Is Omicron really mild?

Credit: Michigan Medicine

With more than 800,000 cases a day in the United States, it is now likely that you or someone you know has had COVID-19.

Michigan Medicine expert Laraine Washer, M.D., answers some common questions about the highly contagious Omicron variant and what being infected means:

Does the Omicron variant cause mild COVID-19?

Washer: For many people, especially those who are vaccinated and otherwise healthy, Omicron does appear to have relatively mild symptoms, including upper respiratory or cold like symptoms like a runny nose congestion, sneezing, and sore throat—which is relatively common—and headaches.

Fever is less common than we’ve seen with other variants, especially in vaccinated people. Cough and fatigue also continue to be common symptoms for people with Omicron.

There are reports that upper respiratory symptoms are more prominent with Omicron than lower respiratory symptoms like cough in otherwise healthy vaccinated people.

Since it is relatively mild, is there any benefit to deliberately catching Omicron to improve your immunity if you are vaccinated?

Washer: It’s an interesting question, but right now is not the time to be deliberately exposed. We do not want everyone to be infected at once for many reasons.

If you happen to need medical care, you may encounter long wait times and place unnecessary stress on already overburdened healthcare providers and systems.

You will place other potentially vulnerable people at risk for infection that could result in serious illness for those individuals.

In addition, if you are infected you will need to isolate potentially taking you away from important occupational or educational functions.

And as far immunity goes, vaccination and, in particular, getting a booster provides robust immunity. Whether or not infection in the setting of being fully boosted provides more durable immunity isn’t yet known.

If Omicron is relatively mild, why are hospitals overloaded?

Washer: The answer is twofold: the number of individuals infected with COVID-19 is dramatically higher than at any other time in the pandemic.

While the infections are mild in most people, those who have more severe symptoms still represent a significant number of people. A small percent of a large number is still a large number.

We still are seeing serious cases of all ages with Omicron infection who are ill enough to need intensive care unit level care and we continue to see deaths, particularly in people who are unvaccinated.

Hospital beds and hospital workers are a finite resource.

When we have large numbers of patients requiring care for COVID-19, we have at times had to limit certain non-COVID-19 care including non-urgent procedures and patients have to wait longer for non-COVID-19 care.

What should people know about Center for Disease Control’s new isolation guidelines?

Washer: The CDC adjusted their isolation recommendations to five days down from 10 days for two reasons.

The science shows that the highest levels of virus and most transmission occurs either in the first day or two prior to symptoms developing and in the first five days of symptoms developing.

But that doesn’t mean there is not virus or risk in days 6-10— it’s just much lower.

The CDC was trying to really target the period with highest risk of transmission and then, recommending masks, particularly high-quality masks, to prevent transmission after day five.

The reason that the CDC has recommended this tradeoff, if you will, is that the sheer number of individuals being infected with Omicron has put a significant strain on many industries across the country.

The decision is due to a combination of science showing highest risk being early and the community needs to have a functioning infrastructure.

Does the booster offer any protection against COVID-19 infection?

Washer: Vaccine effectiveness is lower for infections from Omicron than from Delta, especially for those who have only completed a primary series but have not been boosted.

Those who have received a booster have significantly higher protection against any severity of disease compared to those without a booster.

Vaccine effectiveness of a booster for Omicron is about 65% for symptomatic infection and more highly protective against severe disease and hospitalization. And that data is going to keep coming in and we’ll know more soon.

Are we nearing the peak of Omicron cases?

Washer: You can never call it a peak until after you see the upward slope turn downward.

We may be reaching a plateau, and this is where prevention behaviors can really help us.

Those include getting vaccinated including getting boosted, wearing masks whenever indoors when around people not in your immediate household and staying home if you are sick.

Even when we reach the peak, we expect to have as many cases on the downside, so we have several more weeks to get through.

It will take really doubling down on our preventative measures and doing our best to not become one of the people infected. Even with your best interventions, it is possible you may get infected.

But if you’re otherwise healthy and are up to date with your vaccines, the likelihood you’ll have severe outcomes is low.

Written by Kelly Malcom.

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