COVID-19 New Omicron Variant: Symptoms and Treatment?

The World Health Organization on November 26, 2021 classified the B.1.1.529 variant, or Omicron, as a SARS-CoV-2 "variant of concern," saying it may spread more quickly than other forms of coronavirus.

The Delta variant remains dominant worldwide, accounting for 99.9% of U.S. cases, and it is not yet clear whether Omicron will be able to displace Delta, said Dr. Graham Snyder, medical director, infection prevention and hospital epidemiology at University of Pittsburgh Medical Center.

But the new variant has over 30 mutations in the part of the virus that current vaccines target. It is also suspected of driving a spike in new infections in South Africa. 


Omicron variant

COVID-19 Omicron Variant Symptoms

South Africa’s National Institute for Communicable Diseases (NICD) has said that “currently no unusual symptoms have been reported following infection with the B.1.1.529 variant.”

NICD also said that as with other infectious variants such as Delta, some of those infected with the omicron variant of the coronavirus are asymptomatic.

Chair of South African Medical Association says Omicron cases are mild so far, but it's too soon to the determine risk of severe disease.

"It may be it's highly transmissible, but so far the cases we are seeing are extremely mild," Angelique Coetzee, chair of the South African Medical Association, told The Guardian on 26 Nov 2021. "Maybe two weeks from now I will have a different opinion, but this is what we are seeing."

Individuals are reminded to seek immediate medical attention (go to a hospital’s emergency department) if they develop emergency warning signs of COVID-19 such as:
  • Difficulty breathing
  • Persistent pain or pressure in the chest
  • Bluish lips or face
  • New confusion or inability to arouse
Related: 

How Is the COVID-19 Omicron Variant Diagnosed?

According to the WHO, current SARS-CoV-2 PCR diagnostics continue to detect this variant. Several labs have indicated that for one widely used PCR test, one of the three target genes is not detected (called S gene dropout or S gene target failure) and this test can therefore be used as marker for this variant, pending sequencing confirmation. Using this approach, this variant has been detected at faster rates than previous surges in infection, suggesting that this variant may have a growth advantage.

All variants of COVID-19 are diagnosed with a medical history which includes any recent known exposure to COVID-19, and a physical exam to check for symptoms of COVID-19.If COVID-19 is suspected, tests used to diagnose the virus include:
 
  • PCR tests (genetic or molecular test)
  • Results can take hours to up to one week
  • More accurate than an antigen test
  • Antigen test
  • Results are available in less than one hour
  • Less accurate than a PCR test

  • An antibody test may be used to determine if a person had a past COVID-19 infection, but it is not used to diagnose current infections because it takes up to 3 weeks following infection for the body to produce antibodies to the virus. 

    Regular COVID tests do not test for variants. Testing for variants requires genomic sequencing, which not all labs can do and it can be expensive. State health departments may run tests to help determine prevalence of a particular variant in that state, but it is unlikely individual patients would learn which variant they are infected with.

    Chances of Catching Omicron

    You might want to stay away from these places and situations where, experts say, you're most likely to catch Omicron:
    1. Large Gatherings
    2. Indoor Restaurants
    3. Houses of Worship
    4. Airports
    5. Overcrowded Stores

    COVID-19 Omicron Variant Treatment?

    According to WHO, individuals are reminded to take measures to reduce their risk of COVID-19, including proven public health and social measures such as wearing well-fitting masks, hand hygiene, physical distancing, improving ventilation of indoor spaces, avoiding crowded spaces, and getting vaccinated.

    Experimental antiviral pills - such as Pfizer Inc's (PFE.N) Paxlovid and Merck & Co Inc's (MRK.N) molnupiravir - target parts of the virus that are not changed in Omicron. They will work as effectively against the new variant because these drugs do not target the spike protein – they work by stopping the virus from replicating. However, there is a bigger risk that monoclonal antibodies, such as Regeneron’s treatment, could fail or partially fail because they target parts of the virus that will have mutated. 



    HKUMed finds Omicron SARS-CoV-2 can infect faster and better than Delta in human bronchus but with less severe infection in lung (15 Dec 2021)

    One thing that could explain why Omicron is mild is that it has a much harder time replicating in the lower airways (lungs) than the upper airways (trachea and nasal cavity). Meaning, for a virus to fill up lungs with fluid, as the original and Delta COVID strains did, it needs to be able to invade the cells in the lungs by replicating itself. A study from Hong Kong sought to see how Omicron compared to its two viral siblings in that regard:

    Notice that this is LOG SCALE. Each gradation is 10X the last. This shows that Omicron replicates 10 times slower in the lungs.


    Ivermectin and Omicron Variant 

    Since the Omicron variant is newly discovered, there's little evidence to prove whether any treatment is effective against this variant.

    Theoretically, drugs that target parts of the virus that are not changed in Omicron such as antivirals like Molnupiravir and Paxlovid might still work. As mentioned above, they will work as effectively against the new variant because these drugs do not target the spike protein – they work by stopping the virus from replicating. 

    Ivermectin, has multiple mode of actions against the COVID-19 virus in general (not Omicron variant) as listed and explained in this review paper.

    A schematic of the key cellular and biomolecular interactions between Ivermectin, host cell, and SARS-CoV-2 in COVID-19 pathogenesis and prevention of complications.

    According to Dr John Campbell,

    With ivermectin, because it’s working on so many different levels, it is improbable, to put it mildly, that a virus would mutate in a dozen different ways to avoid all those different mechanisms. We’ve talked about six mechanisms today. It’s very unlikely that we get six mutations that could dodge all of those all at the same time.

    Key Takeaways

    As soon as you have symptoms, consult your healthcare provider and start treatment as early as possible. If treatment is delayed i.e. after 5 days of symptoms, your chances of severe COVID are higher.

    For early out-patient treatment protocol, check out FLCCC (Front Line COVID-19 Critical Care) Alliance I-MASK+ Protocol.

    For post-covid or long covid syndrome, check out FLCCC I-Recover Post-COVID ProtocolFor a simplified version of the I-MASK+ protocol, the FLCCC has also developed the I-MASS protocol.


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