Omicron is on the island. Now what?

This article was originally published on K57 on January 20, 2022.

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Department of Public Health and Social Services (PNC file photo)

 

At a press meeting, the Department of Public Health and Social Services confirmed the genomic sequencing results from the night before: Omicron is on the island.

Official reports say it could have been on the island as early as December 19.

10 samples were sent to Hawaii toward the last week of December 2021. Doctor Annette David, Lead Epidemiologist of State Epidemiological Outcomes Work Group, states, “7 came back as being positive for the Omicron variant.”

Characteristically, the Omicron variant is more transmissible than all variants thus far because it has, among other things, immune evasion. In other words, it can bypass some COVID treatments, such as vaccines (to some extent) and monoclonal antibody (mAb) therapy.

“Immune evasion for the Omicron variant,” says Dr. David, “in relation to the vaccines, really only refers to neutralizing antibodies, but you do have to keep in mind that when we talk about protection, the immune system harnesses not just the antibodies from the B-cells but also cellular immunity from the T-cells.

“It appears the cellular immunity from the vaccines against Omicron remains effective.”

Moreover, though mRNA vaccines–that is, Pfizer and Moderna–have weakened effectiveness to Omicron, their boosters significantly improve protection. According to the Centers for Disease Control and Prevention, mRNA boosters can be up to 90% effective against Omicron.

It is also important to note, says Dr. David, that the primary purpose of vaccines is not to prevent infection but to prevent serious outcomes: severe illness, hospitalization, and death. For those reasons, vaccines and their boosters are powerful tools against COVID-19 and importantly, against the Omicron variant.

Monoclonal antibody therapy

Several mAb therapies are not as effective against Omicron.

However, according to Incident Commander for COVID-19 Response Fernando Estevez, 90% of those who visit mAb clinics in Guam get better, and it could be because patients receive mAb on average within 2 days of symptom onset. Another lurking variable could be that because Omicron is milder than Delta, those who have the Omicron variant tend not to need mAb.

As a result, those who visit mAb clinics are those with the deadlier Delta variant, for which mAb remains effective.

Regardless, Dr. Robert Leon Guerrero, Acting Chief Medical Officer, says that it is important to get mAb if you are among the more vulnerable populations, such as the elderly and immunosuppressed. He says, “Although mAb is not as effective against Omicron, we’re still seeing the Delta variant,” which tends to be deadlier. “We only know if it’s Delta or Omicron three-to-four weeks after the fact.”

Dr. David reminds the public to meet with your primary care physician to find out if you are a candidate for mAb or the antiviral pills.

Paxlovid

Moreover, new treatments for COVID have come out, such as the antiviral pills Paxlovid, which are effective against Omicron. “It looks as though Paxlovid continues to have good activity against Omicron,” says Dr. David.

And in the Public Health meeting today, Estevez mentioned, “We have received our first shipment of Paxlovid.”

But supplies are limited. Estevez says we only have 80 courses, which means only enough for 80 people. He also says that those who are most likely to receive Paxlovid are those who are higher risk, and those happen to be the unvaccinated, the elderly, and the immunosuppressed.