Baptist Health Experts: Omicron, Delta, Boosters and the Foreseeable Path of COVID-19

The Omicron variant of COVID-19 is raising new concerns, particularly because it seems to be more transmissible than the currently dominant Delta variant. But Baptist Health experts reaffirm that being fully vaccinated — and getting a booster, or third shot — will offer the best protection.

“As the pandemic nears the two-year mark, there are more available options to combating COVID-19. Vaccines, rapid COVID tests, COVID pills, and booster shots — all give people the chance to get back to normal,” said Jonathan Fialkow, M.D., deputy medical director and chief of cardiology at Miami Cardiac & Vascular Institute, to open this week’s Baptist HealthTalk podcast segment.

Joining Dr. Fialkow on the panel of experts: Madeline Camejo, M.S., Pharm.D., chief pharmacy officer and vice president of pharmacy services for Baptist Health South Florida; and Samer Fahmy, M.D., chief medical officer at Boca Raton Regional Hospital. 

Both experts are confident, as are researchers and scientists worldwide, that Omicron is more contagious. So far, most cases seem to involve mild symptoms, but it’s too early to tell for certain, they say.

“We’re suspecting that it (Omicron) may be a bit less severe than Delta or the original strain, although that’s not yet confirmed; we’re waiting to find out,” said Dr. Fahmy. “But even if that suspicion turns out true — because you have so many more people infected — the concern is still there that the weight that it puts on our healthcare system, in terms of number of hospitalizations and number of people needing treatment, will still be quite high, as it spreads even further through December, January, and February.”

With vaccinations gearing up to fight Omicron and other potential variants and treatments to avoid hospitalizations in development, there is much that is positive for 2022, the experts say, but everyone has to remain on their guard because COVID-19 isn’t going away any time soon.

“We’re going to continue to have hotspots throughout the United States,” said Dr. Camejo. “There’s going to be more and more treatment options to be given to us for next year with the new monoclonal antibodies coming out to help with the Omicron variant, and being able to give longer protection. And I think there will be more treatments and testing available for the home, which will help de-stress the healthcare facilities. But we have to continue to be on our guard … so that we can get somewhere to normalcy. But I think we’re going to see this around for a while.”

Here are question-and-answer excerpts from the Baptist HealthTalk podcast, which can be heard in its entirety here: can be heard in its entirety here:

Dr. Fialkow: The big buzz going on right now is about Omicron variant, and I know we’re still learning a lot … but what do we know about the Omicron variant?

Dr. Fahmy:
“Right. So, as you said, Omicron is what’s on everybody’s mind when we’re talking about COVID these days, and that’s a change because the Delta variant has been the predominant strain and continuous to be the predominant strain in the United States — up until now. But the latest data shows that Omicron is a little less than 5 percent of what’s circulating in the US at this point.

“What’s concerning about it is that it’s significantly more contagious than any previous variants of COVID that we’ve seen before. And what that means is experiences like they’re having in London and the U.K., they’re doubling the percent of Omicron in a two- to three-day range, which is much faster in terms of doubling, than what we’ve experienced even with the rapidly transmissible Delta variant.

Dr. Fialkow: So, Omicron is more transmissible than Delta?

Dr. Fahmy:
“That’s right. It is the most contagious and most transmissible variant we have seen to date. And I think that’s the biggest concern with it. Part of what makes Omicron concerning is the fact that it has 126 mutations versus the original strain of COVID. And why that concerns scientists and physicians around the world is because that may make it more difficult to treat. So, treatments like Regeneron and monoclonal antibodies that we use — the medications that we give to prevent hospitalizations worked well with Delta, and worked well with the original strain.

“But, unfortunately, with Omicron, we’re suspicious that it will not work. In fact, I think we’re fairly confident that it will not work and we have to switch to other synthetic antibodies to be able to treat it. Vaccination will still be effective, but not quite as effective against Omicron as it was against other strains.”

Dr. Fialkow: What do we know about the efficacy of the booster shots and who’s eligible to receive a booster shot based on CDC guidelines?

Dr. Camejo:
“Talking about the concerns of Omicron, the studies do show that the booster shot does generate a higher level of neutralizing antibodies. And they found that because Omicron reduces the efficacy of the two-dose COVID vaccine, that the booster shot can restore significant levels of protection. So, that third shot really increases (antibody) titers by 25 percent. And as companies are really looking to … more precision medicine, especially with the two mRNA companies, they can switch quickly to try to create vaccines that are specific to Omicron — but that’s not going to happen until probably early next year.

“Everybody’s still monitoring and looking to see how they can adapt to further increased levels of protection and duration. But for sure, if you’ve got the Johnson & Johnson vaccine, which a lot of people did, which it was just that one shot vaccine, we recommend that you do go out and get either a Pfizer or a Moderna booster to get protection. You will no longer be protected with the one shot, especially with what’s happening in our community. And today, everyone 16 years and older is eligible for the booster shot.

Dr. Fialkow: If someone received the first two vaccinations with one company, should they get the booster with the same company’s mRNA vaccine (Pfizer-BioNTech or Moderna)?

Dr. Camejo:
“The CDC is allowing for mix and match dosing to booster shots. It’s all going to depend on where you’re going to get your booster. Right now, for example, if you go to a CVS, it only pretty much has Pfizer available in the majority of their stores, whereas Walmart only has Moderna. You want to try to stick to the same, but the CDC really says it doesn’t matter. The issue is: Get your booster.”