How to Make Sense of Omicron and Changing COVID Protocols

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Jan. 12, 2022 -- If you're confused astir guidance connected the Omicron coronavirus variant -- which seems to alteration astir regular astatine this constituent -- you are not alone.

The wide reported, record-breaking leap successful regular cases seems casual to understand. Beyond that, galore unanswered questions remain: Are cloth face masks ever OK? How tin accelerated antigen tests help, assuming you tin find one? What's up with the CDC’s 5-day quarantine recommendations? What is going connected with the flu?

Jeanne Marrazzo, MD, and Joshua Barocas, MD, addressed these and different pandemic questions during a media briefing this week sponsored by the Infectious Diseases Society of America.

These infectious illness experts besides shared 1 happening astir the pandemic that gives them hope.

Fast and Furious Flow of Information

Contributing to the disorder is the rapid-fire gait of caller technological developments connected Omicron and related recommendations.

"New grounds is coming connected a regular basis," Barocas said. "We are inactive gathering the level arsenic we're flying it."

People tin grip this deluge of information, including the arguable CDC recommendations shortening quarantine clip to 5 days, said Barocas, vice seat of the Infectious Diseases Society’s Public Health Committee.

"The American radical tin digest guidance, adjacent if it's coming rapidly," helium said. "I similar to judge that the American radical tin internalize that guidance and … fig retired what works champion successful their lives."

Without discounting immoderate of the authoritative recommendations, Marrazzo said it's besides important to "keep it real." For example, studies amusement that radical are improbable to walk an full 10 days successful isolation aft they trial positive, particularly if they person nary oregon lone mild symptoms.

Given this reality, the CDC recommendations for 5 days marque much sense, Barocas said.

"The astir apt clip that you're going to beryllium infectious is those 5 to 6 days. We inquire that you disguise afterwards, we inquire that you stay diligent."

"We person to beryllium somewhat realistic astir what radical are consenting and capable to do," said Barocas, an subordinate prof of medicine astatine the University of Colorado School of Medicine.

Four Ways to Reduce Risk

Vaccination, masking, isolation, and investigating are "the 4 pillars oregon 4 corners of a building" that each request to beryllium successful spot to clasp it up during this pandemic, said Marrazzo, manager of the Division of Infectious Diseases astatine the University of Alabama astatine Birmingham.

Barocas thinks of these 4 things arsenic parts of a suspension bridge, and you request each 4 to support the span standing, helium said.

Regardless of the analogy, vaccination and the different measures stay essential, fixed the comparative deficiency of different options astatine the moment. Vaccination tin besides impact quarantine requirements, Marrazzo said.

"If you are afloat vaccinated, you get a walk connected immoderate of the much draconian quarantine requirements."

Down to One Monoclonal Antibody Treatment

Vaccination is critically important close now, Marrazzo said, "because we've got thing other to dainty ambulatory patients with COVID. We person constricted entree to monocular antibodies that work."

Also, a shortage of the 1 monoclonal antibody attraction inactive considered effectual against the Omicron variant -- sotrovimab from GlaxoSmithKline -- is not making the representation immoderate rosier.

To exemplify the disparity betwixt proviso and demand, she said, "We had 16 doses of sotrovimab, which is the antibody that works against Omicron past week, erstwhile our prevalence of Omicron was 99.8%, and we are seeing expanding numbers of cases."

At the aforesaid time, the precocious authorized COVID-19 treatments successful pill signifier from Pfizer and Merck are not yet available.

"We don't person the oral drugs yet, and we don't person immoderate different options,” Marrazzo said.

N95s, KN95s, and Cloth Masks

The benefits of masking are thing new, but what is caller are caller recommendations that radical upgrade their look coverings to N95 and KN95 masks during the Omicron surge.

Wearing an N95 oregon KN95 is recommended "if you tin get them and you tin deterioration them and they're comfy capable for you," Marrazzo said.

But successful different motion to reality, she said "there are cloth masks retired determination that acceptable similar a glove."

"If that feels amended to you and it's truly impermeable and you person occupation moving upstairs erstwhile you're wearing your precise well-fitted cloth mask, should you propulsion it distant and get an N95? I'm not truthful sure,” she said.

Barocas repeated a communal refrain: that a cloth disguise is amended than nary mask. But helium besides said determination is simply a clip and spot wherever an upgraded disguise would beryllium better.

"If you're idiosyncratic who feels that it's indispensable to deterioration a KN95 oregon an N95 astir your immunocompromised household subordinate oregon your vaccine-ineligible children, past absolutely, that's thing that you should do.

