The new COVID-19 variant Omicron has been a game changer in how health care professionals handle the pandemic. Omicron has spread rapidly, leaving many people unsure about how to keep themselves and others safe.
Regina infectious disease specialist Dr. Alex Wong took some time to talk to The Morning Edition host Stephanie Langneger and answer listener questions.
Is it better to wear a double mask or N95? And if the N95 is better, why isn’t it a Saskatchewan Health Authority recommendation?
SHA has actually changed guidelines recently, and is now recommending N95s, in the context of acknowledging that airborne transmission of COVID-19 is actually very real and relevant. Over the past few weeks, N95s have now been recommended for all healthcare workers who are interacting with any COVID positive patients, regardless of any type of contact.
The bottom line here is that respirators like the N95s or KN95s, or KF94s are better than medical and surgical masks and cloth masks because they filter much better what is in the air and what we breathe more, (filtering) 95 plus cents per medical mask, which is probably between 50 and 70 percent, and cloth masks, which are even less.
If you have the financial means to do so, upgrading to a respirator is recommended for all indoor public interactions. If you can’t afford or can’t find a respirator mask, you definitely need to upgrade your cloth mask, at least some kind of medical or surgical grade mask to improve the amount filtered. For. Putting a cloth mask over a medical or surgical mask to try to fit a double mask and reduce the amount of leakage.
As contagious and contagious as Omicron is especially, we really want to do the best we can to upgrade the mask as much as possible for ourselves as well as for all members of your family including your kids.
listen | Dr. Alex Wong on Symptoms, Testing and Safety:
17:11Infectious disease doctor Dr. Alex Wong answers questions about Omicron
What is the best way to use a rapid test?
The best way to use a rapid test at this time is when you are asymptomatic and you want a way to screen yourself to make sure you are not really positive. For example, you can use them before going to work, or kids can use them as an added layer of protection before they go to school.
Once you are symptomatic it becomes challenging and confusing for many people. The challenge with rapid tests is that they are not completely reliable in picking up the virus. So when you’re symptomatic and your risk of getting infected with COVID is high, and the test result is negative, it’s not enough to say: “I really don’t have COVID,” because of the nature of how the test works. In that type of situation, it was advisable to get a PCR test done till some time back. And it is the same even if you are symptomatic.
But if you have a positive rapid test, you can count on it, because the so-called specificity of the test is very high. So if you see those two bars, it’s essentially a guarantee that you have COVID and need to isolate.
The second question on many people’s minds is: ‘Should I just swab my nose, as you know, the box instructions say, or should I potentially swab both my throat and nose as well?’ There is some data that suggests that simultaneously treating throat and nose, or nasal swabs at the same time, may increase yield because of higher amounts of virus in the back of the throat and then the upper respiratory tract type or Overwhelms the amount of virus in the nose.
If you are trying to wipe your throat and nose, do not eat or drink anything for 30 minutes beforehand, to maximize the amount of virus in the back of your throat. But then, regardless of the results, whether it is negative or positive, it is not a reason for you to go out and if you are symptomatic.
The bottom line is that if you are symptomatic, you have to isolate yourself. If you want to be out in five days, you must be asymptomatic on the third day and then have no symptoms for two consecutive days to come out of isolation. If you have symptoms, you cannot go; You are still very potentially contagious.
We have learned about the airborne nature of this virus versus the larger droplets. What is your recommendation for working in an open area with other people where you are more than two meters apart but are allowed to take off your mask at your desk?
When people are smoking in an indoor setting, it’s poorly ventilated, and you can smell the smoke, you know, for like an hour or two or something like that, the same way you can about COVID can think. If you can breathe in and smell that fumes, you can inhale the virus and potentially become infected.
That’s why ventilation is so important. If you upgrade the ventilation and get all that air out quickly, it’s going to reduce the risk significantly. If you’re sitting a lot, the distance isn’t great enough that you’re safe. I personally would wear a mask, if it were me.
Despite the surge in omicron cases, ICU numbers are at their lowest level in more than six months. Isn’t it fair to say that this strain is less dangerous than Delta?
We’ve heard a lot about how, when you do a one-to-one comparison, someone infected with Omicron is less likely to become seriously ill than someone infected with Delta. And this is the case because Omicron reproduces less rapidly in the lungs and generally causes less severe lung disease than previous forms such as alpha and delta, which can sometimes completely destroy one’s lungs. gives. Even an otherwise completely young and healthy person may require life support, or may end up on a ventilator for weeks at a time. We are not seeing that pattern at all right now.
