On the 5th, Westmoreland County School Board had a short meeting giving an update on the coronavirus.

Speaking about Omicron, Dr. Richard Williams, the director for the Three Rivers Health District, said “it’s causing huge case surges across the country. It’s as infectious as the measles, which is the most infectious virus, able to be spread through casual contact.

“However,” he continued, “it’s looking like this causes less severe disease, but more cases. Previous variants reproduced in the lungs, which could cause inflammation, pneumonia, and severe respiratory distress syndrome. Omicron instead seems to reproduce in the upper airways. This may be easier on adults but can act sort of like a respiratory sensational virus in kids and cause some airway reaction. It’s all still under study though.”

According to Dr. Williams, several areas have seen an increase in kids being hospitalized, though he noted that hadn’t taken place yet in Virginia. This is not helped by reports that Omicron slips around natural and vaccinated immunity.

It was not all doom and gloom however.

Testing, vaccination, and boosters

“Boosters do help antibody levels significantly,” the doctor added. “A study from South Africa came out that looked at T-cell immunity, and that appears to be preserved against Omicron. That might account for some of the protection that recently-infected and vaccinated people have against severe disease and hospitalization.”

When it came to testing, where omicron is involved, rapid tests can be unreliable compared to a PCR test, though Dr. Williams did not recommend against using them when he addressed the school board. Testing, meanwhile, remains tricky, as many of the at-home tests are difficult to get. To aid with this, health districts, like Three Rivers, are adding more community testing events to their schedules.

At the time of the meeting, the national caseload was estimated by Johns Hopkins to be around 580,000 cases per day, with the US topping 1 million cases last Sunday. In the Three Rivers Health District, cases were spiking as well, with almost 1000 new cases in the previous week, and another 300 in the days leading up to the meeting. The good news is that hospitalizations have not followed the curve.

“They’re certainly going up, but they haven’t reached the peaks of previous waves anywhere during the pandemic,” Dr. Williams continued, “It looks to be 30% less likely to put someone in the hospital for any number of reasons, from the nature of the pathogen to possibly pre-existing immunity. It appears less likely to cause severe disease, and we’re hoping that spares our healthcare system. We’re in uncharted territory here… It’s very hard to predict what will happen. Delta did not do in the United States what it did in India, so we’ll see what Omicron does,” Dr. Williams said.

When it comes to vaccinations, about 58% of Westmoreland County is fully-vaccinated, and the FDA authorized booster shots for kids as young as 12 years old.

“All the other booster programs for authorized age groups are underway with all three of our vaccines mix-and-match authorized,” Dr. Williams noted.

The campaign to get kids vaccinated, however, has so far been a dismal failure, with it being estimated that only about 15% of kids ranging from ages 5-11 got the jab. The next age bracket, from 12 to 15 years old, clocked in at 43% vaccinated, while 16 and above came in at 52%.

Updated guidelines

The biggest change was the shortened times for isolation with the CDC shortening the recommended time from 10 days to five days for people testing positive for COVID if they were asymptomatic or the symptoms were on the way to resolving. They’d then have to mask up for the next five days around people. The CDC also updated its recommended quarantine period for those exposed to someone with the virus.

In the case of someone that was unvaccinated or who had gone six months since getting their previous shot, then the above guidelines were recommended. If a five-day quarantine isn’t possible due to that person’s line of work, then they’d have to mask up for 10 days. Those that have had booster shots aren’t required to quarantine following exposure, but it’s still suggested they mask up, according to the CDC guidelines.

“They’re trying to strike a balance between risk of people out of work and children out of school, and isolating enough to reduce the risk of virus spread. They feel comfortable going from 10 days to five because 90% of viral shedding is done in the first five days, so you’re dealing with a very small residual tail of risk after five days,” Dr. Williams added.

With regards to students, as far Dr. Williams knew, the CDC had not left any updated guidance for isolating or quarantining students. However, VDH has published recommendations for isolation and quarantine guidance in the K-12 setting,” he noted. “And they are consistent with what happens to adults with shortening the isolation period, with kids being able to come back to school from isolation or quarantine after five days and wear a mask. Students that are developmentally disabled or otherwise unable to mask up should isolate for 10 days, and there is a little bit of difference with regards to vaccination status and exposures.

“If a child was fully vaccinated more than six months ago, they should follow the fully vaccinated guidelines. So they don’t have to quarantine after exposure, and again, this is about balancing the risks of transmission vs. staying out of school,” said Williams.

Cautious optimism

In the end, Dr. Williams was cautiously optimistic, noting that viruses tend to become more transmissible but less virulent as time goes on, which appears to be the case with COVID at the moment.

“It’s not in the best interest of the virus to kill its host,” he concluded, “We will emerge from this Omicron wave with much, much more population immunity than we have now. A lot of us are going to get this, and the virus is in effect vaccinating some and boosting others. If that’s successful, and t-cell immunity holds up, then this may burn through and march over to a low endemic level letting the pandemic fade, but we’ll see.”

Naturally, these guidelines are subject to change as research is done and more is known about how the virus behaves.