Clinically Speaking: COVID-19 Omicron Update

Omicron is now the dominant COVID-19 strain in the U.S. and cases are expected to peak in the coming weeks. Get an update on the variant and the latest guidelines for vaccines and boosters.

Omicron in the general population

According to data from the U.S. Centers for Disease Control and Prevention, Omicron is now the dominant COVID-19 strain in the U.S. and cases are rising rapidly across the country. Several top health officials predict that cases will continue to surge this month as the variant spreads to more areas. Given increased holiday travel and students returning to college campuses and schools, infections are anticipated to peak nationally by February.

Many Omicron infections are going undiagnosed as people may be asymptomatic or have only mild symptoms and are opting not to stand in long lines at community testing centers. Instead, many are using at-home tests which aren’t tracked, leading to concerns that the true infection rate could easily be twice as high as the reported rate, or more. Omicron is also responsible for more breakthrough cases and reinfections in those who have already had COVID.

Experts say there are some symptoms that appear more prominent with Omicron compared to Delta, including cough, congestion, runny nose and fatigue. But unlike with Delta, many patients are not losing their taste or smell. 

While much more contagious, Omicron does not appear to be as deadly as some earlier variants. And although hospitalizations are increasing, a smaller percentage of patients are requiring intensive care or mechanical ventilation, compared with those in previous waves. The COVID-19 vaccines continue to offer strong protection from serious illness, even if they don't always prevent mild infection.

In other news, the CDC recently reduced the time that people with COVID-19 must stay in isolation from 10 to five days so they don’t spread the virus to others, saying it has become clear that the virus is most contagious early on. The CDC does recommend that after five days individuals get a negative COVID test before returning to normal activities and wear a mask for another five days to minimize potential spread. 

COVID--19 cases among the pediatric population

According to the American Academy of Pediatrics, COVID-19 cases among children continued to increase throughout December. CDC data from late in the year showed that the seven-day-average of daily hospitalizations for children was up more than 58% nationwide compared to around 19% for all age groups.

Doctors reported seeing more severe COVID-19 symptoms in hospitalized children, including difficulty breathing, high fever and dehydration.

The higher hospitalization rate is likely due to far lower vaccination rates among children ages 5 to 11. Ever since the Pfizer vaccine was authorized for that age group in late October, less than 15% have been fully vaccinated. Also, no vaccine is approved yet for children under five.

The good news for parents and kids is that the FDA recently authorized—and the CDC is recommending—that adolescents ages 12 to 17 receive a Pfizer booster shot five months after their initial Pfizer vaccination series.

Also, for all age groups, the CDC shortened the recommended interval between the primary Pfizer vaccine series and an mRNA booster dose from six to five months. The recommended interval is still two months for people who received the Johnson & Johnson vaccine initially, and six months for those who completed the Moderna vaccine series. The CDC also recommends that moderately or severely immunocompromised children ages 5 to 11 receive an additional Pfizer primary dose, 28 days after their second shot.

Protecting against Omicron and other COVID-19 variants

According to federal data, about 62% of Americans — approximately 206 million people — are fully vaccinated,  But as per the CDC, only about 35% of Americans have received a booster shot, even as eligibility has greatly expanded.

Americans may be experiencing COVID fatigue, but the data is clear. The risk of severe illness, hospitalization and death decreases significantly for individuals who are vaccinated and get their boosters. And the protection from vaccines is superior to any antibodies we may have from a prior COVID infection. In fact, the government has changed the definition of “up-to-date” Covid vaccination to include boosters. And the CDC continues to recommend wearing a mask in public indoor settings, regardless of vaccination status.

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