This article includes:
- My perspective on Omicron.
- The reasons why now is the time to upgrade masks to N95s or the equivalent.
- Interim patient/staff safety protocols during this Omicron phase (please review specifics below if you expect to have an appointment in the next 3-4 weeks).
- We are doing rapid testing and swabbing for PCR send-outs and can typically accommodate kids and parents/nannies for curbside appointments.
Omicron Update
As epidemiologists predicted, we are now in a “tsunami” of Omicron cases. The 7-day average as of January 10 equaled 680,000 (or 0.2% of the US population) new cases every day! As a comparison, last winter the United States peaked at 247,000 cases per day. In California, the current 7-day average is 43,697 new daily cases which probably understates the true number by about 5 X due to lack of testing capability and asymptomatic cases — so that means every day in the US about 1% of the population is contracting Omicron and roughly 10 million people are sick with it.
Prior to mid-December there were two COVID variants, Delta and Omicron, spreading at the same time, though by the end of December Omicron had all but replaced Delta and accounted for substantially all cases in the US (as many as 95%). Delta spread more easily among unvaccinated people. Omicron, on the other hand, has been spreading extremely rapidly in the unvaccinated and previously infected population but also in the vaccinated, because it is better at breaking through one’s immunity. It’s important to remember that even though Omicron has been infecting vaccinated people, vaccination is still highly protective against severe illness, hospitalization and death. To be clear, vaccinated people are not more likely to be infected. Rather, if a vaccinated person is infected, it is more likely to be by Omicron because Omi has a higher advantage compared to Delta. Individuals who have not only been vaccinated but also have been boosted against COVID have the best chance of avoiding Omicron infection, since a booster is reported to be about 70% effective against symptomatic infection. Time will tell whether new troublesome variants will emerge, but at least for now Omicron seems to be dominating and replacing Delta. So the question is: will it nudge out future variants, i.e. could this be the beginning of the end of the pandemic?
Most fully vaccinated people are not experiencing severe illness from Omicron infection and hospitalization rates are not rising as fast as infection rates are. Hospitalization rates remain highest among the unvaccinated and partially vaccinated, and infection with prior variants (including Delta) probably does not protect unvaccinated people against severe illness from Omicron. It is not totally clear whether the immunity someone gains from an Omicron infection will protect against other variants, but new research suggests that infection with the Omicron variant may help protect against infection by Delta. Additionally, seven separate studies have all shown decreased lung cell infectivity for Omicron, which means it doesn’t take hold or grow as easily in the lungs as other variants. Preliminary research indicates that Omicron might grow faster in the upper respiratory system (nose, mouth, throat, windpipe, and bronchi) than Delta or the original Coronavirus, resulting in symptoms that feel more like a cold, particularly for the fully vaccinated.
Even though Omicron is causing less severe symptoms in individual patients, it is spreading at lightspeed. It’s an Omi-Tsunami! One Spanish physician and medical historian described it as the most explosive and fastest-spreading virus in history. The sheer volume of cases, therefore, is one of the biggest factors in current disruptions in places like hospitals, schools, and other public services.
Upgrading Masks
Since Omicron is more transmissible than any of the previous variants, now is the time to maximize the protection we can get from our masks.
First, be sure to upgrade your masks to a high filtration version, preferably an N95 (or an equivalent such as the Korean version, KF94). The KN95, produced in China, is also a very good mask if you can get the real thing — but unfortunately there are a lot of counterfeits on the market which may not offer sufficient protection, so please do your research prior to purchasing these. The cloth masks that folks were using at the start of the pandemic aren’t sufficient on their own at this point (but a triple-layer cloth mask over a surgical mask could offer good protection). Surgical masks on their own are superior to cloth, but they don’t provide as much protection as a high filtration mask, i.e. N95/KF94/KN95.
Whether you wear a surgical mask, an N95, or a double-mask, it’s critical to ensure that your mask fits properly. The more gaps and slippage with your mask, the less it protects. If the mask isn’t fitted properly, you’ll feel air on your face or your glasses will fog up. Here are a variety of modifications you can make to a mask to help it seal better to your face. And this is some great guidance and data supporting an upgrade AND a super helpful video discussing helpful data on masks for kids.
Testing
Another useful tool in our arsenal for dealing with COVID is testing. We expect the current shortage of home antigen tests to be temporary, but it is definitely aggravating while it persists. Please know that we are doing rapid testing and swabbing for PCR send-outs at GetzWell and can typically accommodate kids and parents/nannies for curbside appointments.
PCR tests remain the most sensitive tests but rapid antigen tests are good at telling you on shorter notice if you are positive for COVID and able to infect others, especially if you use two tests over 24-36 hours. Additionally, it appears with Omicron that you may get the most accurate result by swabbing your throat and nose, rather than just your nose. See the illustrations here for throat swabbing instructions. Either way, if you feel sick, PLEASE stay home, i.e. don’t rely on a negative result from a rapid antigen test at a single point in time. We’ve had a fair number of cases where rapids were negative and PCRs taken simultaneously were positive. And, if you must venture out, wear a well-fitting high filtration mask to protect those around you.
Meanwhile, keep washing your hands, irrigating your nose, eating the rainbow, and wearing your masks. With any luck, we may soon reach a point where COVID is more like the “flu,” with most people protected and our systems no longer strained. And because a COVID infection at this stage in the pandemic is more likely than ever, go easy on yourself if you or a family member turns positive. Take everything day by day and fit in some mood-lifting fun wherever you can. If you’re looking for amusing activities to engage in with the kids, take a look at this comprehensive list.
As always, we are here to support you. We are ready to answer your questions and address your concerns regarding COVID and recovery from it. Don’t hesitate to contact us: 415.826.1701
GetzWell Safety Protocols During Omicron
Because of the recent steep uptick in COVID positivity rates across the nation and in California/Bay Area, we are enacting some temporary additional precautions at GetzWell. We appreciate your cooperation during this time and we look forward to returning to more “normal” operations as soon as it’s safe to do so.
We will be:
- Limiting well child check-up visits to ONE parent accompanying the child who’s being seen by our providers (except for parents of newborns and infants under 5 months).*
- Encouraging virtual appointments for well child check-ups where both parents want to participate.*
- Doing most COVID swabs at the curbside (and at our Noe Valley office we have a double large white curb on the 29th Street side of the office intended for this purpose). We are able to accommodate parents, children, nannies and even grandparents for rapid testing and PCR swabs for send-outs.
Also, please let us know immediately:
- If your child has had ANY of the following symptoms within the last 7 days, as we will need to convert the in office well child check-up to a virtual appointment: runny nose, congestion, cough, sore throat, fever, headache, vomiting, diarrhea, fever or body aches.
- If you have traveled out of state in the last 7 days or have been exposed to COVID in the last 7 days, as we may need to convert your appointment to virtual or reschedule it.
*In order for us to more safely have an in-person appointment with both parents present, we’d require that both be vaccinated and boosted and would request vaccine cards sent to us prior to the appointment.
