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Q&A: 9 things to know about the COVID-19 omicron variant

How is the omicron variant different from others? How should you test for omicron? What mask should you wear? When will the omicron surge end? We provide some answers to these and other questions, with information current as of Tuesday, Jan. 18.

niaid-sars-cov-2-virus-particle.jpg
A particle of SARS-CoV-2, the virus that causes COVID1-9, image captured by a transmission electron microscope at the National Institute of Allergy and Infectious Diseases' Integrated Research Facility in Fort Detrick, Maryland.
Contributed / NIAID
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SIOUX FALLS, S.D. — Discovered only a couple of months ago, the omicron variant of COVID-19 has taken hold of the United States, and is now powering a quick rise in new cases, hospitalizations and deaths.

Omicron's rapid and strong onset, and its unique qualities, means many people don't recognize this version of the COVID-19 pandemic. It's changed how you should protect yourself and your family, what it means to get tested and what getting sick looks like.

And omicron has reshaped the immediate future of the pandemic.

Here are nine pressing questions about the omicron variant, and what you should do about it.

Note: This information is current as of Jan. 18, 2022. Keep that in mind as you seek current information.

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1. Is the omicron variant different from other COVID-19 variants?

Yes. The omicron variant is significantly different from previous variants, including the previously dominant delta variant. Omicron is much more contagious, meaning the virus has more chances to infect other people, accelerating how quickly it spreads. While its effects appear to be generally more mild than previous strains of the virus, it's still capable of causing severe illness and death, especially because it has more chances to infect more people and because fewer treatment options work with omicron. That's why the omicron variant is causing a growing number of hospitalizations and deaths.

Getting fully vaccinated — with a booster shot if at all possible — remains the single best way to keep the virus from causing severe illness or death.

2. What tests should you take and when?

A PCR test, the kind you can get from a nose swab that is processed in a laboratory, remains the gold standard for detecting COVID-19, including the COVID-19 variant. However, this test is a more sensitive and labor-intensive test. It can be inconvenient to get and its results can take longer to receive. But under most circumstances, PCR tests are free.

At-home antigen tests are less sensitive, cost money, and can be hard to find these days. But they return rapid results which means they're more helpful for making decisions about if you should isolate yourself from others.

3. How can you make sure you get the most value out of your at-home tests?

Time taking them. Consider throat swabbing. False negatives are always a greater risk with at-home rapid antigen tests, although positives are nearly always true positives. However, some preliminary research has shown omicron can be more difficult for antigen tests to detect in the early days of an infection, when the virus is most infectious, although it's not clear how much more difficult omicron is to detect early.

An early study indicates omicron may show up in rapid antigen testings earlier via saliva collected by throat swabs. That's led some public health experts to recommend people use the swabs provided in their at-home tests to test both their throat and nose. However, the Food and Drug Administration still has safety concerns about using at-home test swabs on your throat.

THE LATEST OMICRON NEWS:
A seemingly endless stream of “subvariants” of omicron, the most recent Greek-letter variant, has emerged in the past few months. How different are these subvariants from one another? Can infection by one subvariant protect someone from infection by another subvariant? And how well are the existing coronavirus vaccines doing against the subvariants? We asked medical and epidemiological experts these and other questions.

4. Are positive tests likely under reported?

Yes. Boxes of at-home rapid tests are flying off store shelves, meaning there are thousands upon thousands of people taking tests, and most likely aren't reporting them to state and local health officials. But while health officials may not have the full picture of the pandemic, a surge of positive tests in closely tracked PCR tests still reveal community-wide surges in COVID-19.

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5. How is the omicron variant affecting children?

More chances to catch it means more chances to suffer long term. While children and teens remain far less likely to get a serious case of COVID-19, it is more possible than ever, because the more contagious nature of the omicron variant means they have more chances to be exposed to the virus. More concerning are the potential long-term effects on children getting COVID-19, including a potentially fatal inflammatory condition known as Multisystem Inflammatory Syndrome in Children, or MIS-C. The CDC has also found children appear to face a higher risk of developing diabetes in the months after being infected with COVID-19.

Yet despite the risks and vaccine availability for children age 5 and older, child vaccination rates continue to lag .

6. What mask should I wear? Do cloth masks even cut it anymore?

Wear the best possible mask. Cloth masks aren't the best. On Jan. 14, the Centers for Disease Control and Prevention recommended people wear the best possible masks they can get. Cloth masks, due to their loose knit, are better than nothing but not as good as other mask options. The commonly available disposable surgical masks are better than cloth, as are KN-95 respirators.

At the top of the heap are genuine N-95 respirators. All masks work best when worn properly and are fit to the face. If you don't have a KN-95 or N-95 respirator, the CDC says you should wear a disposable surgical mask on your face and put a cloth mask over it.

7. What are the treatments for those infected with the omicron variant, and why are they in short supply?

There's one working treatment. Early research showed two of the three monoclonal antibody regimens used to treat patients with COVID-19 don't work against the omicron variant. The one that still works, known as Sotrovimab, is in high demand — and therefore short supply due to its efficacy and the omicron case surge. Meanwhile, antiviral COVID treatment pills given emergency authorization by the FDA in late December are just now getting distributed in small quantities , with manufacturing to catch up to demand in coming months.

Natural immunity remains, at best, an unreliable shield against COVID-19 — especially compared to vaccination — because individual antibody response varies, wanes over time and isn't effective at keeping up with the ongoing barrage of new COVID-19 virus mutations. A recent study showed natural immunity is, by itself, significantly less effective against omicron than earlier variants.

8. What does the omicron variant mean for hospitals?

They're stressed. Omicron's contagious nature means a lot of people are getting sick all at the same time, and that means more people who are unvaccinated or immune-compromised are ending up at the hospital — again, all at the same time. This surge in hospitalizations is stressing hospitals and health care staff, who also are dealing with workers falling ill with COVID-19 and needing time away from work, just like many other businesses right now. Meanwhile, other patients may suffer or even die because hospitals are overwhelmed.

9. When will the omicron variant surge end?

It's hard to say, and it'll get worse before it gets better. A forecast from Mayo Clinic indicates the omicron-driven surge may peak in Minnesota on or about Jan. 24, although there are many factors at play. Omicron surges in other countries, and in first-hit states such as New York, indicate we may not be far from omicron cases hitting a peak, although a matching surge in hospitalizations and deaths will likely lag behind the daily case high.

Jeremy Fugleberg is an editor who manages coverage of health (NewsMD), history and true crime (The Vault) for Forum News Service, the regional wire service of Forum Communications Co, and is a member of the company's Editorial Advisory Board.
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