What to expect with Omicron

CLINICAL MATTERS

The second case was a 37-year-old male Nigerian national who arrived from Nigeria on Nov. 30, 2021. He was asymptomatic on arrival. He was put under quarantine on arrival per protocol. He was likely unvaccinated since he underwent RT-PCR on the seventh day of arrival. Unvaccinated persons get tested on the seventh day of arrival while vaccinated persons are tested on the fifth day. This came back positive for SARS-CoV-2 and he was transferred to an isolation facility.

In the event Omicron makes it into the community, transmission is expected to be faster than Delta. While there is some data that it may cause milder disease, higher numbers of people getting sick can still overwhelm healthcare systems. In order to prevent overloading of the healthcare system, vaccination is essential to decrease the proportion of people who develop severe disease. Continued use of face masks and the addition of face shields further decrease transmission.

Boosters seem to increase neutralizing antibody levels and activity. Preliminary data from Sinovac and from Pfizer vaccines show that neutralizing antibody activity against Omicron is nearly gone despite the two-dose primary series. A booster dose of vaccine is associated with some restoration of antibody activity. Mixed or heterologous booster vaccination is expected to provide similar levels of protection regardless of which brands are mixed.

1. It already IS in the community. Ask the D’OH that thinks “contact tracing” is waiting for airplane passengers to present themselves on a silver platter. All contacts accounted for? Methinks not. 2. Face shields don’t work except in certain medical procedures done in hospitals

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