No hospital admissions yet, as patients are being treated at home with mild symptoms
News reports continue to indicate the Omicron variant has been identified in the U.S. Last week, panic hit Wall Street as the stock market plummeted 4 percent since the announcement of the new variant. And yet, Washington’s Secretary of Health Dr. Umair A. Shah said Wednesday after an Omicron case was confirmed in California, this is “not a time to panic.”
“We need more data,” said Dr. Pierre Kory of the Front Line COVID-19 Critical Care Alliance (FLCCC). He was echoing what Dr. Shah and other Washington state Department of Health (DOH) authorities were saying.
State epidemiologist Dr. Scott Lindquist said Wednesday it could be weeks before scientists learn more information about the transmissibility of the variant and how it holds up against vaccines. “The biggest concern we have about any variant is: Is it more infectious? And that is the concern for Omicron,” he said.
And yet, there appears to be panicked responses in many places around the world. Travel restrictions have been implemented to/from South Africa by the United States, Great Britain and other countries. Germany appears to be ready to institute a lockdown and quarantine for unvaccinated people.
Unvaccinated people across Germany could soon be excluded from nonessential stores, restaurants and sports and cultural venues. Chancellor Angela Merkel announced the German parliament will consider a general vaccine mandate as part of efforts to curb coronavirus infections, according to one news report. They report 70,000 newly confirmed cases in a 24-hour period.
Ground zero for Omicron
Yet the doctor who made the original report about the new variant says her experience indicates there is no reason for the panic, nor the lockdowns. The South African doctor was one of the first to suspect a different coronavirus strain among her patients, and said that symptoms of the Omicron variant were, so far, mild and could be treated at home.
Dr. Angelique Coetzee is a private practitioner and chair of South African Medical Association. She told Reuters that on Nov. 18 she noticed seven patients at her clinic who had symptoms different from the dominant Delta variant, albeit “very mild.” Patients have not reported a loss of smell or taste, and there has been no major drop in oxygen levels with the new variant, she said.
Coetzee said it was unfortunate that Omicron had been hyped as “this extremely dangerous virus variant” with multiple mutations while its virulency is still unknown.
Now designated Omicron by the World Health Organization (WHO), the variant was detected and announced by South Africa’s National Institute of Communicable Diseases (NICD) on Nov. 25 from samples taken from a laboratory from Nov. 14 to Nov. 16.
Coetzee said a patient at her clinic on Nov. 18 reported being “extremely fatigued” for two days with body aches and headache. “What brought them to the (clinic) was this extreme tiredness,” she said.
“Symptoms at that stage were very much related to normal viral infection. And because we haven’t seen COVID-19 for the past eight to 10 weeks, we decided to test,” she said, adding that the patient and his family turned out to be positive.
On the same day, more patients came in with similar symptoms, which was when she realized there was “something else going on.” Since then, she’s seen two to three patients a day.
“We have seen a lot of Delta patients during the third wave. And this doesn’t fit in the clinical picture,” she said, adding she alerted NICD on the same day with the clinical results.
“Most of them are seeing very, very mild symptoms and none of them so far have admitted patients (to hospitals). We have been able to treat these patients conservatively at home,” she said.
Coetzee’s experience so far has been that the variant is affecting people who are 40 or younger. Almost half of the patients with Omicron symptoms that she treated were not vaccinated. “The most predominant clinical complaint is severe fatigue for one or two days, along with the headache and the body aches and pain,” she said.
Official statistics show that nearly three-quarters of the COVID-19 cases reported in South Africa in recent days have been identified as Omicron.
The Omicron variant
“The data that I’m seeing is that there’s more than 30 mutations to the spike protein on this variant,” Kory said. “Some of the early mutations have been identified or suggested that it’s going to be more transmissible. Whether it’s going to be more deadly, it remains to be seen. We don’t have data on that.”
