BOSTON — Yes, Boston is in the midst of a COVID surge, says Dr. Stephen Kissler, a research fellow in the Department of Immunology and Infectious Diseases at the Harvard T.H. Chan School of Public Health.
But get ready, he said in a media briefing, for a ‘surge within a surge.’ And the reason for that unusual occurrence is the unusual behavior exhibited by the latest VOC (that’s ‘Variant Of Concern’ for those unfamiliar with CDC pandemic terminology): Omicron.
“As the Omicron variant begins to take off, that’s going to add fuel to the fire,” Kissler said. “And that will make the virus more difficult to control over the winter than it would be otherwise.”
Already, the previous iteration of the virus is showing signs of getting out of control - that would be the currently dominant Delta variant. Kissler called recent COVID levels in wastewater - predictive of future infection numbers - exceptionally high.
But perhaps within weeks, Delta could lose its throne to Omicron, Kissler said.
“Unfortunately, just in time for the new year, it’s likely that we’re going to see quite a bit of Omicron,” he predicted. “Probably most places can expect to see a major Omicron surge before the end of winter.”
Similar surges in South Africa and the United Kingdom have been unusual in that they’ve closely followed or happened along with Delta waves, suggesting Omicron readily reinfects. Genomic sequencing has also revealed mutations highly suggestive of immune evasion, though it’s likely current vaccines offer some degree of protection.
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“Omicron is probably the most formidable variant the vaccines have faced so far,” Kissler said.
While high transmissibility is suspected, it can’t be confirmed until the virus is actually on the ground and facing conditions different from those it encountered in South Africa and the UK, two places where it is spreading rapidly.
Similarly, it’s hard to say how pathogenic Omicron is, despite reports from South Africa it is only producing mild illness. Kissler notes that South Africa’s population skews younger. Plus the country experienced a significant wave of the Beta variant, which the U.S. did not. He wonders if that will affect how Omicron behaves here.
In any case, understanding potential disease severity for any given variant is always the most difficult part of assessing its threat, he said.
“We actually don’t have a very clear sense of what biologically and physiologically leads this virus to cause serious disease,” Kissler said. “There aren’t really any mutations we can point to and say, ‘this is going to make the virus more severe, this is going to make the virus less severe.’”
So much actually depends on the age and physical condition of the virus’ victims, Kissler said.
While the Delta variant will likely continue to dominate in the immediate short-term, Kissler said it’s also likely Omicron is already in the U.S. in greater numbers than we know. Given that, he’s got a recommendation for those with holiday gatherings in their future.
“Anytime you’re going to be in a large group of people, I would encourage everyone who’s attending to take a rapid antigen test beforehand,” he said. “Test as close as you can to the thing you’re testing for.”
And while PCR tests are more accurate, the time they take makes them less accurate.
“If it takes a couple of days to get the results back, that’s plenty of time for you to be either newly infected or to have had an infection that was previously undetectable by PCR ramp up into something that’s infectious,” Kissler said.
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