"Personally," helium said, "I would deterioration it successful ample crowded areas wherever there's mediocre ventilation -- thing similar a performance oregon a museum."

The recommendations for wearing N95s oregon KN95s travel astatine a clip erstwhile they are again successful abbreviated supply.

"For example, successful our hospital, we don't person capable N95s for each azygous wellness attraction supplier astatine this point," Marrazzo said. "So we're inactive having radical deterioration surgical masks successful immoderate settings."

Another world cheque is that not each upgraded disguise is comfy for each person. Using the illustration of workers serving radical from down a counter, she said, "Yes, I would emotion those radical to deterioration an N95, but the N95s person rather a scope of comfort. Having worn them from galore hours connected end, I tin archer you that determination are immoderate that you perfectly privation to not deterioration for 8 hours."

Stop Shaming Others

Marrazzo and Barocas agreed it's clip to halt criticizing the idiosyncratic decisions radical marque connected vaccination, masks, and different protective measures.

"We person to stop, and we person to benignant of conscionable travel together," Marrazzo said. "And say, look, we are each experiencing a challenging world close now, and we request to springiness each different the tools, immoderate tools radical volition usage to support themselves. We request to springiness them support.”

Barocas agreed it's clip to halt picking sides. "I deliberation that we request to look astatine this is simply a pandemic of everyone,” helium said.

Two things that astir Americans hold upon, Barocas said, is protecting radical who are susceptible to terrible illness and debar getting sick themselves truthful they tin stay successful the workforce.

The pandemic is "now affecting each assemblage of our nation, of our world,” helium said.

Their Take connected Testing

Marrazzo recommends that anyone who has symptoms isolate themselves if imaginable close way.

"Don’t spell get tested and past hold for your trial results to travel back" earlier acting, she said. “Stay home, and ideally usage a location self-test if available.

"Ideally, if you trial and find retired you’re negative, that's fantastic," she said.

If you trial affirmative and isolate for 5 oregon 6 days, it is overmuch little apt you volition beryllium infectious to others. The CDC recommends radical successful this concern usage caution and disguise up for the afloat 10 days.

Effective monoclonal antibody attraction and N95/KN95 masks are not the lone items successful abbreviated supply, arsenic galore Americans cognize -- accelerated antigen tests are besides scarce.

"We anticipation that the proviso of tests is going to summation soon," Marrazzo said.

"When we accelerated trial astatine location with an exposure, oregon with symptoms, accelerated tests are incredibly bully astatine detecting infectiousness," Barocas said. "We're seeing numbers that are to immoderate of america astronomical -- implicit a cardinal cases. … The usage of accelerated tests is incredibly important for corruption power purposes."

"So portion it whitethorn not support you to get tested, it protects the radical astir you," helium said.

Knowing your presumption is important and is thing infectious illness experts person been recommending with different infectious diseases for decade.

Don't Forget Your Flu Shot

While the flu is circulating, it’s obscurity adjacent the levels of an epidemic, Marrazzo said. Still, the flu does a fig connected your immune system, and thing that does that “is lone going to marque you much susceptible to a atrocious lawsuit of COVID,” she said. “We don't truly speech astir the flu vaccine arsenic a mode to support your respiratory system mostly steadfast and capable to ward disconnected things similar COVID."

Reasons for Optimism

Asked to sanction the happening they are astir affirmative astir astatine this constituent successful the pandemic, Marrazzo chose the oral antiviral attraction Paxlovid from Pfizer. The authorized 5-day regimen "is precise akin to Tamiflu," she said, "and it could marque a truly large difference."

Treating radical aboriginal with this oral medicine could assistance support them retired of the infirmary and could easiness staffing shortages arsenic well, she said.

In studies, she said, Paxlovid reduced the severity of unwellness and hospitalization by astir 90%.

Barocas was affirmative astir however overmuch advancement has been made successful nether 2 years of the pandemic.

"I can't explicit successful words however large my toolbox really has become, compared to March 2020,” helium said.

"I felt helpless" backmost then, helium said. "All I was doing was shuffling platform chairs and trying to support a vessel afloat astatine the aforesaid time."

Vaccines and different preventive measures, treatments, maturation successful nationalist wellness infrastructure, and much entree to genomic sequencing are each agleam spots, Barocas said.

"The information is that I tin spell to the infirmary and nary substance however overwhelmed oregon however exhausted we each are, it is vastly different," helium said. "It's a vastly antithetic scenery than what we had successful March of 2020."

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