A recent development in the COVID-19 saga is the emergence of a new strain in South Africa known as the Omicron variant. The World Health Organization has named it a “variant of concern”, the fifth such strain to be given that title. Cases of the new version are rising rapidly, suggesting that Omicron might soon replace the Delta variant as the dominant virus in North America. How much of a threat is Omicron?

The SARS-CoV2 virus is composed of RNA instead of having both DNA and RNA. RNA viruses are notoriously defective in terms of replicating themselves. As such, they often mutate with variable consequences. In the case of Omicron, there are a number of different mutations that cause it to be more contagious but, perhaps, not as severe as some previous versions. At present, physicians’ experience in South Africa doesn’t seem to show increased percentages of hospitalizations or deaths over previous variants.

This is not a surprise. Viruses have the goal of spreading throughout a population. The more lethal a virus is, the less likely they can spread.  If an airborne virus killed 100% of the humans it infected, it would be difficult for those dead humans to breathe on live ones. The best way for a virus to become widespread is to become less lethal, so there would be many more opportunities to find new hosts. Of  course, people who are elderly or immune-compromised are at risk for worse outcomes.

Omicron may present somewhat differently than other variants. You might see:

-scratchy throat

-mild muscle aches

-fatigue

-a dry cough

-night sweats

Preliminary evidence shows that Omicron may cause reinfection in people who previously had COVID infections. Some vaccine manufacturers believe that their products will be effective against the new strain, but others are less certain. In any case, it appears that the vaccinated population are given decent protection against severe disease, but little against getting infected or spreading the disease. If it turns out that the new strain is resistant to vaccines, drug manufacturers believe it would take about three months to produce a new one. It’s uncertain if the new oral drugs coming out to treat infection will be effective against Omicron.

(Note: The names of SARS-CoV2 variants are taken from the Greek alphabet (Alpha, Beta, Gamma, Delta, etc.). This variant was going to be named after the next letter in line, which was “nu.” The World Health Organization decided it sounded too much like “new.” The next letter was “Xi,” which was coincidentally the name of the current Chinese leader Xi Jinping, so that was ruled out, given the “sensitive” nature of the virus’s origin in China. Omicron was next, so the variant was named that.)

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There’s a chance that Omicron isn’t as contagious as some are suggesting: A (vaccinated) Israeli cardiologist was the first to test positive in that country. He was in contact with several dozen people (most of them vaccinated) when he began to have symptoms. A thorough tracing and testing program found only one of his contacts, a 70-year-old colleague, had contracted the virus.

The standard recommendations against COVID-19 remain unchanged: Remain socially distanced, wear a well-fitted mask, open windows for increased ventilation and to decrease viral concentrations inside, keep hands clean, and avoid crowds. Of course, if you’re coughing or sneezing, do it into a tissue or, at least, into a bent elbow.

When will the pandemic end? If the goal is zero cases, the answer is never. My opinion is that the SARS-CoV2 virus is here to stay, but will morph into a flu-like or cold-causing organism, with severe cases no more frequent than with influenza. Indeed, four different coronaviruses cause “common cold” symptoms every year, comprising about a fourth of all such infections.

Over time, we’ll know more about Omicron and be able to figure out its impact on society. There is certainly no cause to panic or to buy into the hysteria which appears to be the agenda of many politicians, media pundits, or certain “experts.” Wear a quality mask when it’s appropriate, stay away from large indoor crowds, and wash your hands (Mom was right about this one).

Joe Alton MD

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