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What is the omicron COVID-19 variant, and should we be worried?

Nicole Villalpando
Austin American-Statesman

The news over Thanksgiving weekend that a new COVID-19 variant, now named omicron, had been detected in South Africa, Botswana, Israel, Hong Kong and now Canada prompted some countries to impose travel bans, made the stock market take a tumble and might have increased our own worries about a new COVID-19 surge. 

Should we be worried? 

"It's a little too early to know how concerned you should be," said Dr. Katie Theoktisto, an infectious disease specialist at Baylor Scott & White Health. "There are a lot of new variants that come about," she said, but many don't rise to the level of infection that the current prevailing variant, delta, did.

They pop up and fade away. Some, like delta, become the dominant strain, usually because their transmission rates are higher than what existed before. 

"That's the thing with respiratory viruses," she said. "They will mutate. We see different versions of influenza every year."

An Austin school district health care worker tests a patient for COVID-19 at Cunningham Elementary School in August. The omicron variant hasn't been found yet in Austin, but it is probably already in the U.S., experts say.

Why the concern? 

Omicron has multiple mutations that have been found in other strains that are more transmissible and more antibody resistant.

"This one has all of those concerning genetic mutations," said Dr. Brian Metzger, medical director of infectious diseases at St. David's HeathCare. "That's what has raised the concern. The bottom line is we really don't know yet. ... You have to let things play out as they get more data."

There have been coronavirus variants that were more resistant to antibodies, but not as transmissible as alpha or delta, that never really took hold. 

Doctors do know that when you look at omicron's genetics (its family tree), it has a long branch and shows an ancestor from as far back as 2020, Metzger said. It probably emerged in this form in late September or early October and just wasn't detected until now. "We're hoping that means it's not as transmissible, but we don't know that yet," Metzger said. 

It's possible that it was circulating in areas without good COVID-19 surveillance for a while before it hit South Africa, which has good surveillance.

Why don't we know everything?

Doctors haven't seen enough cases yet. They don't know yet if omicron is more transmissible than delta, which still makes up more than 99% of cases in the U.S.

They also don't know how effective the vaccines or natural immunity from a previous infection are to this variant or whether omicron will cause more severe disease.

A lot of the answers to these questions are going to come in the next two weeks as vaccine manufacturers test the vaccine against samples of this virus, and as more labs test for this variant and track the rate of its spread. Health organizations around the world will be looking at the pattern of its spread and what kinds of symptoms patients are having.

"There's no reason to panic right now," Metzger said. "There's so much we have to learn in the next two or three weeks."

COVID-19 boosters:Every adult who's been vaccinated can get a COVID booster shot. Here's what you should know

Medical assistant Maria Solis gives Leif Ramirez, 11, his first dose of a COVID-19 vaccine at a mobile clinic. Ramirez said his advice to other children and adults was "Just get it and don't be worried. It hurts a little bit, but it's better than getting COVID."

Is omicron in the U.S.?

"I think it's already here," Metzger said, but it just hasn't shown up in our surveillance system yet.

The Centers for Disease Control and Prevention works with public health laboratories across the U.S. to analyze thousands of specimens each week and identify the genetic sequence of the COVID-19 infections found by those labs. The CDC also collects data from commercial labs, but it's not every COVID-19 specimen every week at either type of lab.

While the U.S. has increased surveillance efforts since delta, depending on omicron's transmissibility, it could take a few weeks before it shows up in one of the tests that is part of the surveillance system. 

"We're going to be watching," Metzger said. The surveillance efforts will look for it and then continue to look for it to see how quickly the cases double to figure out how transmissible it is. 

The CDC and infectious disease specialists also will be looking to see what the spread looks like in the countries with known cases. 

The big question, Metzger said, is "does this compete with the delta variant? We almost can't imagine something that is more transmissible than delta."

Vaccinations:What you need to know about children and COVID-19 vaccines

Will the vaccines and boosters work against omicron?

Officially, we don't know yet.

"My best guess is a decrease in effectiveness," Theoktisto said, but that doesn't mean the vaccines won't work. Vaccine manufacturer Moderna, however, is already working on a booster to target new variants.

People who have been fully vaccinated and received a booster, "should feel really good," Metzger said, but they are not invincible, even with the booster.

The booster, though, does increase antibody response and broadens the type of antibodies the body makes beginning a few days after receiving it. It continues to increase those levels each day until two or three weeks after the booster. 

We also have new treatments, including a COVID-19 pill from Merck and Pfizer, to be used in the early stages of the disease as well as monoclonal antibodies to try to prevent hospitalization. While we don't know for certain if these treatments work against omicron, there's no reason to believe they wouldn't. 

COVID-19 precautions:Health leaders encourage testing, continued masking ahead of post-holiday COVID-19 spikes

What should we be worried about?

The flu is back and hospitals already have seen more cases than last year. We're about a month or two away from peak flu season. 

They also have seen COVID-19 cases starting to tick back up. In about a week, we will know what the Thanksgiving holiday gatherings have done for COVID-19 infection rates, and about a week later, we'll start to see those hospitalizations.

Travelers wait in line at a security checkpoint at Austin-Bergstrom International Airport on Nov. 18. Any effects of Thanksgiving gatherings will appear soon.

Can we still travel for the holidays?

Theoktisto recommends looking at the CDC's travel advisories as well as considering the transmission levels where you are traveling, your own baseline health, your vaccination status, and the vaccination status of the people you're going to be with. 

Take precautions:Before you gather with family and friends, think about COVID-19 safety

What can we do to prevent omicron?

It's the same things doctors said to do for delta, alpha and the original COVID-19.

"The pandemic is not over," Theoktisto said. "We have to continue to do the things we've been practicing these past two years."

  • Get vaccinated, and get a booster if you're six months past your last Pfizer or Moderna COVID-19 shot or if you're two months past a Johnson & Johnson shot.
  • If you had COVID-19, still get vaccinated. We know natural antibodies wane with time.
  • Wear a mask indoors and anywhere that is crowded.
  • Wash your hands often.
  • Maintain 6 feet of distance with other people.
  • Get tested if you have any symptoms.