SARS-CoV-2, the virus that causes COVID-19, has changed a lot since it first emerged in late 2019.

It has mutated into multiple strains (alpha, beta, gamma, delta, etc.), each carrying a slightly different twist to its method of infection.

Omicron, a variant first identified in South Africa in November 2021, has been spreading rapidly around the world and across the U.S., faster than any previously known strain of the coronavirus.

At the beginning of December 2021, omicron accounted for less than 1% of COVID-19 cases in the U.S. In just a few weeks, omicron overtook delta as the dominant COVID strain in the U.S. By January, Omicron BA.1 variant accounted for nearly all COVID-19 infections.

Omicron’s rapid spread allowed it to mutate several times. The strain has fractured into subvariants, each more transmissible than the original, including BA.2, BA.4, BA.5 and BA.2.75.
As of July 2022, omicron variant BA.5 is causing a wave of cases across the United States.

The omicron BA.1 variant mutations have it allowed to escape some of the immunity from vaccines and from past infections.  BA4 and BA.5 can also evade immunity from past BA.1 infection. Vaccines still protect against infection, just not as much as they did against past variants. For those who had an infection with BA.1, vaccination or a booster improves protection against BA.5.

Symptoms

All the variants of the virus cause similar symptoms, including:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

Severe infection leading to respiratory compromise and death is less common with the Omicron variant.  This is partly due to the virus itself, but more importantly due to immunity from vaccination or a combination of past infection and vaccination. The risk of severe infection is still high for those who are not yet vaccinated as well as those with compromised immune systems.

Anecdotal reports have come forth suggesting the omicron variant causes more coughing and sore throats and less loss of taste and smell. Further research is needed to clarify this.

Vaccines and Therapeutics

The best way to protect yourself from infection and severe illness from COVID-19 is by staying up to date with all COVID-19 vaccines.

Fortunately, vaccination still provides very strong protection against becoming severely ill if infected by any variant of the virus. The latest data from the Centers for Disease Control (CDC) show that you need to stay up to date with all boosters to get the best protection from vaccination.

The CDC reports that protection during the Omicron period against symptomatic infection that led to an emergency room visit was 84% better than not being vaccinated if you had a booster in the last 4 months—while it was only 40% better than being vaccinated but not boosted.

The protection against hospitalization was 71% better for those who had a first booster in the last 4 months. For those over the age of 50, the protection against hospitalization was 80% better after a second booster compared to 55% for those who had only 1 booster more than 4 months ago.

For those who are at higher risk for severe infection due to immune compromise, older age, or other medical risk factors, antiviral treatments are available. Paxlovid is an oral antiviral that, if given early at the onset of symptoms, decreases the need for hospitalization by nearly 90%. For those who cannot take Paxlovid due to interference with other drugs, intravenous monoclonal antibodies are also available.

Boosters for the fall

The Food and Drug Administration has authorized vaccine manufactures to produce boosters for the fall that include both the original SARS-COV-2 strain and the latest Omicron variants BA.4/5. It is estimated that, if studies show that the vaccine is more effective against BA.4/5, it will be ready for distribution in October or November 2022. This bivalent vaccine would only be used as a booster, and not replace the original components of the vaccine used in the primary series.

The CDC has stressed the importance of staying up to date to get protection now. Don’t wait until the fall if you are eligible for a booster now.

Getting vaccinated and boosted is the best way to prevent severe illness, hospitalization and death from COVID-19. Everyone age 6 months and up is now eligible for vaccination against COVID-19.

As always, you can add additional layers of protection by handwashing, masking up indoors and social distancing.

Edward-Elmhurst has COVID-19 vaccine appointments available to ages 6 months and older, including booster doses for those eligible. It is easy to schedule a vaccine appointment. You do not need a MyChart account. Schedule your COVID-19 vaccine now.

The information in this article may change at any time due to the changing landscape of this pandemic. Read more about COVID-19.