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What do primary care physicians need to know about omicron?

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The COVID-19 pandemic has affected hundreds of thousands of people in the US and many more across the globe. Recent variants of the virus include the delta variant and the omicron. Although health officials are still investigating the newest discovery, there are some basic facts that primary care physicians need to know about omicron.

The omicron variant (B.1.1.529) was first identified in South Africa and Botswana in November 2021, even though there may have been earlier cases in the Netherlands. In the US, the first case was reported in California on December 1, followed by multiple reports in several other states. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have classified the omicron variant as a “variant of concern.”

Early reports about omicron indicate that this coronavirus variant spreads quickly but cases have been mild. The symptoms may be slightly different from those found in individuals suffering from COVID-19, including the delta variant, as Yale Medicine pulmonologist Lauren Ferrante, MD, points out. Dr. Ferrante notes that “the reports show that patients in South Africa—many of whom were young—have had severe fatigue, but no loss of taste or smell.”

Even though the omicron variant is fast spreading, the delta variant remains the biggest virus threat in this country. Precautions such as masks, frequent hand washing, and social distancing continue to be encouraged by health officials. The CDC is urging everyone to get their vaccinations, including booster shots, to protect against the virus.             

The omicron variant has been found to have more mutations than any of the other COVID-19 variants. Stuart Cohen, Chief of Infectious Diseases at the University of California Davis Health, points out that the number of mutations are in the spike protein. All of the vaccines produced to-date are focused on targeting and developing an immune response to the spike protein. That spike is what attaches to the cells, so it relates to the transmissibility of the variant. Mutations in the spike can increase the transmissibility and potentially increase the virus’s ability to avoid the antibodies made by the vaccine.

Immunologist David A. Ostroy, PhD, addressing a worldwide consortium of scientists, found that the omicron variant has more mutations than the delta variant at four key sites within the virus. The site affecting transmissibility has more than three times the number of mutations in the delta variant. Early reports regarding the omicron variant’s effects on people have linked it with a mild form of the disease but researchers state that more data are needed to confirm those observations.

In early December 2021, President Joe Biden’s Chief Medical Adviser, Dr. Anthony Fauci, stated that scientists needed more information before drawing any conclusions about the severity of the new variant. Early indications point to it being less dangerous than delta, although it spreads more rapidly. Fauci said, “Thus far, it does not look like there’s a great degree of severity to it. But we have really got to be careful before we make any determinations that it is less severe or it really doesn’t cause any severe illness, comparable to delta.”

Primary care physicians should continue to urge patients to get the appropriate vaccinations and booster shots, to protect against COVID-19 and the delta and omicron variants. According to a WHO official, the coronavirus vaccines remain effective for protecting individuals against severe COVID cases. Dr. Mike Ryan stated that there was no indication that the omicron variant would be better at evading the effects of the vaccines than any of the other variants. Dr. Ryan, WHO’s emergencies director, stated, “We have highly effective vaccines that have proved effective against all the variants so far, in terms of severe disease and hospitalisation, and there’s no reason to expect that it wouldn’t be so” for omicron.