Omicron cases are finally starting to go down. Omicron has been gripping the world for the past two months. Finally, peer-reviewed literature is coming out to inform us how much our pandemic tools protect us. I reviewed a recent article from the Journal of the American Medical Association where the authors tell us how much our vaccines still protect us.

The paper captures the period when the Omicron variant truly began to surge. The article’s authors reviewed COVID testing data from the United States from December 10, 2021, to January 1, 2022. Each patient had information on the variant the individuals were infected with, their comorbidities, their vaccination status (unvaccinated versus two shots vs two shots with booster), and the vaccine they took. They used this information to create a series of statistical models exploring how one’s vaccination status affected their risk of being infected with Omicron and Delta. Their results were the following.

Overall, being boosted significantly decreased one’s chance of having COVID-19 against Delta and Omicron. When the authors compared boosted individuals to those who were unvaccinated and those who had only received two doses, those who received their booster vaccine were roughly three times less likely to become infected by SARS-CoV-2.

This was approximately the same amount of protection whether individuals received three doses of the Pfizer or Moderna vaccine. So if we were in a room with ten people with a virus risk present, only three people who were boosted would likely test positive, compared to all ten for those without the booster or unvaccinated.

That was for Omicron. Being boosted provides even more protection against the Delta variant, which is still floating around. In that case, boosted individuals are approximately ten times less likely to become infected. So back to our room of ten people, only around one person present would be possible to test positive compared to individuals with two shots.

Getting yet another shot may feel like a nuisance. Fortunately, it is a great way to protect yourself from getting infected. The pandemic will improve this coming Spring and Summer, just like last year. Be sure to do what you can to get yourself there healthy.

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Approximately six months after experiencing a Covid-19 infection, upwards of 1.6 million people in the USA still have alterations in their smell sensation.

The cells lining the inside of our node are known as the olfactory (nose) epithelium. These cells protect the olfactory nerves that help us to smell.

Covid: Why do some lose smell? Genetics.

Now comes a study published journal Nature Genetics that reports a genetic risk factor linked to smell loss of smell after a Covid infection. We are closer to solving the mystery of why some Covid sufferers experience a loss of smell.

Why do some individuals who get a Covid-19 infection lose their smell while others retain it? We may have some new clues:

A genetic spot, near two genes for smell, is associated with Covid-induced loss of smell and taste. A change in this gene increases the chances (by 1.1-times) a person infected with Covid-19 will lose their smell.

Fortunately, about 80 percent of those with Covid-19 will regain their sense of smell, some experience long-term loss of the senses of smell and taste.

The genomics and biotechnology company 23andMe researched subjects living in the United States in the United Kingdom. Of the nearly 70,000 individuals who self-reported receiving a positive Covid-19 test, 68 percent experienced a loss of smell or taste.

After looking at the genetic differences between those who lost smell and those who did not, the researchers identified a genetic difference near two genes, UGT2A1 and UGT2A2. Nasal tissue involved with smell expresses these genes.

The researchers demonstrate how access to a massive database can help identify genetic differences. Now, researchers will try to figure out how the two genes are involved in losing smell.

Women appeared slightly more likely to have a loss of smell, while African-Americans and those of East Asian descent were significantly less likely to report loss of smell or taste. Genetic variation in the identified region does not explain the differences.

Covid: Why do some lose smell? Final thoughts

The 23andMe researchers open the door to a better understanding of why some experience long-term Covid-19 symptoms such as a loss of smell. Inherited genetics may play a role.

Smell and taste researcher Danielle Reed offers that previous studies hinted that the loss of these senses is secondary to a failure to protect the sensory cells of the nose and tongue from viral infection.

Instead, the current study points to an alternative explanation — “The pathways that break down the chemicals that cause taste and smell in the first place might be over or underactive, reducing or distorting the ability to taste and smell.”

My take

I have some issues with the study, including that the subjects self-reported having a Covid-19 infection.

A separate study showed age under 40 and nasal congestion at the time of viral infection is predictive of a higher chance of smell recovery. Difficulty breathing at the time of infection and prior head trauma decreases the chances for recovery.

Finally, early research suggests loss of smell and taste is less likely with the omicron variant. Thank you for joining me today.

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I keep reading that hospitalizations are way less; cases are milder; and the disease is not as bad as that with previous variants, such as Delta. 

If that’s the case, I’m not seeing that at all where I am (outside of Chicago). This wave is the worst one we’ve yet endured. 

Almost half of all the beds in my hospital are occupied by Covid patients. More than half of my ICU is Covid patients, and all of them — every single one — is on a ventilator. We have surpassed our record numbers from last Fall, and the end is not in sight at all. And, every hour, more and more Covid patients keep coming to our hospital. 

On top of all this, we are all exhausted after nearly two years battling Covid on the front lines. We are spent — physically and emotionally. Moreover, so many staff are out sick with Covid, and it is causing stress and wreaking havoc on every level. Everyone is on edge. 

