Dr. Stuart Weiss: Monday 12-27-2021COVID-19 Omicron Update
Rapid Test Center of New York
Dr. Stuart Weiss, FACEP, FAAP, CBCP
Dec 27, 2021
CoViD-19 News and Information you can trust. Welcome new readers from the Rapid Test Center.
Topics:
- Omicron variant update – Some good news
- CDC Changes announced today
- Home Test Kits available
| Over the past few days, there has been some data pointing to the fact the Omicron comes on faster, leaves faster and causes less severe disease. Some good news as the US numbers continue to rise. OMICRON Variant update TransmissibilityThis variant continues to extremely transmissible. One epidemiologist I read recently wrote that this may be one of the most contagious diseases to hit humanity in a really long time, or ever. This may be a bit of hyperbole but it does point to the fact of how well this virus has adapted to spreading in humans. In just a few short weeks, Omicron has gone from obscure to the dominant variant in the US and much of the world. The remaining question is whether it will push out Delta or will Delta find a population to infect along side Omicron. As further proof, if you look at the case number graphs in the Northeast, the curves literally go straight up. Its an incredible thing to see. As fast as it spreads, it seems that the huge increase in cases peaks relatively quickly as well. South Africa, where this was discovered just 4-5 weeks ago, is clearly now showing that the huge rise in new cases has peaked and they are now on the downward slope of the infection curve. Disease Severity It seems more clear that Omicron is causing less severe disease. Researchers looking at Omicron’s spread and course in South Africa, Scotland and England have found that people are having much milder disease, especially if they are vaccinated and boosted. In South Africa, the risk of hospitalization was about 70% lower in those people infected with Omicron versus other variants. In Scotland, they compared Omicron and Delta and found about a 2/3 reduction in hospitalization in people with Omicron. The English data also shows a reduction in hospitalization but less than the data in Scotland and South Africa. The data is less clear about how people in the hospital fair. There is some suggestion that if you end up being admitted to the hospital, you may still get very sick but this is not clear. Some reports suggest that admitted people who are vaccinated require less oxygen and less ICU support. At the same time, unvaccinated people may have almost the same severity as Delta variant. Lastly, there still seems to be an increase in hospitalization in very young kids, less than 2 years old. Here in New York City, there is a four fold increase in pediatric admissions in very young children. Testing Issues Testing has gotten out of control here in New York City and I suspect other places as well. It is like the wild west with anyone popping up tents on street corners and parking lots. There is no control on what people are doing. Over this past weekend, I watched a brand new tent with a catchy testing name on its side set up right outside my apartment building doing antigen tests in an unheated outdoor environment. There is absolutely no quality control going on and whatever test they were using, I’m sure it was not intended to be used in 35 degree weather. People were getting results and then visiting their grandmothers. Please do not do a test in that type of environment and trust the results. Treatment There are two CoViD pills that have now been approved. One is made by Merck and the other is made by Pfizer. Both of them must be started very early in disease progression and long before severe illness. I am much more excited about the Pfizer pill, Paxlovid. It is around 88% effective at preventing hospitalization and death in unvaccinated people and seems to be very safe. It is taken as three pills twice a day for 5 days. It is used for treatment and not for prevention. Unfortunately, it wont be available for widespread use for a month or two. The US Government ordered enough pills to treat 10 million people but as Dr. Anthony Fauci said last week at a Whitehouse press briefing, “The sobering news is it is a quite complicated and synthetic process, and there’s a long duration to make the drug”. The Merck pill is more available but has a much lower effective rate (around 30% effective) and has side effects. CDC ISOLATION AND QUARANTINE GUIDANCE CHANGES Tonight, the CDC released new guidance for isolation and quarantine. This is based on the data that indicates that Omicron grows faster in people so the incubation period is shorter and if they are vaccinated, many people, but not all, will clear the virus from their bodies faster. The majority of CoVid-19 transmission occurs 1-2 days prior to symptoms and 2-3 days after symptoms. So here is what the CDC said tonight: Isolation – Separating yourself if you have confirmed infectionIf you have CoViD-19 (test positive) you must still Isolate yourself but the time period is shortened to 5 days if you are asymptomatic and you can wear a mask around others for 5 additional days. If you have fever (or other symptoms), you must continue isolation until you are fever free for 24 hours without fever reducing medicine. This means you can come out of isolation after 5 days and return to work but you cannot take your mask off at any time, that includes eating in the office or restaurants. This protects others in case you take longer than 5 days to clear the active virus from your body. Quarantine – separating yourself when you have been exposed to an illness but don’t have a confirmed case.If you have been a close contact to someone who has CoViD-19, here is what the CDC says: *If you are boosted or completed primary series of Pfizer or Moderna within the last 6 months or received J&J within last two months: *You do not need to quarantine and may go out immediately *Wear a mask around others for 10 days *Get a test at day 5 to make sure you don’t have CoViD-19 *If you are unvaccinated or completed primary series of Pfizer or Moderna longer than 6 months ago or got your J&J longer than 2 months ago: *Quarantine yourself for 5 days *Get a test on day five to see if you have CoViD-19 *Wear a mask around others for an additional 5 days *Here is where they hedge a bit (I don’t like this part): If you can’t quarantine, you must wear a “well fitting mask” around others at all times for ten days. So now that the CDC has come out with updated guidance, we need to see what individual states do. We will keep you informed as information changes. Dr. Stu Weiss |
| Expert Consulting for Challenging Times iCrowd is busy helping our clients navigate these difficult times. From deciding which medical accommodations to accept to which policies to adopt, we have the expertise to help you make the right decisions. We are happy to help so please feel free to reach out to us at any time. (drop me a note at [email protected]) Home Test Kits We have access to home test kits and we’re thinking about selling them through our centers in New York City. If you or your company needs test kits for your employees, let us know. We anticipate a real shortage soon as testing numbers are skyrocketing and the US Government has bought up 500 million test kits. Drop me an email if you are interested ([email protected]). I know many of you have written to us about purchasing kits, sorry it is taking a bit to get back to you. |
