Omicron Expected to Produce 'Explosion' of COVID-19 Cases, Though Less Severe than Delta

Sarasota, FL (WorkersCompensation.com) – COVID-19 cases are expected to spike in the coming weeks, as people head indoors to escape the cold weather. That, combined with traveling and get-togethers during the holidays could be a recipe for disaster in some companies. Testing employees before they return to the office following holiday festivities is one of the best ways employers can protect their organizations, according to a medical expert.

“It’s going to buy you a ton of secondary exposure and prevention,” said Scott Cherry, DO, chief Medical Officer for Axiom Medical. “You can go down a path of medical surveillance testing ongoing, but that one time test buys you a lot.”

During a recent webinar Cherry discussed expectations due to the emergence of the Omicron variant and the difficult decisions businesses are making. He also offered strategies for organizations trying to protect their companies while continuing to operate in the face of skepticism, fear and complacency among their workers.

Omicron

To gain insight into how Omicron may impact the U.S. researchers are looking to South Africa, which has become the epicenter for the new variant. What’s most notable is the transmissibility of the variant.

“We predicted a spike for winter independent of Omicron,” Cherry said. “With Omicron, I think we are going to see almost an explosion of cases over the next four-to-eight weeks.”

Scientists use the ‘reproductive number’ to determine the transmissibility of infection. Herd immunity, where enough people have been infected so the virus would not proliferate, would have a reproductive number of less than one – meaning each person affected would infect less than one person. The reproductive number for the Delta variant is at least two, meaning each infected person transmits the virus to at least two others. Early estimates for the Omicron variant put its reproductive number at four.

One study done in a laboratory showed the Omicron variant’s ability to reproduce in upper respiratory cells was about 70 times as fast as the Delta variant. “It’s gives us insight into why South Africa, in a matter of weeks, was overtaken by the Omicron variant.”

One positive note about Omicron, at least so far, is that the severity is much lower than the Delta variant. Within South Africa, for example, the death rate of COVID-19 for the Omicron variant is 1/10^th that seen with the Delta variant.

“This is great news if this continues on in that trend,” Cherry said. “However, because of such high numbers of cases, I do worry about implications about population health, especially critical infrastructure and other industries that really need their employees to be at work, whether on the front lines serving the public, or emergency response. I think because of high transmission that’s going to be, what I’d call a severity factor.”

People who’ve contracted the Omicron variant of COVID-19 generally do not have some of the typical symptoms from other mutations. Shortness of breath, for example, is not a common symptom associated with Omicron, along with other symptoms typical of upper respiratory infections, such as coughing and sneezing. Instead, body aches, fatigue and malaise are more common.

That makes it even more difficult to determine the specifics of Omicron. “Before Omicron, the coughing, sneezing were the primary mechanisms that made people most contagious because they correlate with a high viral load,” Cherry said. “It’s to be determined with Omicron because those symptoms are not there but the infectiousness is really off the chart.”

The lower severity risk associated with the Omicron variant should not make employers lax about their protocols, Cherry said. He cautioned that even though the Omicron variant has a much lower rate of associated hospitalizations and deaths, the sheer number of cases expected may still produce high totals of severe cases.

Strategies for Employers

The OSHA Emergency Temporary Standard is back on the books, following an appeals court’s Dec. 18 decision to lift the stay that had temporarily blocked implementation. A number of lawsuits seek to permanently prohibit the ETS. However, experts advise employers to prepare in the meantime.

Along with the concerns about enforcement of the ETS, many employers are also now focused on protecting their workforces in the face of the highly transmissible Omicron variant. Cherry advises employers to take a multi-layered approach, especially since the Omicron variant seems to be able to evade the protections offered by vaccines and booster shots.

“Sadly, Omicron is fairly evasive to antibodies against COVID,” he said. “That’s why there is this huge transmission rate.”

While a full dose of the three available vaccines have provided protection from the virus of an estimated 80 – 90 percent, that drops to just 30 percent against the Omicron variant. When a booster shot is included, the protection rate is roughly 70 percent.

“Say you have a fully vaccinated and boosted population; you have about 70 percent coverage,” Cherry said. “With 100,000 employees, 30,000 would still be at risk of getting the infection. That helps business leaders decide how to move forward, putting the emphasis on vaccines or other layers of a multi-layered approach.”

What that means for each particular business depends on a variety of factors. Testing, mask wearing, hand hygiene, isolation/contact tracing, daily attestations of health, personal protective equipment, contagious respiratory illness assessment and environmental cleaning and safety controls are among the other strategies that should be considered.

“It’s going to be a mix of several inputs; the medical science, the clinical practice, the availability of vaccines, the effectiveness of vaccines, but also it’s a political discussion and compromise,” Cherry said. “This can be fairly contentious, but the ideas and potential suggestions are not unreasonable.”

Cherry’s biggest piece of advice is to screen employees for symptoms of illness. While not all workers can afford to stay home if they are sick, employers should make every effort possible to enable that.

 “It’s absolutely critical because you don’t want someone sick coming into the workplace,” he said. “Monitor yourself and your workplace for symptoms. Do not come into work if you are sick if you are in a job that has paid time off or short-term disability. We’d at least like to see it in those realms because I don’t think we’re seeing that.”

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