General Wellness

I Stand Corrected – Omicron IS The Most Infectious Microbe Humanity Has Encountered

Even outspoken epidemiologists who have warned of pandemics for decades and have micro analyzed the one we are living through right now have been taken by surprise by the rate at which the Omicron variant has taken over as the dominant strain of Covid-19 worldwide.

In S. Africa, where it emerged, they went from a few hundred new cases of Covid a day, to over 13,000 in a mere few weeks. In the US, we went from identifying it in only a few states to just about everywhere in under a week. I don’t have today’s stats but a few days ago, it represented 75% of all new Covid cases. It is now in every country on the planet.

Why is it so contagious? The exact cause is not yet completely clear, but it is likely a combination of things including greater ACE-2 receptor binding capacity, increased replication within cells as well as a better ability to evade both our innate (built-in, non antibody) immune system as well as the adaptive (T and B Cell and antibody) immune system, acquired either by natural infection and/or vaccination.

Although Omicron still seems to cause less severe disease, this is also a significant contributor to it’s exponential spread. More people with mild to no symptoms are walking around, not aware they are infected, spreading it to everyone around them. Sicker people stay home and get tested earlier (and then hopefully isolate).

Do NOT be comforted by it’s apparent diminished severity. More infection still leads to more hospitalization and death. And YES, the vast majority of those with more significant illness are UNVACCINATED!

Lest you smarty pantses who got Covid “naturally” think you’re better off than those who got vaccinated, you’re wrong! Studies show that those who got Covid more than 6 months ago and did not get a vaccine afterwards, are 5x more likely to contract Covid AGAIN from Omicron than those who got infected and then followed up with a vaccine.

SOOOOOO, don’t be silly and lower your risks of getting significantly sick, or worse yet, sicken someone else, by getting vaccinated.

And keep in mind that 2 shots is NOT fully vaccinated if your second shot was more than 6 months ago. FULLY vaccinated means you also got the booster which dramatically increases levels of circulating antibodies and thus, protection.

Another interesting item I read yesterday was a study looking at non-Covid deaths and Covid vaccination. Accounting for every variable you can think of, not only did vaccination lower the risks of Covid deaths, but it also lowered the risks of all non-Covid related deaths. Things like heart attacks and strokes. Why this may be is not clear. It may have to do with the fact that those who want to get vaccinated probably do other things to be healthier also. Those who don’t get vaccinated are more likely to have other behaviors which put them at risk for not only Covid, but other diseases. I know this is a generalization but this was suggested by the paper.

On another note, Natalia and I did a taste test of some vegan perogies (Supreme Pierogies). Not exactly healthy food since they came from a factory with all kinds of oils, additives and preservatives… but they tasted really good. Especially slathered with slow cooked onions and some vegan, soy based sour cream. As someone who used to eat vats of sour cream before I started eating plant-based, I am a connoisseur and I can guarantee that you can’t taste the difference. I’m looking forward to the traditional Ukrainian Christmas Eve feeding frenzy with family. We are all vaccinated and boosted and we all plan to test today or tomorrow just to be on the safe side. Keep some windows open a crack for ventilation. That’s the way to do it.

Travel safely.

Gather safely.

Enjoy being with family and friends safely.

Stay safe and be well.

AC

I was out taking care of a few errands on Sunday and I was shocked by how many people were unmasked. Workers and shoppers alike. Not even pretending, wearing it under their noses or protecting their chins, necks or wrists. Just plain no mask. Adults, kids, older, younger… It’s as if everyone has given up. No one cares about what’s going on. It’s someone else’s problem. 

I keep having conversations with unvaccinated patients who “aren’t worried about getting it” but who can’t give me a reasonable response when I ask about protecting everyone else around them. “Well, vaccinated people also get sick and can pass it along” is a common retort.  People love to hear good news about their bad habits. Acknowledging that vaccinated people are getting sick is a reality, but is also a distortion of the truth, which is, that vaccinated people don’t catch the disease as readily as those who are not vaccinated. Nor are they getting significantly sick if they do. Not even close.

