Public Health

What patients may ask about the COVID-19 Omicron variant

Sara Berg, MS , News Editor

As the U.S. continues to struggle with the dangerous COVID-19 Delta variant, a new SARS-CoV-2 strain has emerged: Omicron. While much remains unknown about the transmissibility and severity of the new variant—and how effective the currently approved and authorized COVID-19 vaccines will be in protecting people against it—doctors, scientists and public health officials are working hard to better understand the Omicron variant.

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While there are still many unknowns, here are some questions patients may have about the emerging COVID-19 Omicron variant.

First reported to the World Health Organization (WHO) by South Africa, B.1.1.529 was classified as a variant of concern and named Omicron on Nov. 24. This prompted the U.S. and several other countries to restrict travel to and from South Africa. The U.S. was set to lift those travel restrictions Dec. 31.

The first U.S. case of the Omicron variant was identified in an individual in California. This individual, who was fully vaccinated, traveled from South Africa on November 22 and tested positive for COVID-19 on November 29. The person is reported to have mild illness. The Centers for Disease Control and Prevention (CDC) and the WHO have classified Omicron as a “variant of concern.”

State and local public health officials continue to work with the CDC to monitor the spread of Omicron. As of December 20, the Omicron variant “has been detected in most states and territories and is rapidly increasing the proportion of COVID-19 cases it is causing,” said the CDC.

In recent weeks, COVID-19 infections in South Africa saw a steep increase, coinciding with the detection of the Omicron variant. At this article’s deadline, Omicron accounted for nearly 60% of cases in the United States, according to data from the CDC.

What makes this variant concerning is the number of mutations, which may have an impact on how easily Omicron spreads or the severity of illness it causes, says the WHO. There is also a potential reduction in both the efficacy of the monoclonal antibody treatments and in the neutralization by post-vaccination sera, says the CDC.

Learn more from the CDC about what you need to know about variants.

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The Omicron variant is still new, but the WHO has noted that this COVID-19 variant is more easily spread from person to person. It is possible that with Omicron’s more than 30 mutations, it is helping the variant spread more easily while allowing it to evade protective immunity generated by vaccines or natural immunity through previous infection.

In fact, on Dec. 14, the WHO noted that the Omicron variant is spreading faster than any previously detected strain of SARS-CoV-2. But while the COVID-19 Omicron variant is more contagious, it is not yet entirely clear whether the strain causes more milder or more severe disease than others.

Again, it is not yet totally evident whether infection from the COVID-19 Omicron variant causes more severe disease. But preliminary data does suggest that the rates of hospitalization in South Africa have been increasing.

Preliminary studies of the Omicron variant suggest that infections may be less severe than those experienced from Delta. But, with Omicron, the virus spreads more quickly, which remains a cause for concern. More data is needed to better understand whether Omicron infections—especially reinfections and breakthrough infections in people who are fully vaccinated—cause more severe illness or death than infection with other variants, says the CDC.

Early evidence suggests that for those who are fully vaccinated against COVID-19, Omicron appears to result in mild illness. This can resemble the common cold, which is another form of the coronavirus. These symptoms can include sore throat, headache, cough, fatigue, congestion and runny nose.

The initial reports of infections, according to the WHO, were among college students who tend to have milder symptoms. Understanding the true level of severity of the Omicron variant could take several weeks.

While research is ongoing, preliminary evidence suggests that there might be an increased risk of reinfection with the COVID-19 Omicron variant. This means that people who have previously tested positive for COVID-19 and recovered can become reinfected more easily with Omicron, according to the WHO. More information will become available in the upcoming weeks.

Current COVID-19 vaccines remain the best line of defense to protect against severe illness, hospitalizations and deaths. But it is important to note that breakthrough infections in people who are fully vaccinated are likely to occur with Omicron. With other variants, such as Delta, vaccines have remained effective, further emphasizing the importance of vaccination and boosters.

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Vaccines remain the best public health measure to protect people from COVID-19 while slowly transmission and reducing the likelihood of new variants emerging. The CDC and WHO continue to work to better understand the potential impact of the Omicron variant on existing countermeasures. This analysis of Omicron variant vaccine efficacy includes the COVID-19 vaccines and boosters from Moderna, Pfizer-BioNTech and Johnson & Johnson.

"Emergence of the Omicron variant further emphasizes the importance of vaccination, boosters and prevention efforts needed to protect against COVID-19,” said CDC Director Rochelle Walensky, MD, MPH. “Early data from South Africa suggest increased transmissibility of the Omicron variant, and scientists in the United States and around the world are urgently examining vaccine effectiveness related to this variant.”

The CDC recommends that everyone 5 or older get fully vaccinated to protect against COVID-19. Everyone 18 or older should also get a booster shot.

It is imperative that everyone who is not fully vaccinated against COVID-19 get vaccinated. And those who are fully vaccinated and eligible should get a booster shot for added protection against COVID-19 variants.

“I strongly encourage the 47 million adults who are not yet vaccinated to get vaccinated as soon as possible and to vaccinate the children and teens in their families as well because strong immunity will likely prevent serious illness,” Dr. Walensky said. “I also want to encourage people to get a COVID-19 test if they are sick. Increased testing will help us identify Omicron quickly.”

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Given how contagious Omicron is, some experts recommend upgrading from a cloth mask to an N95 or similar high-filtration respirator when in public indoor spaces. These masks are made of material with an electrostatic charge, which can help prevent you from inhaling virus particles.

At minimum, though, consider double masking. This means wearing a cloth mask over a surgical mask for a tighter fit. A mask fitter can also help improve the fit of a person’s mask for better protection against Omicron. While double masking or a mask fitter may not offer as much protection as an N95, they are a big improvement compared to a cloth mask alone.

The AMA strongly supports vaccination of all who are eligible to protect against the worst outcomes of COVID-19. Among other things, the AMA supports COVID-19 vaccine mandates by employers and appropriate take-up of COVID-19 vaccine booster shots.

Additionally, the AMA has developed frequently-asked-questions documents on COVID-19 vaccination covering safety, allocation and distribution, administration and more. There are two FAQs, one designed to answer patients’ questions (PDF), and another to address physicians’ COVID-19 vaccine questions (PDF).