Health authorities say Omicron, like the Alpha variant, is detectable via some PCR tests using a method known as S gene target failure, in which a certain telltale gene is missing. Studies have shown the S gene dropout, as it is also known, to be a reliable marker of the variants, though genetic sequencing is still needed to confirm the results.
Can existing tests tell if someone is infected by Omicron? Testing experts say yes and no. The majority of tests used by commercial and public health labs can detect SARS-CoV-2, but they can’t confirm which version of the virus is present.
That’s because the tests intentionally target parts of the virus that don’t change much. Variants are designated based on differences in mutations. In Omicron’s case, those differences are in the spike protein, a part of the virus that changes frequently to bypass drugs and immune cells, and are therefore difficult to test for.
The majority of the tests available will show if a person is carrying the COVID-19 virus — but there’s no way to tell whether that virus is the Omicron variant. For that, a doctor would have to send your sample to a lab that can then sequence genetically looking for the genetic signatures unique to Omicron.
“If you need to do sequencing to identify the variant you’re always going to be lagged a bit and it’s going to be more expensive. If you just rely on this S-dropout as identification then it’s easier,” said Trevor Bedford, a biologist and genetics expert at Seattle’s Fred Hutchinson Cancer Research Center.
PCR tests generally look for three genes in order to detect the coronavirus. In the Omicron variant, one of the genes — the spike gene, or S gene — isn’t detected by PCR tests. Virologists can use that trait to help identify potential Omicron cases. “S dropout” testing has helped speed up detection rates for Omicron, according to the WHO.
“We are asking any lab in Washington that does this S dropout testing to send all samples to the state,” Lindquist said.
National Institutes of Health Director Francis Collins on Sunday said it will take weeks to understand if the Omicron variant can evade coronavirus vaccines that are being used in the U.S. The CDC recently changed the definition of vaccine, raising concerns among some people.
As of Wednesday, nearly 81 percent of Washingtonians ages 12 and older have received at least their first dose of a COVID vaccine. More than 1 million people have also gotten either a booster shot or third dose, according to the DOH.
The WHO over the weekend said the omicron variant poses a “very high” global risk, but health experts worldwide are still gathering more information to understand the transmissibility and severity of the new strain.
Dr. Pierre Kory shares the most important thing is getting early treatment if you get infected with any of the variants of COVID-19. That is regardless of a person’s vaccination status. Video courtesy of Newsmax
Early treatment is key
“We’ve had great success in treating the last several variants,” said Dr. Kory. “When Delta came out, we really had to go back to the drawing board. We had to use higher doses, more combinations of medicines, especially later in the illness. I have strong faith that we’re going to figure out how to treat this one.”
“Vaccines have not been the answer,” he said. “So far. If you look at all over the world, the highest vaccinated countries are still having horrific problems with cases.”
“Whether it’s protecting against the more severe outcomes, which are death and hospitalization, there is data showing that vaccines have done that,” Kory said. “But I am really tired of differentiating between unvaccinated and vaccinated.“
“In my opinion, there’s only two types of patients, one who got early treatment and the one who didn’t,” he said. “Whether you’re vaccinated or not, you need early treatment. With this variant, I gotta tell you, it sounds to me like the vaccinated are going to need early treatment, just like the unvaccinated will.”
For more information about Dr. Kory’s treatments and the efforts of the FLCCC, visit here.
Would IVM work against Omicron? Or preventive? Million dollar question….
It’s too early to tell, because there are so few cases. However Dr. Pierre Kory believes it will likely offer some level of effectiveness. He and his team just don’t know how much.
In evaluating the surge of the Delta variant, Dr. Kory and the FLCCC team decided to double the weekly IVM requirement for use prophylactically. They also adjusted all their recommended protocols.
Home – FLCCC | Front Line COVID-19 Critical Care Alliance (covid19criticalcare.com)
Is there a different protocol for the Omicron variant?
Is there no alternative to PCR?