Let’s be clear. Vaccination is not an impenetrable shield. They still need to wear masks, distance and avoid crowded situations. But the reality is also that if infected, vaccinated people spread the virus to a much lesser degree and for a much shorter period of time. They also have a much shorter course of the disease and have a much lower chance of dying. Vaccinated people are not taking up space in ERs, overrun with all kinds of sick people. They are not taking up a room in the hospital or an ICU bed. It’s almost all unvaccinated people.

Omicron has been described as the most infectious virus humanity has faced. Although that may be a bit dramatic, it certainly is more infectious, at least 2-4x more than Delta, and is causing massive surges of cases worldwide. It’s now in all 50 states and just about every country that has a reasonable reporting system.

Last week, Omicron accounted for 3% of new cases in the US. This week, it now accounts for 74% of new cases. It is expanding at a rate significantly greater than even Delta.

The degree of disease from Omicron seems to still be less than the disease Delta can cause, but it is still early. One US study suggested that the degree of disease is no different but in S. Africa, where Omicron has been present for much longer since it originated there, their disease burden remains low. There, it is clear that the vast majority of hospitalizations remain in unvaccinated people. Well over 90%.

S. Africa’s vaccination rate is only 26%, which is why this variant emerged there in the first place and spread like  wildfire. Worldwide, almost 8.5 billion vaccine doses have been given with 46% of the world’s population being fully vaccinated. We are better than average, at 61% fully vaxed, but that is still pretty poor compared with many other developed countries. As far as boosters go, less than 30% of those fully vaxed have received the booster. If it’s been 6 months since your last dose, you must get a booster. Some infectious disease specialists feel that these really should have been thought of as a 3-dose mRNA vaccine (2 dose for the adenovirus vector vaccines). I am not sure I agree with that. I think that we may need regular boosters, just like we need annual Flu shots, at least for the foreseeable future. Then again, anyone who makes predictions about how this pandemic will continue to evolve, probably doesn’t know what they are talking about. The virus will do what the virus will do.

Even though the Omicron-related disease may be more mild (the jury is still out about that), again, it’s all about the numbers. More sick people by definition will lead to more severe cases and deaths.

And we don’t even know what kind of long-haul symptoms might arise. We know that even young, asymptomatic people who have had Covid develop long haul symptoms. We shouldn’t expect Omicron not to lead to such symptoms as well.

Preliminary evidence suggests that the Moderna vaccine MAY be more effective than Pfizer or J&J against Omicron, but the bottom line is that any vaccine is better than none so get it ASAP.

Get together during this holiday season, just do it safely. If you can, test yourself before getting together, especially with older, more frail relatives and friends in the mix. Travel carefully.

Keep doing all the things we know help to protect everyone and slow the disease down.

GET VACCINATED and GET BOOSTED. And again, get your FLU shot. Don’t ignore the other bugs out there. Remember that a few years ago, over 80,000 people died in one season from the flu in the US alone.

WEAR A MASK!!!! The vaccine is imperative, but it is not a forcefield. Masks protect you, not only from Covid, but also the flu as well as all the other respiratory viruses. Use an N95/KN95 in risky situations.

DISTANCE and VENTILATE. The closer you are, the more likely you are to catch it, especially in still air.

WASH YOUR HANDS. Covid may not be as readily transmissible through surfaces, but the flu certainly can.

GET HEALTHY! It is still your best defense against not only Covid, but all disease. Remember that although we have lost over 807,000 people to this damn virus, more than double that number has died in that same time period from vascular disease (heart disease and strokes). And 80-90% of those deaths were preventable with simple lifestyle choices. Dr. Dean Ornish’s mantra is perfect:

1. Eat better. Eat a mostly whole foods, plant based diet. Eliminate sugar, dairy and processed factory made “food”. Minimize animal products. They all cause inflammation.
2. Move more. All exercise is good but the more you move throughout the day, the better. Take the stairs. Park farther away from the door. Anything to keep moving.
3. Love more. We need each other. Better in person. And we need to take care of each other. We are social creatures.
4. Stress less. Chill the f&^! Out! (I need to take my own advice with this one especially). There is I think a Buddhist saying that “You should meditate once a day. If you don’t have time to meditate once a day, you should meditate twice a day.”

Have a great Holiday.

Stay safe and be well.

AC