Hi everyone, it’s Kevin. Today is Friday, December 17th. In recent weeks, COVID has been climbing in our region and the World Health Organization named the Omicron variant a new variant of concern. On today’s podcast, Doc Andrews and Doc Hurley will talk about why we’re seeing the spike in cases, what this new variant means and how we can keep ourselves safe through the holidays. Docs, once again, thank you both for joining me today.
Doc Andrews, what accounts for the spike in cases we’re seeing at EB and in the Northeast and Midwest?
The current uptick in cases, arriving a year after last winter’s COVID wave, appears to be the start of a seasonal spike in places with cooler weather that were spared the worst of the initial U.S. Delta surge. During the summer we read about the under-vaccinated Southern states struggling with COVID Delta surges. Unfortunately, now it’s our turn. Several factors are driving the sharp increase in cases: colder weather forcing people indoors, sometimes without masks; the hyper-contagious Delta variant, which can cause breakthrough cases; and waning protection against infection for those who got vaccinated early, especially seniors. The first ones to get vaccinated are the first ones to experience waning immunity. Even so-called natural immunity doesn’t guarantee protection. According to a new study, unvaccinated people who had a recent infection were five times more likely to be re-infected than those who were fully vaccinated and didn’t have a prior infection.
Cases are up significantly in Minnesota, Illinois, as well as Connecticut, Rhode Island, New York, and Massachusetts. All these states have a couple of worrisome things in common, and the big one is that winter is setting in and the other good part is over 60-70 percent of their populations are vaccinated.
I think one under-reported condition is that of COVID fatigue. What do I mean by COVID fatigue? I mean everyone, even myself, is tired of avoiding or not being social and wearing masks. People don’t want to miss out on birthdays and graduations any longer, let alone things like Thanksgiving or Christmas. So individuals and families are deciding what risks they are willing to take in order to see each other. It can be a risk-benefit analysis that individuals are making at a very familial insight.
Doc Hurley, let’s talk a little bit more about the Omicron variant vs. the Delta variant and what it means to us.
It’s still early, but the enhanced transmissibility of Omicron suggests it is likely to displace Delta in most locations. The Delta variant, which drove the last wave, is still the predominant strain and is thought to be responsible for a large part of the current acceleration of cases. The Delta variant is more than twice as contagious and twice as likely to cause hospitalizations compared to prior variants. That having been said, Omicron is anticipated to be a significant driving force in the number of COVID-19 cases seen nationally and locally. Anthony Fauci has stated that the Omicron variant was “clearly highly transmissible.” But he also said that there are “encouraging signals” about the severity of Omicron disease.
What we know so far is that genome sequencing of Omicron reveals it to be more heavily mutated as compared to the Delta variant. It is said to have over 32 mutations in the spike protein itself as compared to the 18 found in Delta. These mutations on Omicron’s spike protein allow it to more easily attach to the body’s cells. It’s unknown whether these mutations also make the disease resistant to vaccine-derived antibodies. As far as symptoms are concerned, initial reports by a physician in South Africa suggest that the symptoms of Omicron were ‘unusual’ but ‘mild.’ According to the doctor, individuals infected with the Omicron are only reporting mild symptoms like fatigue, body ache and “scratchy” throat rather than a sore throat.
While the Delta variant can also trigger mild symptoms, with fever, fatigue and cough being some of the most common signs, the big difference as I see it is that people who came down with the Delta variant were more likely to have extremely severe symptoms, needing hospitalization and ICU care if unvaccinated.
Many important questions about Omicron remain unanswered. It is still unclear if the virus causes milder or more severe illness. It is also not yet known if it might escape immunity from earlier COVID-19 illnesses, vaccines or waning immunity.
In the United States, there’s still a lot of uncertainty. But based on what has been observed in South Africa, it’s likely to become the dominant strain in the coming weeks and months and contribute to a winter surge in case numbers.
Doc Andrews, you talked about how people are getting COVID fatigued and people are clearly getting frustrated—we’ve all done what they’ve been asked to do by getting vaccinated and wearing masks. Give us some reason to think why what we’re doing is actually working.
I do want to say I think that many people are following all the medical advice of getting vaccinations, boosters, and wearing masks but they, along with everyone else, are getting frustrated, as you stated. Interestingly, EB is seeing a lot of breakthrough COVID cases. This means that when employees who are vaccinated get COVID, they are considered a breakthrough case. I want to mention that while this is true at EB, this is not true on a larger statistical population. Look at the state of Rhode Island, for example. In Rhode Island, less than 10% of the COVID cases are breakthrough cases. The percent of fully vaccinated people who do become infected are less likely to become severely ill and, therefore, less likely to be admitted to the hospital and die. So the vaccination really is working.