In fact, I asked my Hospital Medicine colleagues about whether they thought this latest Omicron wave was “mild.” One said straight up, “It’s bullshit.” The other said, “Hell no!” 

So, Omicron “mild”? Hardly. 

Now, I can’t say for sure that all of the people coming in sick with Covid are infected with the Omicron variant. They very well may be left over Delta infections. And, based on what I have been seeing my multiple vaccinated family members and colleagues getting infected with Covid, their illnesses are indeed mild. 

Here is the operative word of that last sentence: vaccinated.

For the overwhelming majority of those who are vaccinated, Covid is a mild illness. In my hospital, about 90% of those hospitalized are unvaccinated. In my ICU, my patients are not old nursing home residents: the vast majority are between 40 and 60 years old. They are fathers, husbands, sisters, and daughters. And every single one of them is unvaccinated. Every. Single. One.

So, really, for an unvaccinated person, is the Omicron strain all that “milder”? I really don’t think so. And, as one my colleagues told me, “‘Mild dead’ is still dead.” Amen, sister. 

This is the absolute worst wave yet. Covid cases among my group of ICU specialists across the country have shot straight upwards, and we will definitely surpass the last horrific wave. We are so done with this virus, and the problem is the virus is not done with us. We are doing our best and trying to stand as tall as possible. But, it is so very hard. 

Omicron “mild”? I’m surely not seeing it. 

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Fortunately, a booster dose appears likely to restore most of the protection. These are the conclusions of a recent study from researchers at Massachusetts General Hospital (MGH), Harvard, and the Massachusetts Institute of Technology (MIT).

Omicron aggressively spreading

Explosive. That’s the word I would use to describe the growth and spread of the Omicron coronavirus variant. The virus has been discovered in 89 countries and has a doubling rate of 1.5 to 3 days in regions with community transmission. These are observations from the World Health Organization (WHO) today.

Is the rapid growth secondary to the variant virus’ ability to evade our immune systems, or is it secondary to increased transmissibility for other reasons? We don’t know.

Let’s take a quick look at the preliminary evidence regarding the lack of effectiveness of vaccination without a booster shot. The Boston region researchers tested blood from people who had received the Moderna, Pfizer/BioNTech, or Johnson & Johnson vaccines against a pseudovirus engineered to look like the Omicron variant.

There appeared to be very little (if any) neutralization of antibodies of the variant from any of the vaccines. However, the blood from those who recently had a booster shot neutralized the variant.

These research observations are in line with some other recent reports. In a study announced earlier this week, Oxford University (England) researchers tested subjects’ blood samples 28 days after their second dose of the Oxford-AstraZeneca or Pfizer-BioNTech vaccine.

When the scientists introduced Omicron to the samples, there appeared to be a substantial fall in the neutralizing antibodies that fight Covid. Some recipients failed to neutralize the virus at all. This response appears inferior to that seen against earlier variants of the coronavirus. Here is the take of the study’s authors:

“This will likely lead to increased breakthrough infections in previously infected or double vaccinated individuals, which could drive a further wave of infection, although there is currently no evidence of increased potential to cause severe disease, hospitalization or death.”

The researchers reported this pre-print study, which is yet to be peer-reviewed, on the MedRxiv server.

Good news

BioNTech and Pfizer said last week that a three-shot course of their COVID-19 vaccine neutralized the new Omicron variant in a laboratory test. However, the two doses resulted in significantly lower neutralizing antibodies.

Moderna and Johnson & Johnson have not released their data about the vaccines against the new variant.

I am glad that I got a booster vaccine shot. Thank you for joining me today.

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The Omicron variant is circling the globe already. Almost as soon as it was announced governments enacted international bans on travel to try and curb the spread. This makes little sense as previous attempts to contain and or eliminate the virus have been abject failures, and there is even less willpower to carry on with these types of measures now that vaccines are here and widely available.

The past two years have heard an almost constant refrain of “follow the science” and we’ll get out of this, but where is the science on banning travel?

The WHO is clearly against closing borders based on the available evidence.

Travel bans at this stage of the pandemic, where there is vast inequity of vaccine availability from rich to poor countries, little appetite for restrictions in much of the developed world where vaccine access is ubiquitous, and research showing massive disruption to lives and livelihood caused by travel bans (with little or no benefit in reducing the spread of the virus) just doesn’t make a lot of sense.

Unless you’re a politician.

If you’re a politician in the West signing off on travel bans, you are a BOLD person of ACTION. Taking the hard but necessary steps to keep your constituents safe by banning travel from scary places.

More bullshit safety theater to make the West feel good while imposing do-nothing restrictions that will crush the lives and livelihoods of people half a world away we’re too cheap and short-sighted to offer meaningful help. Like actually getting shots in arms in Africa instead of coddling ourselves with booster shots.

The things that work to limit the spread remain unchanged:

1. Wash your hands
2. Wear a mask indoors (fit it properly over nose and mouth)
3. Social distancing

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