie Cole (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And we're talking about the Omicron variant today with Dr. Bud Lawrence. He's the Medical Director of Henry Mayo Newhall Hospital Emergency Department.

Dr. Lawrence, always a pleasure to have you on. So tell us about the new strain Omicron. It's a variant of concern. Tell us a little bit about this variant and how it differs from Delta and the original.

Bud Lawrence, MD (Guest): Well, good morning again. Thank you so much for having me. I always enjoy taking part in educating the community. So talking a little bit about the Omicron variant. I think most people out there at this point, understand that the variant is there. They know the name, but how is it different from the prior strains is a good question.

Two differences from the prior strains are that number one, it's much more contagious, much more virulent. So, you're much more likely to spread it if you have it and much more likely to catch it, if someone around you has it. So, I think that's one of the main differences. And then the second difference really is that it tends to make patients not quite as sick as the prior variants did. So I think those are the two main differences. I think in terms of contagiousness, if you just kind of, for comparison with the original SARS COV 2 virus, the original COVID that came out, that Coronavirus, if one person was expected to maybe get around two and a half people sick, and on the Delta variant, which was much more contagious, it was almost double that. So one person, if you had it, you could be potentially get five people sick. Well, this new Omicron, we think if you are infected with Omicron you can get up to seven, seven people or more sick.

And that kind of seems to be independent of vaccination status, which has been something that's somewhat concerning. The transmissibility, people who are vaccinated and even boosted can get Omicron. But, the information on that remains the same, which is that if you are vaccinated, it's much, much less likely that you're going to have a severe form of COVID, that you'll be really sick requiring being in the hospital with a breathing tube and those kinds of things. It really limits that risk.

Host: Well, as you're talking about symptoms, are they a little bit different as well? It's not as much of a lower respiratory, is it? Tell us a little bit about where the symptoms differ with sore throat and sniffle sounds more like, you know, a severe cold.

Dr. Lawrence: It really is. What you said is exactly spot on. So, I think this is one of the differences in why Omicron isn't making people stay in the hospital for these long prolonged stays on a ventilator is because it really does not seem to be affecting the lower lungs quite as much as Delta did. And to be honest, we're still seeing some Delta patients. What we think are Delta patients. They're still about four or 5% of these COVID infections that are Delta. And we are seeing patients come in with lower respiratory issues, but for the most part, Omicron is going to be an upper respiratory. So that's going to be things like you described, runny nose, headache, fatigue, sneezing, sore throat, horse, voice, chills, those sort of symptoms that you would really attribute to a common cold.

Those are the same symptoms that we're seeing with Omicron. So, very important, if you are sick to hopefully go out and get yourself tested, just so you can understand if it's COVID or not. Because those symptoms really are so very similar to a common cold, which by the way, most common colds are caused by a Coronavirus. So it does make sense that those symptoms would overlap.

Host: Well, it certainly does and people don't all know that Dr. Lawrence, that the common cold is a Coronavirus anyway. Now, before we get into some of the other issues I want to ask you about today and keeping ourselves safe, you mentioned testing. Tell us a little bit about what you want us to know about getting tested, because first of all, it helps us to keep records, but some people come to the emergency room just to get tested and we don't really want them to do that, but they don't know where to get tested or these at-home kits are not available where they live. Tell us about that.

Dr. Lawrence: Yeah, it's very tricky. There are challenges to be sure about finding places to get tested. So one of the issues with Omicron being so contagious and having similar symptoms to a common cold is that we have now a huge cache of people who are out there trying to get tested. And this obviously is overwhelming the standard system for testing, which would be places like doctor's offices or urgent cares.

And so what we're seeing is these places do not have the capability to test people, or the amount of people that are requesting to be tested. So, a lot of patients are coming to the emergency department. I would say that our emergency departments nationally are overwhelmed, with sick patients, with holding patients that are supposed to be admitted to the hospital because we don't have enough nurses to take care of patients in the hospital.

This is not a local issue to our hospital, Henry Mayo. This is an every hospital problem across the country. So if possible, we would recommend that you get your COVID test, try to find an urgent care potentially that is offering it. And you can call them ahead of time. Try to schedule with a physician's office. There are still, I'll reiterate two types of tests. The main type of test that you're going to find for home testing that you can maybe even find on Amazon or elsewhere is called an antigen test. That's the one that comes back in usually 10 to 15 minutes. These tests are becoming more and more reliable.

