How Omicron is changing the COVID-19 rules

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With the Omicron COVID-19 variant sweeping across New York City — and dampening holiday plans — it’s presenting an entirely new set of questions about vaccinations, quarantining, symptoms and testing.

“We are seeing positivity rates go up across New York,” said Dr. Daniel Baker, medical director of Lenox Hill Hospital. “And that is partly due to the fact that everyone is getting tested. But let’s not forget that also means the disease is there.”

According to Baker, most available data is not yet based on the Omicron variant, so much of the newer information floating around is anecdotal.

“What we are seeing in South Africa and in the UK is that this variant is exceptionally transmissible and good at breakthrough infections,” said Baker. But he said that the current CDC guidelines for quarantining and exposure haven’t changed.

Risky symptoms on seminar between business people. A businessman sneezing and coughing in the boardroom while his colleagues with face masks defending themselves from coronavirus.
Risky symptoms on seminar between business people. A businessman sneezing and coughing in the boardroom while his colleagues with face masks defending themselves from coronavirus.
Shutterstock / Dusan Petkovic; NY Post illustration

“Our data is so limited with Omicron. So while we should not yet rewrite our playbook, it is time to rethink some of it.”

Here, Baker answers some pressing questions and sheds light on what we know so far about the new variant.

A potentially briefer quarantine

Baker said experts are now reassessing whether vaccinated people who are infected need to be isolated for 10 full days. “There is data coming out that said vaccinated people have the same viral load in the early stages, which is why they can still transmit the disease. [But] it seems that they clear the viral load quicker than unvaccinated people,” said Baker. While there isn’t a definitive conclusion yet, Baker said to cut isolation time from 10 to five days, people would still need two negative COVID-19 tests.

You should still test if you’re asymptomatic and vaccinated

When available and accessible, get tested for covid-19
When available and accessible, get tested for COVID-19.
MediaNews Group via Getty Images

In a perfect world, we would be testing as a community. “If we all did surveillance testing, that would help us understand how far and wide COVID has spread,” Baker said. But long lines at testing sites and scarcely available at-home tests has made that a lofty goal. So what should one do if they are vaccinated and have come in contact with an infected person?

“If you are asymptomatic and vaccinated, I would still recommend testing three days” after being exposed, said Baker.

If you test positive, notify anyone you’ve been in contact with over the past 5 days

If you test positive, tell anyone you potentially exposed over the previous five days
If you test positive, tell anyone you potentially exposed over the previous five days.
Bloomberg via Getty Images

You may have heard that Omicron produces symptoms more quickly than the older variants, but Baker says such information is still anecdotal. After a positive test, you should still notify people you’ve been in contact with over the past five days — a more “conservative” approach that’s been “done with previous variants,” Baker said.

“If studies show Omicron comes on and clears quicker, we can change that,” said Baker, adding that he recently dined with a fully vaccinated and boosted friend who tested positive for COVID-19. “Rightfully so, she called me and we talked it through. We all got tested and luckily I was negative. That would be assuming she even had it when she came to dinner. But let’s be honest and have that conversation with each other.”

Test before travel — even if you’re boosted

Don't cancel travels, but be cautious by testing and following mask mandates
Don’t cancel travels, but be cautious by testing and following mask mandates.
REUTERS

Since the start of the pandemic, a key message has been to wear masks and practice social distancing to protect neighbors and family members who are most at risk. The latest moral dilemma? Holiday travel that might take Omicron out of the city and spread it wider.

“I am not saying don’t travel,” Baker said. “But vaccinated and boosted individuals still need to be diligent. Try to test before you go and be very cautious while traveling.”

The current wave may not be as deadly due to growing immunity

“Yes, hospitalizations will go up, but I don’t think it will go up to levels seen in previous waves,” said Baker, adding it is not a fait accompli that everyone will get it. One of his big concerns is that health care workers will be forced to quarantine due to Omicron infection, leading to a strain on the hospital system.

As of this morning, Northwell Health, which has 22 hospitals across New York City, Long Island and Westchester, is treating 446 patients, as opposed to nearly 1,000 patients this time last year.

“What we will see moving forward is there will be an increasing population of those with immunity,” said Baker, whether that’s from vaccination, a previous COVID infection or a mix of both. “I am hoping this population helps us get to a point where it could relieve future concern” about COVID.

What to do if you simply can’t get a test

Even Santa and his elves can't deliver at home covid tests this year.
Even Santa and his elves can’t deliver at-home COVID-19 tests this year.
EPA

When all else fails and you’ve been exposed and can’t get a test, Baker said to fall back on conventional COVID wisdom.

“You have to monitor yourself and recognize that minor symptoms you would attribute to colds could very well be symptoms of COVID in boosted individuals,” he said. “Wear masks indoors where there is a mandate and curtail some of your social activities within the first three to five days of the exposure.”

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