The challenge with Omicron right now is that there is a normal lag between the number of cases and subsequent ICU and hospitalization. We are seeing that across the world, including Ontario and Quebec, where the number of people in hospital and ICU is increasing very rapidly, even though the nature of the disease is slightly different.
The problem is that when so many people become infected, even if only a small fraction of those people become seriously ill, it will be significant enough to put considerable strain on our health system. We expect a significant increase in the number of hospitalizations and ICU admissions in the coming weeks. And that’s when we’re going to face some real challenges in our health care system.
What happened to Delta? Did Omicron push it out? how did it? And can it come back when Omicron depletes? Or is the virus getting weaker as it mutates?
It is very, very unlikely that Delta will re-emerge because Omicron has some survival and reproduction advantages. The main thing is that it is very permeable. And the reason for this is probably twofold. One is that it replicates much more quickly in the upper respiratory tract, which makes you contagious more quickly. The second reason is because of all these mutations on the so-called spike protein, which does a better job of avoiding protection than either natural infection or a vaccine. Our body’s defense against omicrons is not as good as it was with earlier periods.
We can think of Omicron almost like a new virus compared to all the other forms we have had in the past. So for those reasons, it’s spreading so fast, so fast, that vaccines and natural cover or some combination of the two aren’t completely protective, obviously, against getting infected. There will probably be some other version at some point, hopefully not in the near future that will do something similar to Omicron. And we’ll have to see what it does on a clinical level as well.
How resistant are people who have had Delta or a previous version of COVID to get Omicron now?
Along with the oomicron there are some important mutations and changes that occur with this so-called spike protein. The data suggest that recovering from natural infection with Delta, for example, offers only very limited protection against becoming infected with Omicron. This number can be as low as 15 percent or 20 percent. So this is nowhere near as good as we believe in the case of the previous variants where they are relatively minor changes in terms of mutations in the spike protein. From an immune system point of view, Omicron is almost like a new virus and what we have in terms of our immune memory doesn’t do much good in terms of protecting us from it.
Dr. Wong, we also had a lot of questions about whether someone should get a confirmatory PCR test if they test positive in a rapid test. If your rapid test comes back positive, will you go for confirmation? And How Should You Record a Positive Rapid Test?
Right now, I think the government’s public health guideline is just for isolation. If you are significantly symptomatic, I believe the guidance is still there that you should try and use a PCR test to make a diagnosis if you can.
Many people are asking how do I document a rapid test? As far as I know, there is no official way to report a rapid test in the province at this time. If you can, do a quick test on yourself, or have someone do a rapid test on you and film it with your cellphone to document the whole process from start to finish, and then talk to your family doctor. do so that it can be achieved. Chart relatively quickly.
Keep that video as the document: ‘Yes, indeed, I did indeed have COVID.’ I think the video would be something that could potentially be valid. At this point in time it’s really hard to know what’s going to happen next.
What do we do in case of boosters or those who had three or four shots because of mix and match?
Guidelines are changing so fast that it is difficult to generalize to everyone. I would just strongly suggest everyone go and take as much dose as you really deserve. We know with Omicron, that the third or fourth dose will make a tremendous difference in terms of protecting you from symptomatic infection, although it appears that two doses continue to provide meaningful benefits against hospitalization and critical illness .
When can we expect booster shots for teenagers and vaccines for children under five to be rolled out?
We’d expect a booster for those 12 and older in the relatively near future. They are already approved in the United States. And I know regulatory processes are working there through Canada.
Unfortunately, the news is not as good for children under the age of five. Trials for both Pfizer and Moderna have been delayed for various reasons. Pfizer’s trial doesn’t seem like they use a high enough dosage. So he had to give a third dose which delayed everything. Moderna has asked to enroll more patients. So we’re probably not looking at it until maybe April, May or even more at this point, which is frustrating for a lot of people with young children. But this is another reason to do what we can to protect them.
Thank you, Dr. Wong, for your time this morning. we really appreciate it.
Thank you, Steph. always a pleasure.
Written by Florence Hwang with files from The Morning Edition. Q&A edited for length and clarity.