Jan 7, 2022
It is now clear that Omicron can infect those with previous COVID-19 infection and natural immunity, as well as those fully vaccinated, and of course, the smaller fraction of individuals who are COVID-19 naive. While we have a mix of prolonged Delta cases and in many cases with moderate to severe symptoms, Omicron syndrome has been characterized as mild and brief with a notable absence of pulmonary symptoms.
How did Omicron secure this large and growing ecological niche? We have learned that Omicron replicates at a 70-fold increased rate over Delta. Additionally, Omicron appears to generate immunity not only against itself, but also against Delta, the prior dominant variant. So as Omicron moves through the population rapidly, it provides a larger immunologic barrier to further Delta expansion and will likely work to bring down the Delta curve while the Omicron peak continues to build in a sharply upward and hopefully brief spike in cases.
Additionally, modeling studies suggest that the dual Lilly (bamlanivimab and etesevimab) and Regeneron (casirivimab and imdevimab) monoclonal antibody products are unlikely to neutralize Omicron, leaving only sotrovimab by GSK as the remaining monoclonal antibody in our armamentarium for high-risk seniors who develop severe symptoms with Omicron.
While many have said, Omicron is “mother nature’s booster,” it will be some time before we can celebrate as the blend of Delta and Omicron, which present with similar features but take two separate clinical courses, is bound to confuse both the patients and the doctors trying to grapple with this new clinical reality.
This week’s program has a new song from RC The Rapper, who teams up with First Nations Country Music Singer Jordan Shingoose with the new single “Home,” which is about home and the importance of medical freedom. We also have the rockstar of evidence-based medicine, Dr. Paul Alexander who will update us on the evidence for natural immunity and the emergence of Omicron and how this changes the calculus for the global COVID-19 vaccine program.