Dealing with Omicron Surge: Baptist Health Experts on Boosters, Testing, Symptoms & More

The Omicron variant, much more transmissible than the previously dominant Delta strain, has yet to peak in South Florida and across the nation, as hospitals treat surging admissions, primarily among unvaccinated patients or those with underlying medical conditions.

Meanwhile, booster shots have proven to help rebuild significant immunity to fend of severe illness from Omicron. But many questions persist as Omicron spreads regarding boosters, COVID-19 testing (both PCR and home-based antigen tests), symptoms and when to isolate or quarantine if you have tested positive or suspect you’ve been exposed. 

“If you did get vaccinated earlier on in the pandemic, and it’s been more than five months since your second vaccine dose, getting a booster raises the level of antibodies that you have that are prepared to fight against the Omicron variant,” explains Samer Fahmy, M.D., chief medical officer at Boca Raton Regional Hospital, part of Baptist Health. “So, if you want to prepare your body the best you can, you should get your booster …”

Dr. Fahmy was part of an expert panel Tuesday on Resource LIVE hosted by Jonathan Fialkow, M.D., deputy medical director and chief of cardiology at Miami Cardiac & Vascular Institute.

Also answering questions were Leo Huynh, D.O., chief of Emergency Medicine at Baptist Health’s Baptist Hospital; and Melanie Rodriguez, PA-C, manager of Urgent Care Express, Outpatient Services at Baptist Health.

Here are some question-and-answer excerpts from the Resource LIVE session, which can be seen in its entirety here:

Boosters vs. Omicron

Dr. Fialkow: So, let’s talk about Omicron and the boosters. What are we learning in the scientific community regarding the boosters’ effectiveness against the Omicron variant?

Dr. Fahmy:

“Obviously, the vaccines that we have were developed against earlier strains of COVID, so they are not perfectly built for Omicron. But that said they are still very effective at preventing severe disease and hospitalization in people that have contracted the Omicron variant. So, yes, they’re not exactly tailored for it, but they’re still very effective and it’s still recommended that you do get vaccinated.

“If you did get vaccinated earlier on in the pandemic, and it’s been more than five months since your second vaccine dose, getting a booster raises the level of antibodies that you have that are prepared to fight against the Omicron variant when you do get exposed to it. So, if you want to prepare your body the best you can, you should get your booster five months out after your last shot.

“And if you are going to choose a booster, I would recommend you choose one of the mRNA vaccines, Pfizer or Moderna are the preferred two. And both of them in lab studies have shown to increase the number of circulating antibodies, and those antibodies are really what we’re looking for. That’s what’s going to help protect you. That’s what’s going to help keep that virus from making copies of itself when you do get exposed to it and it does enter your body.”

Isolation and Quarantine: What’s the Difference

Dr. Fialkow: Can you quickly just tell the difference between isolation and quarantine so when the viewers hear those terms they can figure out which one speaks to them?

Dr. Huynh:
“If you test positive, then we expect you to isolate yourself — and that’s isolating from the general population, as well as even people in your household, as best you can. Quarantining is if you have symptoms and you haven’t tested yet, or your test is pending or you’ve had an exposure. So, you have to wear a mask and try to stay out of the general public until you do get tested. There has been an evolution in the quarantining period from the CDC (Centers for Disease Control and Prevention). So, it’s all based on five days at this point. So, you stay at home for five days if you’re quarantining. And, we do ask if you do have a fever that you extend it so you’re fever free for at least 24 hours. And when you do come off a quarantine, obviously we do expect you to wear a mask for at least five days beyond that.”

Omicron Symptoms

Dr. Fialkow: Are we seeing a difference in symptoms with Omicron, or are we able to draw any conclusions regarding how this viral variant might be, compared to Delta and some of the previous COVID 19 variants?

Dr. Rodriguez:

“With the Omicron variant, we are seeing the symptoms very similar to that of an upper respiratory infection. So … more of like a running nose, a scratchier sore throat, plus or minus a fever. Also, we’re seeing headaches. Some people are having more severe headaches than others. And then varying levels of fatigue. Some people are just feeling absolutely drained and others are just saying they feel kind of crummy, like they know a cold or a flu is coming on. So, data is suggesting that COVID 19 caused by Omicron variant is less severe than prior variants of COVID.”

Where to Get Tested

Dr. Fialkow: Can you speak a little bit about where people with different levels of COVID concern or infection should get tested?

Dr. Rodriguez:
“I do want to remind everybody that Baptist Health, whether it be in the emergency departments, urgent care or urgent care express, we are providing COVID 19 testing for those in need, but there’s a few things that we wanted to touch on. Baptist Health is not a community testing site. If you’re looking for COVID testing for travel or work clearance, or if you’re asymptomatic and maybe you’ve been exposed, what I would first recommend is reaching out to those community testing sites that have been provided to you. They could be a good resource to get tested quickly.

“Now, if you are someone who may be at high risk or someone who does have symptoms, mild or severe, definitely we would want you to seek care from medical professionals and get a full evaluation. So, whenever patients seek care at a Baptist Health facility, they will receive full vitals, an exam by either a PA (physician assistant), nurse practitioner or a physician. And the patient would be triaged in dependence of their severity. So, someone who’s having chest pain and difficulty breathing will be seen sooner than a patient with a sore throat or a fever. So just keep that in mind, please be patient with your healthcare providers because we are working day and night, so hard for our patients because we want to see everybody in a timely manner.”

PCR vs. Antigen Testing

Dr. Fialkow: Let’s talk about the different kind of testing pros and cons, or the abilities and limitations of the different kinds of testing?

Dr. Huynh:
“We have evolved throughout this pandemic and now testing is readily available. And there’s always a question on which is the best test and how I should be tested. So, antigen tests are readily available at the community testing sites and even over the counter at your local pharmacy. It actually acts as a very good screening tool; it’s a very good test, pretty accurate, and a very quick turnaround time. So very good for the population to understand if they’re positive or negative. PCR (available at community testing sites) is our most accurate test. It may take a little bit longer.

“And the question is: Do I need to get a confirmatory PCR test if I’m a positive antigen? Typically, the answer is a no. Again, just look at the entire picture. If you have a cough, you have a fever, you have a sore throat, you have the symptoms of COVID and you test positive, then don’t get too caught up in testing. But, certainly, antigen testing (available as home-based tests) is a great tool for the entire population, readily available and really helps us determine our quarantine guidelines.”

Accuracy of Home-based Antigen Tests

Dr. Fialkow: So how accurate all these home tests for both positive and negative test results?

Dr. Fahmy:
“These home tests are a really good resource for patients to have, but they should be used correctly and used in the right scenario. If you don’t have any symptoms at all, and screening yourselves because you’ve had some sort of exposure, they may have some false negative results. They may give you a negative result when you are in the beginning stages of catching COVID, and you just haven’t made enough copies yet for it to detect it.

“The best time to use the antigen test is if you have symptoms — that’s what makes them the most accurate. If you have a sore throat, if you have a cough and you swab, that cough is probably because there’s virus there and the antigen test is built to detect a certain protein on top of that virus. So, it should detect it. If you did have a high-risk exposure and you have access to home tests, one of the methods that we’ve recommended is serial testing, which makes it more accurate. Serial testing means let’s test yourself once a day or once every other day for a few days.”