There are still some brands out there that might not be so reliable. For the most part, they're fairly reliable and they're very helpful for detecting do you have virus floating around in your body, which is very helpful because the other tests called the PCR test, which usually takes hours or days to come back is much more sensitive. It's going to be a bit more accurate, but the issue is that it will continue to detect the genetic material from those viruses long after you've cleared your infection. So you are not sick, you're not contagious, but you can do a PCR test and it can still come back positive, which has been causing some issues for things like nursing home patients or people that are trying to get back to work. Those kinds of things, or back to school, when you talk about students. So the antigen test is a really good solution for a quick result. And some of these can even be purchased online to be delivered to your home. Again, just keep your eyes out for any alerts on any companies that create tests that may not be quite reliable.

But that's always continuously changing. But bottom line is that best place to get your COVID test would be at your physician's office or an urgent care. And I'd recommend calling ahead prior to going to ensure that they have a slot and a test for you so that you can get that test done and have your answer.

Host: That's really great advice. And then you mentioned people are starting to go back to work in person. Do you have any tips to share on keeping safe if you do have to work in an office? Should we be upgrading our masks because that's another little confusing thing is the cloth masks. Now we're hearing about those. Should we all be trying to get N95 or KN95? What do you think about what we should be doing? Really some tips to help us keep safe wherever we work.

Dr. Lawrence: Well, I definitely think that again, as this pandemic goes on, we are getting more and more information that we're able to process and make better and better decisions. So, as time passes, we're getting more and more data, which is extremely helpful. And some of that data has been coming back saying, hey, maybe these cloth masks or these gaiters, they're not quite as protective against Omicron for example, which is so contagious. So, the recommendation really starting to come out to say, hey, why don't you use surgical masks? That is a good answer to keep people safe with a product that has reliable supply chains that we can make sure that everybody has enough. Right?

That's kind of a concern when it comes to N95s. So N95s, some people will come out and say, hey, you should be using an N95 or a any variant, essentially of an N95. However, there is still an issue with N95 supply to healthcare providers, and really N95s should be used by healthcare providers first.

And if we have plenty of N95s to go around, then certainly people in the community can use them, if you're able to find N95s online or wherever, feel free to use them. But, the answer really is a great medium would be a surgical mask. Definitely, it seems to be working better than just a cloth mask again, not only to protect yourself from others, but in the event that you're asymptomatic and have COVID, it can protect others from you.

Host: What about quarantining? That has changed as well and is confusing to some people. If we do test positive, or even if we don't have a test, can't get to a test, but we feel sick. We're assuming maybe it is, COVID. But even if it's not COVID, even if it's the flu or a cold, what are the latest quarantine recommendations? What do you want people to know, so they can help keep the community safe? Cause that's what this is about, Dr. Lawrence.

Dr. Lawrence: It is, it is protecting others and making sure our community as a whole is doing well. So, the CDC just recently came out with two recommendations, one for isolation and one for quarantine, which are essentially the same thing as it kind of all under that bubble of quarantine. So, isolation really they're defining like if you are COVID positive. If you test positive, they want you to isolate yourself for five days, which is different. It used to be 10 days, but they've shortened that time period. And some people are sort of skeptical about that, but it actually is based on science and that science that they're referring to is that most viral infections and it seems that COVID follows this pattern, most viral infections that you get, you're really contagious one to two days prior to you becoming sick. And then another two to three days after you're sick and then you're much less contagious. And that's how it works with many of the viral infections that we see. So, they've shortened that isolation time.

So, if you are positive, they want you to be isolated for five days. And then as long as you have no symptoms, or you have resolving symptoms, meaning your cough, or your runny nose is getting better and you've had no fever for 24 hours, you can leave isolation, but you've got to wear a mask when you're around anyone that's in your house or outside your house for five days.

And so that's actually much better in terms of people being able to return to work or return to school or return to the community. And, it's one of these things that I think is something that people will hopefully appreciate when they do have COVID. So, they're not stuck in their house for 10 days.

And the second piece is quarantine is defined as you've been exposed to COVID and you're not sick, but you had a very close contact with someone who was COVID positive and they've broken that down to say that, hey, if you were unvaccinated or unboosted, you haven't had your booster and you're six months from your second dose, or two months from your dose of Johnson and Johnson vaccine, then essentially you have to be quarantined for five days.

