A commuter is wearing a mask for a bus ride. The omicron variant of the coronaviruses is now dominant in both the U.K. and the U.S. There is data indicating how severe its symptoms might be.
Paul Ellis/AFP.
Scientists were alarmed when it was discovered.
The variant looked different from earlier versions of the coronaviruses, and it became clear that these changes gave omicron an ability to sidestep our vaccines and spread very rapidly.
It has taken longer to untangle what makes an omicron illness different from its predecessors. Does this variant cause less severe disease than those before it?
With infections at all time highs in the U.S., the clinical picture is now coming together and starting to confirm what other countries have found.
Scientists at Case Western Reserve University have found that the risk of being admitted to the hospital or the intensive care unit during the omicron surge is half of what it was during the delta surge. This shows what doctors are seeing with their patients.
The Mount Sinai Health System's emergency rooms are busy but many of the COVID-19 patients are not sick enough to be admitted.
Your absolute risk depends on a number of factors, including your age, health, and economic situation.
Even if it's less nasty than the delta variant, it's still a nasty disease in the older age group. "You don't get off scot-free just because you're in the middle of the day."
The World Health Organization director-general Tedros Adhanom Ghebreyesus said that Omicron does appear to be less severe than Delta, but it does not mean it should be categorized asmild. "Omicron is hospitalizing people and it is killing people."
According to the Department of Health and Human Services, there are more than 126,000 hospitalizations across the country and more than one in every four intensive care beds is filled with a COVID-19 patient.
What are the symptoms when you get sick with omicron?
The hospital numbers don't tell us what a typical case looks like.
The vast majority of people with omicron have a mix of symptoms that don't require hospital care.
Many of these cases look like an upper respiratory infections. What you think of as the common cold.
The associate director of the Center for Emerging Viral Threats at LSU Shreveport says that it's mostly that sore throat and nose. If there's any cough at all, and it's not achy, the cough is less common than previous versions.
The data from the U.K. shows that the five most common symptoms are headaches, fatigue, sneezing, and sore throat.
The symptoms come on more quickly with omicron. The time it takes to develop symptoms after being exposed is three days. The original variant took more than five days, while delta took four.
Losing smell and taste is a telltale sign of omicron infections, but it is not as common as COVID-19. Older patients are less likely to have symptoms related to lower respiratory problems.
It appears that certain symptoms show up more with omicron than they do with delta. Lower back pain, nausea, and night sweats are three that have gained attention.
Scott Roberts, an assistant professor of infectious diseases at the Yale School of Medicine, says it's possible that doctors and patients are paying more attention to the symptoms than they did before.
He says that a lot of this is magnifying the symptoms under a microscope. "Omicron and delta are very similar."
Omicron can't be defined as causing only a small group of symptoms. Many patients are still having a variety of symptoms, but less often, like headaches, dizziness, and trouble breathing.
He says that Omicron can present in many different ways.
It's not clear how much vaccines and prior infections are responsible for some of the early clinical impressions that omicron is causing a milder constellation of symptoms, says Dr. Daniel Griffin, who's chief of infectious diseases at ProHEALTH New York and an instructor at Columbia University.
He says that people who have been vaccinations ahead of time are getting milder symptoms.
People who had breakthrough infections tended to have less symptoms than people who were unvaccinated.
What is my risk of getting very sick if I get omicron?
A mild illness can turn into a life-threatening one with the new coronaviruses. The risk appears to be lower with omicron than it was with delta.
A study published online on January 2 shows that the chance of ending up in a hospital is lower with omicron compared to the delta variant.
The scientists at Case Western Reserve University analyzed health records from more than half a million people who had been exposed to the disease, and they found that there were at least 14,000 people who may have been exposed to the variant.
Delta is still circulating in the community. Dr. Pamela Davis, who contributed to the study, says that you're pushing more and more towards the omicron variant.
The researchers looked to see if there was a difference between the people who were at the beginning of the omicron wave and those who were at the end of the delta wave. The data scientist who led the study says the difference was huge. We didn't need to do any complicated statistics to see the difference.
The risk of needing to go to the ER was 70% lower during the early part of the omicron surge, and the risk of being hospitalized was 50% lower.
The risk of being admitted to the intensive care unit or being put on a ventilator for a person with delta decreased substantially at the end of December. The chance of being admitted to the intensive care unit fell from 0.8% to 0.4% and the chance of being put on a ventilator fell from 0.4% to 0.1%.
Scientists have observed a lower risk with omicron in South Africa and the U.K.
About 60% of the people in the study were vaccine free. The data shows that there is a reduced risk for hospitalization with the omicron variant compared to the delta variant.
Kids under age 5 who are not eligible for vaccine, and kids ages 5 to 15 who may have been vaccine-free, were all shown to have a reduction in risk.
The consistency suggests that the reduction in severity is due to something inherent with omicron itself and not simply because of changes in vaccination status.
"So this is something that's different from omicron and delta," he says. This reduction in risk doesn't mean that omicron will be mild for everyone. The chance of being hospitalized for people at high risk for severe disease, such as older people or those with underlying health problems, is still significant. If you're over 65, your risk of being hospitalized with COVID is 5% with the omicron variant, which means 1 in 20 people will end up in the hospital. The original version of the virus had a rate of 1 in 10.
Pamela Davis says that the risk is not zero. Many people are going to be admitted to the intensive care unit, and some people are going to need mechanical ventilation.
She says that everyone should be boosted. Beingvaccinated greatly protects you from severe disease with omicron. The U.K. government published a study last week that found that three doses of vaccine cut the risk of hospitalization by 80%.
How bad is it if you end up in the hospital?
Even though early data shows omicron is milder than delta, many hospitals are packed because of the large number of people getting infections.
Many of the patients who end up in the ER or being admitted are not struggling to breath or have low oxygen levels.
The first disease and of delta were a hallmark of those two conditions.
In the past, a severe case of COVID-19 would cause havoc on the lungs and lead to inflammation. The change in the disease means fewer people need to be intubated or given supplemental oxygen.
Roberts says that the lungs are okay. Lab research shows that omicron does not replicate in lung tissue.
Many of the patients who are being hospitalized have underlying health conditions or are older and more vulnerable to a viral infection. Roberts says something tips the patients over the edge. Diabetes or heart failure can be caused by an omicron infection.
Roberts says it's rare for people who are boosted to get seriously ill from omicron. Most of the patients at Yale New Haven Hospital are unvaccinated. Almost all of the people who are vaccination have not received a booster shot.
It's good news that omicron is easier on the lungs, but it's not the case for some of his patients. An omicron infection can feel like the same disease to him if he is unvaccinated.
"If we have a patient who's younger, if we have a patient who's vaccinations, if we have a patient who recently recovered from delta, we're tending to see very mild disease with omicron." It's hard to see that the virus is milder in fresh people.
