Why get vaccinated if it doesn’t work as well against Omicron?

Here is a newsflash (and it was news to me as well): the Omicron variant is not the Delta variant which simply mutated into the Omicron variant. These variants are not necessarily Alpha to Beta to Gamma to Delta to Omicron. When the genetics is carefully assessed, it turns out that Omicron actually evolved from the original Wuhan strain which appeared 2 years ago. As an FYI, today (Friday January 21st), marks exactly 2 years since the first official case of Covid was diagnosed in the US. We later determined, after reviewing stored lab cultures, that the virus actually reached our shores weeks earlier, but we lacked the testing, and information from China, to make that diagnosis.

Although there are outbreaks of  variants in many different places, that does not mean that all the previous forms of this virus have died off. There are plenty of places where people are not vaccinated and even the Wuhan strain is still present in significant amounts. It’s also still circulating in the US.

ANY replication of this virus gives it the opportunity to mutate into a variant of concern. The fewer infections, regardless of which variant it is, the better.

Trying to rationalize how concerned you are about which variant you get or for how long you need to quarantine based on the variant you have is not useful. The CDC quarantine advice is too vague and general. Unless you are an essential worker AND had little to know symptoms all along, the 5 day rule may apply, but you still must wear an N95 for an additional 5 days. But for everyone else, stick to 10 days after symptom onset or a positive test. And do not use the antigen test as a rationalization to get out of quarantine. If you do it a few times, maybe, but there are too many false positive and negative results to be definitive after one test.

This virus is here to stay, in various forms. It’s not the flu virus whose previous versions die off season to season. Again, it’s a novel virus and we continue to learn about how it replicates, mutates and impacts our health. We know a lot but there is a lot more to learn.

Please get vaccinated and boosted and continue to do all the other important mitigating steps.

Wear a proper mask. The best one you can.

Distance and avoid crowds.

Be hygienic, but don’t overdo it.

Get healthy!

Have a great weekend.

Stay safe and be well.

AC

Spoiler alert, Covid ain’t goin’ anywhere anytime soon.

The confusing information from many outlets continues to march on. Last week there were numerous reports that some scientists and infectious disease specialists feel that there are signs that this pandemic may be nearing its end. Comparisons are made to the pandemic of 1918, when there were similar patterns of disease worldwide, followed by a lull, and then another resurgence, and then it disappeared. Until it naturally reappeared in the 1949-1950 season but then resurfaced again, after a lab leak in Russia, in 1977 (sound familiar?). There are various reasons we know it was a lab leak. First of all, the lab was known to be messing around with that virus and secondly, there were almost no genetic differences when it was compared to the virus from 1950, a virtual impossibility if the virus simply evolved and reappeared naturally. It was put on ice in 1950, thawed out for experimentation in the mid 70s, and escaped. Lest you think this can only occur in other countries, there have been many hundreds of well documented “incidents” reported in US labs over the decades, including a number of deaths from infection. We experiment on pathogens just like every other country does.

Although there are signs in some places that this most recent Omicron variant surge may be slowing down, the overall pattern on a national and certainly a global scale, is still very concerning. Surges are spiking all over the place, including in the US. Hospitals are overwhelmed, and not only with Covid. In our local hospitals where I practice, we are starting to see the overwhelm impacting on the care of all patients, including those with non-Covid medical issues. Our own patients have had 10+ hour waits in emergency rooms and EMS services are strained, having also to prioritize patients. It also isn’t helping that one local hospital just closed and another is closing at the end of January, the Pandemic being the last nail in the coffin of an already struggling healthcare system.

As for comparing the Covid pandemic to the 1918 flu, there are more differences than similarities. First of all, the influenza of 1918 was a typical flu in that it was seasonal. It spread year round but both peaks occurred in the cold weather and lessened in the warmer weather. This is NOT happening with SARS-Cov-2. It’s a year-round virus with many large outbreaks in the warmer seasons. Secondly, our ability to travel, allowing the virus to spread as quickly, was nowhere as efficient back then than it is today. Thirdly, the 1918 pandemic was caused by a “naturally” occurring virus. Certainly, human activity, specifically animal agriculture and domestication for meat consumption, caused it to develop and jump to humans, as do almost all epidemics. Although the coronavirus which causes Covid-19 probably originated in bats, as many other coronaviruses do, the SARS-Cov-19 was likely manipulated by humans in ways that nature would never have, making it much less predictable. Lastly, they had no cure and medical care in general was significantly more primitive. Today, we have amazing treatments available, including the vaccine.

As epidemiologist Dr. Michael Osterholm has repeated many times, anyone who makes any kind of definitive prediction about what is going to happen with this virus, doesn’t know what they are talking about.

Although many more people worldwide still need, and will get vaccinated, our rates here in the US seem to have stalled at under 70%. Those last holdouts are too entrenched in whatever beliefs they have and will likely never get the vaccine. In addition, as time passes, protection from either vaccination or natural infection wanes and we have seen an even lower rate of booster doses being received, essentially making even the vaccinated people more vulnerable. All this allows the virus to continue to spread and replicate increasing the chances of an even more concerning variant to emerge. Could it mutate itself out of existence? Possibly. But sitting around hoping when we have treatments and strategies to limit transmission available to us now, is misguided.

The reason we only get one annual vaccine for the seasonal flu, is because it is seasonal, peaking in the middle of the winter, when we are all cooped up and in closer contact with each other. And just like with Covid-19, the flu virus mutates and changes, so each year the vaccine changes a bit to try to predict the upcoming variant. With Covid-19, we may be headed toward twice-a-year boosters, since this is a year-long transmissible infection and antibody levels drop off significantly by 6 months, in both natural infection and vaccination. It’s also way too early for us to be able to predict mutations, and make a protective vaccine in anticipation. We can’t even keep up with what is emerging today. It is what it is.

Results take work. Not wishful thinking. We can’t rely on someone else to come up with something to get the job done. It takes everyone to work together for us to beat, or more likely to co-exist, with this virus in some semblance of a normal way.

Appreciate what you have (we still live in the most peaceful, free and prosperous time in human history) but please continue to be careful and look out for everyone around you. 

If you have not yet been vaccinated or boosted, please do so. Even if you got Covid, you still need a booster. Most recommend waiting 3-6 months, but it still adds protection beyond what natural protection you may have.

Continue to distance and wear the best mask you can when out in public.

Work on your own personal health. It’s your best protection if you do contract the virus.

Ss

AC