You stay at home for five days, and then you wear a mask around others for five days after. And so that's essentially similar to the isolation. If you did have COVID, but once you develop any symptoms, if you have any symptoms of a viral infection, you've got to get tested. And, you've got to quarantine yourself further until you have a negative test, essentially.

And if you're boosted, you've got your vaccines and you have a booster and you're exposed to somebody, they're actually saying you don't have to be quarantined at all. You just have to wear a mask for 10 days so there's a significant loosening of these restrictions as we learn more and more about how this virus operates, how people who are infected are contagious and how best to keep this infection from spreading further around the community.

Host: Well, that's really what it's about. And it certainly is for the good of all of us, for the community. So, doing these things is pretty simple. As we get ready to wrap up, can you tell us what to expect after this surge? Do you have any theories? And while you're telling us that, can you speak just a little bit about the importance of vaccination?

You just mentioned it, but also the booster, as you think that maybe we're going to have boosters every year, like the flu that will include these variants as they start showing their little heads, but give us your best advice about what you think is going to happen and what you want to see the community do and what you're doing at Henry Mayo Newhall Hospital?

Dr. Lawrence: Well, I think, you know, I wish I had a crystal ball. If I had a crystal ball, I'd have all these answers, but

Host: But that's what I'm asking you to have ball Dr. Lawrence.

Dr. Lawrence: Right. That's right. Well, I would say to you that, I think there's a couple of different possibilities. I think one possibility, the optimistic possibility, which I would be hopeful for is that Omicron being much less deadly, causing much, much less severe illness, that enough people get it, that it becomes kind of like a common cold and Coronavirus fizzles out.

This particular COVID fizzles out much like the Spanish flu. Ideally, that would be the ideal situation that this Omicron could actually be a blessing in disguise and could get us clear of this pandemic. That's the ideal option. The other possibility is that because there's so many coronavirus replications going on with so many people being sick, that we could see a different variant that causes different issues, and could be even further resistant to our vaccinations.

So there's a lot of things that could be happening. I think that what we need to do as a population is to understand that hey, to be vaccinated is your own choice. It's the United States of America. You can choose to do whatever you'd like to do, but it is becoming more and more convincingly obvious that if you are vaccinated and in fact boosted that this is much more protective for you with COVID infections than not being boosted and not being vaccinated.

Majority of the patients admitted to hospitals across the country that are sick with COVID, are unvaccinated patients. And that just is very telling. Again, use this information to make your own decision, but it's becoming fairly, fairly clear. So, certainly, vaccinations and getting boosted seem important. There is some information out there that perhaps these vendors that are creating Moderna and Pfizer that create the main vaccines that are mostly used, might be coming out in March or so with a booster that could include specific information to combat the Omicron variant. So, there is something to be said about looking forward to that.

I do think at some point we're going to have a likely, and I think people are already working on this. I've been saying this for a long time, but a combined flu-COVID vaccination that people just get every year that is up-to-date with various variants. I think that's likely will be inevitable. So here at Henry Mayo, we are doing our absolute best to deal with this very real surge of patients with Omicron. Numbers are increasing, nursing staff, physician staff are ill with COVID, you know, people were in the front lines treating these patients. And so our staff are getting this infection as are all hospitals across the country, which is making our nursing shortage so much more evident and severe, and this is leading to delayed times in emergency departments. And I think one of the most important things is if you do have to come to the emergency department or you have an issue that you would have gone to the ER for before, you definitely need to come and be seen. I would just ask for patience at not only Henry Mayo's emergency department but speaking on behalf of the emergency medicine community as a whole, be patient when you go to an emergency department nationally, because there is just such an overwhelming number of patients and overwhelmingly significant nursing shortage, that things will just take more time.

But that doesn't mean that we won't get to you, and that we won't be able to address your problem. So, I would just ask the community to be patient, to wash your hands, use your masks, don't touch your eyes and nose, all the things we've been saying this whole time hold true. And, in an optimistic way, hopefully we are seeing the light at the end of the tunnel with this Omicron variant. Of course, anything can happen. But, that would be my optimistic wish is that this carries us through the pandemic and this COVID becomes endemic and becomes a non issue.

Host: Well said, Dr. Lawrence, always such an informative guest. You just lay everything right out there in such easy to understand ways, and really you all must be exhausted and bless your heart for everything that you are all doing. My goodness. Thank you again for joining us and really giving us great information today.

And for more up to date information, we encourage you to check the Henry Mayo website at Henrymayo.com and click on the COVID-19 link at the top of the page. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. Thanks so much for listening.