The New Version of the Pandemic
What is different with this wave?
The amazingly higher transmissibility of omicron is the most obvious difference from other variants. This virus is transmitted largely by airborne spread — a similar route as other variants. Airborne spread is through very fine droplets that hang about in the air for minutes to hours and are produced by an infected person breathing normally and more so by heavy breathing or shouting. This is the primary mode of transmission of all coronaviruses. To combat this, you need a well fitted mask, preferably an N 95 or equivalent and when indoors to stay away from other people — especially if the air circulation is poor.
The reason for the easy transmissibility with this variant is unknown. It is speculated that the viral load necessary to overwhelm a person's defences and produce sickness is likely much less than with other variants and therefore the necessary duration of contact with an infected person is shorter. Also, the virus seems to take up residence very easily in the nose and adjacent passages while not so readily settling in the lungs.
What are the timelines for omicron infections?
From contact to symptoms is often only two to three days — which is shorter than other variants. The time to develop serious illness is unclear, however hospitalizations and serious illness with other variants typically occur within two weeks from onset of symptoms.
How serious is this variant?
This is not yet known. It will take more time and more studies before we have a robust understanding. The results of current reports are conflicting. However, it does appear to be more serious in younger people than previous variants.
Are current vaccines effective against Omicron?
Vaccines serve to both reduce the chance of symptomatic infection as well as to reduce the severity of the infection. With regards to the prevention of symptomatic infection, our vaccines are not as potent against Omicron as they were against previous COVID variants. Where they previously showed a 90 plus percent disease prevention efficacy, the early indications on efficacy against Omicron after double vaccination is in the mid 30%. Fortunately, efficacy appears to be increased to about 75% with a booster dose.
However, the picture is radically different with vaccines more important function – the prevention of serious disease. This can be measured by the rate of hospitalizations. Currently in Ontario with the dominant omicron virus, unvaccinated persons are admitted to hospital with COVID-19 at a rate 13.5 times greater than fully vaccinated persons and to ICUs at a rate 28.7 times greater than fully vaccinated persons.
Are there unexpected effects with this wave?
There is a growing problem with case data collection. The number of cases is increasing so fast that we are exceeding our capacity to test and identify all of the positive cases. Further, patients are being asked to self-isolate if their test is positive and are not asked to report their positive status, unless they are a critical worker. Thus, the daily count for new cases is now markedly under reported.
What is the prediction for the size and significance of this Omicron based wave of the pandemic?
The doubling time in Ontario is currently 3.8 days. We have never seen this rate of disease increase in this pandemic. And it may actually be shorter as in the UK where Omicron is dominant it is 2 days. Despite significant underreporting, In the last week, the new case numbers in Ontario have gone from 3,520 to 9,815 with an estimated 97% of all new cases caused by Omicron. Hospitalizations have gone up 38% in the same week, with at least some of the increase in hospitalizations due to the increased number of Omicron cases.
It is certain that more Ontario residents will get infected by Omicron than were infected by any of the previous variants and will do so by this February, or sooner. Most of the hospitalizations and possibly deaths will occur in unvaccinated persons. The large number of people required to isolate may cause some temporary labour shortages which could effect the critical operations of our communities.
What is important for you?
- Find what you can do to stay positive.
- Maintain key activities that you can still do — that keep you centred.
- Nourish your relationships. COVID starts to win if it strips us of our human connections.
- See your doctor or go to the ER for chest pain or breast lumps or all the other medical things that are still important.
- Remember, like all plagues this will eventually die out.