A Harvard emergency medicine physician says we should be concerned about the omicron variant of COVID-19 but that it's too early to tell about the seriousness of the mutations.
Dr. Jeremy Faust of Harvard University's Brigham and Women's Hospital in Boston joined The Lead Live on Friday to discuss the variant. Faust writes a newsletter called Inside Medicine, published via Bulletin — a Meta-owned service including The Lead and others.
Faust has written extensively about COVID-19 and is one of the country's leading experts on emergency medicine.
"This could be more contagious, this could evade our vaccines, but we don't know that," Faust said. "But what we are hearing is it's very contagious. The question is in terms of the vaccine holding up and severe illness whether we have anything to worry about. In terms, of severe illness I really haven't heard anything that bothers me, but the contagious piece I am beginning to hear that there is quite a lot of contagion."
The omicron virus exploded onto the world stage after South African physicians started noticing highly mutated strands of COVID-19 in ill patients in that country. However, they also reported the variant appeared to be mild. The World Health Organization said the variant is of concern but also said it was unclear how fast it could spread.
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I think that's totally avoidable. If the public knew what it looks like in an ICU, when this virus is let to roam free, I think they would have second thoughts."
"It is not yet clear whether infection with Omicron causes more severe disease compared to infections with other variants, including delta," The WHO said in a Nov. 28 statement. "Preliminary data suggests that there are increasing rates of hospitalization in South Africa, but this may be due to increasing overall numbers of people becoming infected, rather than a result of specific infection with Omicron. There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants. Initial reported infections were among university students—younger individuals who tend to have more mild disease—but understanding the level of severity of the Omicron variant will take days to several weeks."
Faust said people commonly believe that scientists have the technology to predict how severe an illness will become, but that's far from the truth. Instead, Faust said we have to wait and see how this latest version of COVID-19 presents itself.
"This started because a genetic analysis of a variant was done," Faust said. "Scientists look at the (genetic) sequence, and they are able to say that sequence has meaning to us — we think. We see how many changes and mutations are part of that genetic sequence. That tells me, hmm, maybe that's a scary branch. But the reality is we actually don't have the technology to make that leap to say that."
Faust said he's not sure the variant came out of South Africa; it's more likely that it was just detected there first but that this strand a loaded with mutations.
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"This has so many mutations that it's almost like time has been accelerated," Faust said.
What scientists believe, Faust offers agreement to this theory, that the variant lived inside one person for a long time, and that person had a severely compromised immune system. The treatments to bolster that one patient's immune system likely provided the variant to evolve quickly.
Now, Faust offers caution here: "I don't want people to think that is a common thing. This is a problem that only happened to a patient that basically has no immune system left. We are talking about the proverbial 'bubble boy,' people who literally have to be on immune surpressing medication and that's the level this can happen at."
At this time, omicron has been detected in the United States three times. Scientists warn that it's only a matter of time before it spreads.
Through the pandemic, Faust has been a member of research teams looking at COVID-19 fatalities, including in Texas. Faust published a paper this year that found COVID-19 was the leading cause of death in Texans aged 25-44 from July through September of 2020. Even more troubling was they found that COVID-19 was the leading cause of death in the Hispanic population.
"We certainly saw that in Texas," said Faust, adding that he expects a fuller readout of COVID-19 mortality in the coming days.
When it comes to another area of concern — long COVID — Faust said this needs greater attention.
"We don't even know how to define it," Faust said. "We don't even know what we're saying when say long COVID. That's really important because there can be different forms. There can be different meanings. One of the distinctions I think that needs to made is what I call medium COVID and long COVID. So medium COVID is two to six months after the virus you are still feeling symptoms or symptoms that might be related to your previous infection. In a way, I think medium COVID is something that probably happens with almost any serious virus — medium flu, medium RSV or anything. It's the equivalent of biological shrapnel. Your body is responding to that. I think it's very common. I think COVID does this at pretty high rates.
"Then there's long COVID, which is six months to maybe a year, where people could have longer-term symptoms. I think those examples are going to be less frequent. I think the research there is going to be very focused one what are the symptoms that really do persist, because we've heard of hundreds of symptoms. They can't really all be part of the story — some of them probably are."
And when it comes to health care workers, Faust is direct that the support is appreciated, but that also means getting vaccinated and taking the virus seriously.
"We are asking people to make sacrifices and say, look, do whatever you can to slow this virus down," Faust said. "Do whatever you can to stay out of the hospital and the ICU. We can only do our job if we have the resources. There are literally moments that people have feared like we haven't had enough beds or ventilators. Unfortunately, that's a reality. It doesn't happen as much because I think we have done a decent job at slowing this down, but honestly, there have been places and times where we didn't achieve that. I think that's totally avoidable. If the public knew what it looks like in an ICU, when this virus is let to roam free, I think they would have second thoughts."
