The omicron variant of COVID-19 is spreading rapidly across the U.S., and is driving transmission in states neighboring Mississippi, likely to outcompete the remains of the delta variant in the state after beginning community transmission. With the first signs of another winter spike in COVID-19 cases emerging, public-health experts are offering advice for avoiding an infection while visiting family over the holidays.
This week, the Mississippi State Department of Health announced a weekend COVID-19 caseload of 1,434, higher than previous weekends in the trough since the end of the delta surge, and following Friday numbers of 911 cases, an increase from the average.
In a statement to the Mississippi Free Press, MSDH Communications Director Liz Sharlot confirmed that, in addition to a growing trend of new cases, testing volume suggests higher transmission is occurring. “We have seen an increased demand for testing—which often occurs when an individual is ill. We have also seen a steady rise in cases in long-term care facilities,” Sharlot wrote.
“It appears that it’s increasing quickly in some areas,” State Epidemiologist Paul Byers warned on Dec. 17. In neighboring Louisiana, public-health leadership is warning that nearly a third of all new cases are the rapidly growing omicron variant, with test positivity rate and hospitalizations growing alongside it.
Mississippi seems to be behind the curve in detecting new cases of the omicron variant, though a growing majority of cases in the region are clearly the new, more infectious variant. As of Friday MSDH had only successfully sequenced two cases of the virus with more suspected cases under investigation.
What might the omicron surge look like? Experts have pegged its infectiousness at roughly 30% higher than delta, a concerning development that is allowing it to overwhelm the earlier variant at rapid speeds in places like New York, which have seen the highest total number of cases in the pandemic so far.
But while the sheer volume of the omicron wave in the Empire State now eclipses the past peak, hospitals are not seeing the same deluge of critically sick patients as they did in the past winter, lending some much-needed hope to the developing theory that omicron presents a milder disease, especially in the highly vaccinated population of New York.
But research from the U.K. confounding that theory is still emerging, with researchers from Imperial College London finding that “hospitalisation and asymptomatic infection indicators were not significantly associated with omicron infection, suggesting at most limited changes in severity compared with Delta.” A normalization in hospitalization may occur as the omicron wave develops, traveling from younger adults to older, more immunocompromised elders.
More concerning, omicron has indeed proved capable of evading many forms of immunity. Experts warn that prior infection with the original strain of COVID-19 or with the delta variant more recently is unlikely to provide significant protection. The same Imperial College London study concluded that “Omicron was associated with a 5.41 fold higher risk of reinfection compared with Delta. This suggests relatively low remaining levels of immunity from prior infection.”
Omicron may evade the initial vaccine series as well, with two shots of Pfizer or Moderna or one shot of Johnson & Johnson still exposing individuals to the potential for a breakthrough infection. However, the newest evidence indicates that a recent booster shot of either Pfizer or Moderna provides strong protection against breakthrough infections of COVID-19. These booster doses are also available to individuals who took a single shot of Johnson & Johnson.
As Dr. Eric Topol recently explained to the Mississippi Free Press, aging vaccination status may expose an individual to symptomatic infection, but protection against severe disease and death is far more durable than against transmission. Individuals who are exposed to omicron without a booster dose of vaccine may be susceptible to infection, but they remain significantly less likely to require hospitalization or ventilation.
Planning for the Holidays
With a new infectious variant of COVID-19 on the rise, expert guidance for holiday gatherings includes both long-established principles for infection control and the use of rapid testing to avoid creating disease clusters.
Coronavirus is an airborne disease, and as such the primary form of infection control should be an intelligent combination of masking, distancing and most importantly ventilation. Outdoor gatherings, or indoor gatherings with a strong crossbreeze, are effective ways to reduce the risk of infection.
But rapid testing is just as important to avoid family transmission of the virus. Rapid testing is primarily used to determine whether an individual is presently in the infectious stages of a COVID-19 infection. Rapid tests are available for purchase at most pharmacies, as well as by appointment at MSDH testing sites, hospitals and clinics.
With Mississippi still at the early stages of the spike in new cases that omicron is likely to cause, Mississippians can expect less rapid-test shortages than those seen in more heavily hit areas. Buying rapid tests ahead of time can allow for quick identification of potential infections, preventing family gatherings from becoming the source of larger outbreaks.