How Nervous Should We Be About Omicron? Advice From Boston Doctors

How worried should we be about the new omicron COVID-19 variant? And are its symptoms any worse than previous strains?

Even as the first handful of cases have now been identified in the United States, there are still a lot of questions about the variant.

NBC10 Boston asked three top Boston doctors on Tuesday to answer some key remaining questions about the omicron variant in the weekly "COVID Q&A" series.

"There are a lot more questions than answers right now," said Dr. David Hamer, an infectious disease specialist at Boston Medical Center.

How worried should we be about the omicron variant?

"I think we should be watchful, but not nervous," said Dr. Daniel Kuritzkes, Brigham and Women's Hospital's chief of infectious disease. "President Biden said 'This is cause for concern, but not for panic,' which I agree with. There's every reason to think that getting vaccinated and taking simple public health measures like continuing to wear a mask when in crowded situations indoors are going to be highly protective."

"The majority of people were able to protect themselves from COVID when there was no vaccine. It just required some self discipline to do so," he added. "There's no reason that can't be the case again."

"If we do see a further rise in cases and there was a shift toward more transmissability because of this variant, the measures Dr. Kuritzkes described -- indoor mask use in public places, being really cautious with contacts, trying to minimize places being in contact -- those measures can greatly reduce the risk of becoming infected," Hamer said.

"This isn't going to render the vaccines completely ineffective," said Dr. Shira Doron, the hospital epidemiologist at Tufts Medical Center. "And even if it did -- which it won't -- we have so many other tools now in the toolshed. We have oral agents coming soon, we have the monoclonal antibodies and we know how to support people who end up in the hospitals. We will not go back to square one."

What are the symptoms of the omicron COVID variant?

All three doctors said they don't expect symptoms from the omicron variant to differ much from the other strains.

But they also said it's too soon to know for sure.

"I'm not sure there are any major changes in sort of the array of symptoms associated with these viruses," Hamer said. "One of the changes is if you become vaccinated and get a breakthrough case, you're much more likely to have milder symptoms."

Those include upper respiratory issues, nasal congestion, runny nose, sore throat and some headache, fatigue, muscle aches and possibly fever.

"So far, from what I've been reading, it's really hard to say there's more loss of sense of smell with this strain or more cough with another. I don't think there's a variant specificity to the array of symptoms," Hamer added.

"I completely agree," Kuritzkes said. "We're really looking at issues around the frequency with which symptoms are caused and potentially having more or less severe symptoms, but the range of symptoms are going to be the same. All these variants nevertheless remain SARS-COV-2. They still cause the same illness by the same mechanism. So we're not going to start seeing appendicitis popping up as a possible complication because you've got the omicron variant instead of the delta variant."

Doron said she expects to see a lot of speculation about different symptoms and whether they are more or less severe as the variant spreads. But most of that will be anecdotal.

"That's what we've seen with other variants," she said. "Ultimately, when the larger studies are done and the variants have been compared to each other, there have been no differences, and I expect that to continue to be the case. But we'll see."

Will omicron overtake delta as the dominant strain in the US?

Kuritzkes said it's far too early to tell if omicron will overtake the delta variant as the predominant variant in the U.S.

"I think we'll have data about neutralizability in a week or so," he said. "It's going to take longer to get a sense of its transmissability. It requires a larger survey to understand how does omicron compete with delta. It will take a large number of cases to know if this is a more dangerous virus in terms of the ability to cause severe disease compared to the other variants. Even with alpha, that took months to be settled."

"These more epidemiologic data take weeks or months to gather and to be able to really get a clear picture," agreed Hamer. "The lab work on neutralization with antibodies against the vaccine with a strain can be done quickly. That's going to be very important. But that alone isn't sufficient to give us a feel for how much of a problem this omicron's going to be."

When will COVID stop mutating?

COVID-19 is going to continue mutating as long as it is widespread, Doron said.

And that's why vaccination remains so important.

"If we could really drive up vaccinations and drive cases down to a point where they were at a very low level, lower levels of cases means less infection means less mutation," Doron explained. "But if we can't get there, we will continue to see new variants."

"The reality is setting in a little bit. We probably need to learn how to live with this virus," she said. " This may be what it continues to do for a very long time. Vaccination is what changes the game. It is extremely powerful in reducing the risk of infection, but more importantly your risk of severe complications from infection."