So no matter how frustrated everyone is with our current COVID situation—those that were vaccinated, those that were vaccinated and contracted COVID, or those that were vaccinated with a booster shot—all are adding levels of protection, albeit different levels of protection. The truth is there is no magic bullet. Every step a person takes to mitigate the virus from masks to booster shots is like an add-on feature. Just like when you buy a car, you can add floor mats, heated seats, or maybe even lane assist to improve your ride and your safety. Taking multiple and varied COVID precautions decreases your risk of the most serious outcome—death.
I would be remiss not to mention that now, unlike a year ago, there is treatment with monoclonal antibodies for certain people. That is why it is so important to follow up with your PCP if you do, in fact, develop COVID.
Thanks Doc for that. We’re heading into the holidays, we talked a little bit about Thanksgiving, we’re seeing that surge in cases—let’s talk about what we can do the rest of the way as we prepare for Christmas and the New Year. What advice and guidance can you give us?
Dr. Hurley:
The Holidays will present us with a whole host of challenges to navigate. So Dr. Andrews and I would like to offer our “Holiday Survival Guide”! It’s our collection of sure-fire tips and recipes to survive COVID and…our relatives.
Dr. Andrews:
Survival Tip #1: Dealing with COVID. As much as everyone wants COVID to be over, it’s not. So we have to keep our guard up. Unfortunately, there really is no other choice. There are two overarching goals at this point. One is to maximize your personal protection against serious life-threatening hospital-level care. Another is to mitigate the spread of the disease. This means getting vaccinated, getting boosters, wearing masks, socially distancing, washing hands, getting tested and staying away from others if you feel ill. And speak with your PCP if you actually need to be treated if you get diseased.
Dr. Hurley
Survival Tip #2: Get a Booster if you’re eligible. Although we are still learning about how long natural immunity lasts versus the vaccine, the boosters help the immune system learn about the virus better and better each time a booster is received. So for you to survive the holidays, we recommend that if you are over 18 years of age and you completed the COVID-19 mRNA vaccination series at least six months ago, or received the Johnson & Johnson vaccine at least two months ago, Get a Booster! If you’re immunocompromised, talk to your doctor about getting a third dose, NOW! Eligible individuals are able to choose any authorized COVID-19 booster, regardless of the vaccine type that was used for the initial vaccination. The Pfizer and Johnson & Johnson boosters will be administered with the same dosage as the initial vaccine, whereas Moderna’s will be a half dose.
Dr. Andrews:
Survival Tip #3: While COVID-19 is a new virus, the idea of booster shots is not. Most vaccines given in the U.S. require several doses to achieve immunity. I like to think of a COVID-19 vaccine booster as the third dose of a multi-dose series. And there are a lot of vaccines that require boosters. For example, adults should receive a tetanus vaccine every ten years. Other vaccines may require two doses, like the measles, mumps, and rubella (MMR) and the chickenpox vaccines. The one most of us are familiar with is the seasonal flu shot, which needs to be given yearly for maximum protection. So, I say get your booster and your seasonal flu shot!
Dr. Hurley:
Survival tip #4: Peace on earth, good will towards men? Or how do I respond to my Uncle with “different” beliefs such as:
“Take a COVID-19 vaccination and your life span will be shortened. Get the shot and you will be sterilized or become impotent. Shots include the insertion of tracking bots. The pandemic is a government-created conspiracy.” I know…I know we’ve heard it before. But behavioral scientists DO have the answer!
Dr. Andrews:
So, do not demonize! We know the COVID-19 vaccines are up to 95% effective yet multiple surveys show us that up to 33% of adults are unlikely to take a vaccine, some won’t and others are unsure. Reasons vary from a minority of anti-vaxxers, to larger groups of people who say “well, wait and see…if it’s safe” or those who think they are actually at too low a risk to need the shot. I know that instinctively, many of us would want to tell them they’re wrong, but this is not the way to proceed. It’s human nature that if our strongest beliefs are directly challenged, we can end up believing them more firmly. It’s called the “backfire effect.” A defense mechanism kicks in that leads us to actively search out information that shows we are right. And there is plenty of misinformation out there to be found.
Dr. Hurley:
This knowledge of the backfire effect should lead us to being empathetic, actively listening, and focusing on the benefits of taking the vaccine. And rather than contradicting your Uncle, you can suggest places where they can find out additional information. If people feel respected and trusted they are more likely to listen; and if they can find out on their own, then they will have time to process and engage with it without feeling defensive.
Dr. Andrews:
Survival tip #5: So if you want to survive the Holidays, “Be a Role Model.” In 2008, the Harvard researcher Christakis showed us that we instinctively want to copy those we feel closest to, and are less likely to disregard the behavior of those we feel that are in our “in-group.” So, be the model of COVID behavior you wish to see in your friends and during your travels this Holiday Season. And please help me to help you stay healthy. So with that, I want to wish each and every one a happy and healthy holiday season.
Thanks Docs; I really appreciate the information today and the survival guide. It’s important that we continue to fight the virus and stay on the science side with all of the validations that we’ve seen and can apply. And I’d also like to thank you both for taking the time to again share your expertise with our listeners and throughout the pandemic.
Thank you everyone; we’ll talk soon.
