Omicron Variant: Your Questions and What We’ve Learned…So Far

Note: This blog was updated on Jan. 10

The Omicron variant has been detected in most states and is rapidly increasing the number of COVID-19 infections. The Centers for Disease Control and Prevention (CDC) continues to monitor the latest surge, collaborating with global public health and industry partners to learn more about the virus.

Infectious disease expert Dr. Stephanie Stovall, chief of quality and patient safety at Lee Health, says it takes time to collect and analyze viruses from patient samples, so the numbers can change quickly as more data becomes available.

“We don’t yet know how easily it will spread in our community, the severity of illness it will cause here, or how well available vaccines and medications will work against it,” Dr. Stovall says. “But we should all continue to increase our layers of protection with vaccinations, including boosters, masks, and pre-holiday COVID-19 tests.”

Dr. Stovall shares the latest available information about the Omicron variant and how to stay safe during a potential rapid spread.

What is the difference between the Omicron and Delta variants?

Dr. Stovall: The Omicron variant has more than 30 mutations to the spike protein compared to previous variants and the ancestral strain of SARS-CoV-2. Many of these mutations are in the receptor binding domain (RBD) of the spike protein, which likely enhances transmissibility of the virus.

Does a COVID-19 test differentiate between variants?

Dr. Stovall: Standard viral tests (nucleic acid-based PCR or antigen) don’t differentiate between variants.

Is the Omicron variant more contagious than other variants?

Dr. Stovall: Early data suggests that the Omicron variant is easier to transmit than the previous variants. This is also evidenced by the surge of new cases we are seeing in the U.S. currently. But how easily the Omicron variant spreads compared to the Delta remains unknown.

The CDC expects that anyone infected with the Omicron variant can spread the virus to others, even if they are vaccinated or don’t have symptoms.

Does the vaccine or booster shot help prevent the Omicron variant?

Dr. Stovall: In vitro data and extrapolated data suggests that vaccination still prevents hospitalization (severe disease) and death in the preliminary time, but the efficacy of 80 percent and greater drops to about 70 percent. A booster shot, if you’re eligible, will restore some of that loss.

Again, vaccines remain the best public health measure to protect people from COVID-19 disease, slow transmission, and reduce the likelihood of new variants emerging.

Everyone I know has tested negative first on home tests, and then positive with a PCR test. Are PCR tests more reliable than home tests?

Dr. Stovall: PCR tests are always more reliable. Home tests can have sampling error and may not pick up the infection when there are fewer viruses present. Additionally, there is some data suggesting that early in the course, the Omicron variant (the predominant virus strain right now) may not easily replicate in the nasal passage until later in the course of infection, thus antigen tests may be less accurate if from nasal swab.

Ten days after contracting the Omicron variant, I still have lingering symptoms. What do I do?

Dr. Stovall: “If you still have symptoms after 10 days, you can still transmit the virus, though the risk is much lower. Masking is recommended for all in our area due to the increased community spread of COVID right now. If you are not improving, see your doctor.”

Am I allowed to stop quarantine after five days?

Dr. Stovall: The CDC recommends that individuals isolate (not quarantine, which is for exposed people who may become infected) for five days at home and then continue wearing a mask whenever they may be in contact with another person for an additional five days IF their symptoms are improving and IF fever is resolved for more than 24 hours.

If I’m positive myself, am I allowed to be around other people who tested positive?

Dr. Stovall: It is not recommended to be around others when you are positive. We don’t know if a person can simultaneously be infected with more than one circulating variant, but biologically it is likely possible.

I have been diagnosed with the virus, but have no symptoms. How is it possible to infect people if you have no symptoms?

Dr. Stovall: Because the virus is what infects people and can be expelled from an individual through speaking, coughing, sneezing, singing, or potentially through touching their mucous membranes and then someone else. Unfortunately, the virus has to replicate enough for a person to get symptoms and by then there is enough to spread.

I know many people who were diagnosed with COVID-19 who later got their vaccines and booster shots. Yet, how come they still were infected with the Omicron variant?

Dr. Stovall: Yes, many people are having second infections. People who are under-vaccinated or vaccinated quite a while ago are also getting infected. Boosted people are also having breakthrough cases.

The takeaway message is that a large majority of people with breakthrough infections (those who were fully vaccinated, including the booster shot, and then became infected) report having mild symptoms.

The majority of patients we are seeing in our intensive care units and those receiving ventilation support are people who were unvaccinated.

I never developed any symptoms other than a cough, but I quarantined with a person who had a fever and body aches. Should we have been in our own rooms? I never got her symptoms and she never got my cough.

Dr. Stovall: If you both got sick at the same time, there’s minimal risk that you have different variants. People who were infected at the same time or from the same source are isolated together as a standard practice (it is also done for those who are unable to care for themselves). The manifestation of the infection is likely related more to the host immune response than to the virus itself.

How come some people get a fever (with the shakes and chills) while others develop only a cough? (Both were vaccinated around the same time)

Dr. Stovall: Every immune system, like every individual, is different. Sometimes the reactions differ because the load of the virus that infected you is different; other times it may be different because your antibody and T cell responses are more robust than someone else’s. Also, one virus may have mutations that another doesn’t, so that may also make a difference in response.

Is wearing masks in public places/indoors, as well as social distancing protocols, still recommended?

Dr. Stovall: Lee County (and many other areas in Florida) has had increasing community transmission of COVID for the past 2-3 weeks.

Until we learn more, it’s better to socialize inside the home with only one or two other vaccinated households. Consider wearing a mask if there is a chance some attendees may be unvaccinated or if people in your own household are in a high-risk category.

You can lower your risk during grocery shopping or other public indoor activities by choosing places where people wear masks. If others are not wearing masks, consider choosing a close-fitting mask with good filtration.

What about travel?

Dr. Stovall: Travel is not recommended until a person is fully vaccinated. For international travel there may be additional guidelines related to testing and isolation or quarantine. Strict masking is recommended for all travel.