IV Mirus on the omicron variant

Alex (The Daily Moth): About a month ago, the omicron variant was first identified. We didn’t know much about it, but we know now that it is extremely contagious… We also know it can infect those who are already vaccinated with breakthrough cases. And obviously it can infect the unvaccinated. But I’m seeing some say that the cases are milder compared with the Delta. What have you learned about the omicron up to now? What have you learned?

Dr. IV Mirus: So we see that omicron infects many people, even if they are vaccinated or unvaccinated. It seems that those who received two vaccines — 40% of this group still became sick. We have looked at data from other countries and found out that vaccines don't offer the same protection as it does for Delta. So we looked at — we also found out that those who became sick with omicron, most of them did not require hospitalization. That means they weren’t severely ill. It’s much less compared with Delta. With Delta, 1.5% of those infected required hospitalization. With omicron, it is less than 0.5%, less than one percent. So that means severe infections or illness is lesser compared with Delta. So that is good news. But my concern is that if the rate of infection and transmission is higher compared with Delta, that means more people will be admitted to hospitals, in the ICU, regardless. So that is a big concern. Yes, omicron is milder, but it spreads so fast compared with other strains in the past. So that is my biggest concern.

Alex: I get it. It spreads faster, but it doesn’t harm people as much. I remember that Delta was considered extremely contagious, but omicron seems to be even more contagious. Wow.

Dr. Mirus: And really, the reason why omicron doesn’t cause severe illness is possibly because more people are vaccinated now compared with Delta when it was spreading. Or, the virus itself, the omicron strain might not be as severe. We don’t know. We don’t know because more people are vaccinated now in the world. So we notice that for people who are vaccinated, their symptoms are very mild. They are able to recover. But for people who haven’t received vaccinations, it is a risk, a gamble.

Alex: I understand.

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Alex: What kinds of cases are you seeing in patients now? In your area with the coronavirus? Those who are vaccinated and those who are not? Can you share what you are seeing?

Dr. Mirus: Yeah. If you’d asked me last week, I would have said that rates of Covid-19 were going down. The numbers were consistent in the emergency department with cases. But it seems that over the past two days, we are reaching maximum capacity. I am expecting that in the next two, three days, in the next couple of weeks, it’ll get worse. Chances are that either you or someone that you know will have the coronavirus in one or two weeks. It will spread like crazy. So, most of the cases we are seeing are fortunately not severe illnesses. Most of the people who show up to the emergency department are not vaccinated. It seems like if you are vaccinated, you can get sick, but for only one or two days with a fever and body aches. A bit of a cough, but it’ll go away and you’ll recover, just like the common cold. But if you are not vaccinated, it varies wildly. You don’t know what you’ll get. Severe illness? There’s a low chance, that’s true, but you never know. Or it might be mild. It ranges all the way. So those who are unvaccinated are taking a risk. It is an unnecessary risk. Vaccination will protect you against severe illness, it will. The symptoms and body aches will go away fast. For the unvaccinated, it’s a risk. I have no promises, no guarantees, right? So that unvaccinated group is what we are seeing the most in the emergency department right now.

Alex: Wow. Yesterday President Biden announced that he would make available 1,000 military medical personnel and 500 thousand — 500 million at-home rapid 15-minute antigen tests. Do you feel that it is helpful or? What can governments, state governors, the federal government do — city governments do to help the public through omicron? What is your view as a doctor?

Dr. Mirus: So, the best option would probably be to create a new vaccine to protect against the omicron. The problem is that it’s too late. We can manufacture it and distribute it, but the vaccine requires two weeks before your immune system builds up. By a month’s time, I expect that omicron will be widespread -- because in Africa, cases have already started going down. There was a serious peak, but it’s going down. So, the next best option would be to take at-home tests. How does that help? If you can identify those who are sick, who are showing symptoms, and catch it early, they can stay at home instead of socializing. You might feel okay but have a little bit of symptoms, you might not feel great, and if you take an at-home test and it comes out positive, you will know you’ve got to stay home and you’re not able to go out to an event or get together with family or whatever. If I’m staying at home, that means others will be protected as well. The spread will be slowed down. That’s my goal. If the spread is slower, then that means healthcare workers have a chance to take care of many people. If the virus is spreading rapidly, it means many more people will go to the emergency department at the hospital and we would be stuck. Another big concern — regarding the military personnel coming to the hospitals — it will help because the vaccines are no longer 90% or 95% effective in protecting — it’s down to 60% or 50%. That means that since the pandemic started, my chances of getting sick are high again, comparable with the start of the pandemic back in March, right? I’m now accepting that I have a higher chance of getting the coronavirus. That’s a part of my profession and a part of what I do. So if I get sick, who will replace me? Another doctor? What if they get sick, too? Who will take care of them? Also think about the nurses, anesthesiologist techs, and many others who are a part of the team that take care of patients — infections will occur among them and who will replace them? Our “bench” will be used up. So yeah, I think the (military) will help but it’ll be a huge peak and it’ll go down. We’ll see what happens.

Alex: Appreciate you sharing your thoughts on that. I think that’s all the questions. Do you have anything you’d like to add?

Dr. Mirus: I know I’ve been saying this every time, but again, please if you haven’t received the vaccine, please go ahead and get one. It’s the safest vaccine in history. Now is the time. We don’t have any more time because omicron will spread and it’ll touch you at some point in the next two or three weeks or a month. So now is the best chance to get the vaccine and warn your immune system, your body that the coronavirus is out there and is coming. That way your body has a good chance to fight back.

Alex: Understood. Thank you so much for your time, I really appreciate it as always. Take care.

Dr. Mirus: Of course. Take care, stay well.