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q and a: infectious disease expert on severity, transmissibility of covid-19 omicron variant

cases of the covid-19 omicron variant of concern have b...

stephanie smith, professor, department of medicine division of infectious diseases, poses for a photo at the mazankowski heart institute in edmonton, on tuesday, jan. 26, 2021. dr. smith studies covid-19 and its u.k. and south african variants. photo by ian kucerak ian kucerak / postmedia
cases of the covid-19 omicron variant of concern have been soaring in recent days in alberta.
as we learn more about the latest variant, postmedia spoke with infectious disease expert dr. stephanie smith, director of infection prevention at the university of alberta, about what is currently known about the variant, its severity, transmissibility and what we can expect with future cases.
this interview has been edited for length and clarity.

what do we currently know about omicron?

we’ve now seen a couple of studies that have been published from the united kingdom and from south africa that gives us a bit more data about the severity. there’s increased transmissibility, but this issue of severity has been kind of the unknown. the data from the u.k. and south africa would suggest that it’s slightly less severe compared to delta, so we’re seeing fewer hospitalizations compared to delta.
i think that there’s probably a combination of reasons for that. one is related to the variant itself and it being potentially less severe because it tends not to replicate as much in the lower part of the lungs and so it doesn’t cause as much damage there. but also because we have much more fully vaccinated population, and that is protective against severe disease to a certain extent. so i think those are encouraging signs. i think we still obviously don’t have all the information in terms of what we can expect here in canada.

what makes omicron more transmissible?

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the issue of more viral replication in the upper airways, leading to potentially more aerosolization and therefore greater transmission, especially in the early part of disease, may be contributing to that. then there’s the issue of some immune evasion. so even though you may have two doses of vaccine, and that does help to protect you against severe disease, it doesn’t provide as much protection against getting infection. that combination of the increased ability to transmit plus the immune evasion is resulting in these incredibly rapid rises in cases. i look everyday at our statistics and our doubling rate is really quite astounding.

the predictions are that there’s a doubling rate of about every three days, and we do seem to be fairly close to that. with the statistics that we have, if we predict to the beginning of january, we could potentially be seeing upwards of 10,000 to 12,000 cases a day.

how else does omicron differ from delta?

there is also some indication that the symptoms are a little bit different and that the hallmarks that we’ve seen in the past, the lack of smell and taste don’t seem to be as prominent. it does seem to present more like a typical cold, so stuffy nose, sore throat, body aches and that kind of thing. it can make it even more difficult in some ways to distinguish from other respiratory viruses.

what could the wave of omicron look like?

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when we look at somewhere like south africa, they had an incredibly rapid rise of cases, but now they’re actually already seeing a decline. and the u.k. also appears to be nearing their peak. there is the possibility that we could see this incredibly rapid rise, but then just as rapid decrease. it’s still kind of early days and so difficult to predict.
the challenge is that right now we’re seeing this incredibly steep rise in cases, the vast majority are in younger people and we’re seeing fairly mild disease. so we really haven’t seen a huge spike in hospitalizations and we wouldn’t expect to for probably another week or two. i think that’s what we’re all bracing for.

how can albertans best protect themselves against the virus?

there has been some data to suggest that a single-ply cloth mask is not going to be as effective as a multi-layered medical mask and the fit is important. masking is important, but also reducing the number of people that you’re having contact with. and then vaccination, obviously, is incredibly important, as well as being cognizant of your symptoms and getting tested if you do have them.

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