Frequently Asked Questions about COVID-19 — December 29, 2021

  “Shared expectations lead to predictability.”

436. Take-home rapid tests (if you can find one) are helpful this year.

         QDo I have to wait days to get the results of a Covid-19 test?

         A:  To meet increasing demand, at-home antigen tests are available.  These rapid tests can be hard to find as manufacturers are still ramping up their production capability.  But the ability to do this test on a while-you-wait basis is something new.  A handful of rapid antigen tests are available without a prescription, including the Abbott BinaxNOW, and the Quidel QuickVue At-Home Civiid-19 Test.  Prices start at about $7.00 per test, although President Biden has announced plans to reduce prices by roughly one-third.

These tests detect small viral proteins, called antigens. The tests require rubbing a shallow nasal swab inside your nostrils and then exposing the swab to a few drops of chemicals. They provide results in about 15 minutes.  The other type of test is a polymerase chain reaction (PCR) test, which has typically been considered the gold standard for detecting the virus.  Samples are typically evaluated at a laboratory and involve making many copies of the virus’s genetic material. That process helps PCR tests to detect even minute traces of the virus.  However, the results can take days or even weeks to be available.

Rapid antigen tests, which do not amplify the virus, are less sensitive than PCR. tests. If you take one during the earliest phase of infection, before the virus has replicated widely, the test could return a false negative.  Some of the at-home rapid antigen tests have an overall sensitivity of roughly 85 percent, which means that they are catching roughly 85 percent of people who are infected with the virus and missing 15 percent.  These tests are more sensitive in people with symptoms than without.  Antigen tests are excellent at flagging people who have high viral loads — and who are thus most likely to be actively transmitting the virus to others and in need of medical care, experts say.

437. Many of the world’s vaccines have little effect on preventing Omicron infections.

         Q: Are other countries more effective in controlling Covid-19 than we are?

         A:  Vaccines have two measures of success.  They first prevent the person from being infected with a disease, and they secondarily prevent serious disease and death in those who do become infected.  Initially, the goal was to eliminate the Covid-19 disease, much as had been done with smallpox.  Months ago, as all Covid-19 vaccines have been discovered to wane in their strength over time, and as new mutations have occurred, it was recognized that we’ll always be living with this disease and that we need to reduce Covid-19’s virulence or ability to cause serious illness.  Data has been collected around the world to study the effectiveness of vaccines against both of these goals.  These conclusions were recently published in The New York Times by reporter Stephanie Nolen.  The AstraZeneca’s vaccine, given in Brazil, like many other viral vector vaccines, is showing early indications that it does not prevent infections by Omicron.   A growing body of preliminary research suggests the Covid vaccines used in most of the world provide almost no defense against becoming infected by the highly contagious Omicron variant.  However, all vaccines still seem to provide a significant degree of protection against serious illness from Omicron, which is the most crucial goal.  Only the Pfizer and Moderna shots, when reinforced by a booster, appear to have initial success at stopping the Omicron infections, and these vaccines are unavailable in most of the world.

The other shots — including those from AstraZeneca, Johnson & Johnson, and vaccines manufactured in China and Russia — do little to nothing to stop the spread of Omicron. And because most countries have built their inoculation programs around these vaccines, the gap could have a profound impact on the course of the pandemic.  The need is increasing to find acceptable scientific technology to reduce the risks from an ever-expanding pandemic.

438.  New therapeutics have been granted Emergency Use Authorization by the FDA.

         Q:   I heard that two new drugs have been approved for treating Covid-19.  Is this true?

         A:  Yes!  The Food and Drug Administration has authorized the Pfizer Paxlovid and Merck’s Molnupiravir, the first two treatments for Covid-19 in pill form.  They can be taken at home with a doctor’s prescription and will be available to some Covid patients who are at higher risk of becoming severely ill.  Initial supplies have already been shipped and limited quantities are immediately available.

 439. Omicron may double the risk of getting infected on planes.

          Q:  Airplanes were once judged to be quite safe from airborne infections.  But now?

          A. Aircraft passengers are twice or even three times more likely to catch Covid-19 during a flight since the emergence of the Omicron variant”, according to David Powell, MD, the top medical adviser to the world’s airlines.  The new strain is highly transmissible and has become dominant in a matter of weeks, accounting for more than 70% of all new cases in the U.S. alone. While hospital-grade air filters on modern passenger jets make the risk of infection much lower in a plane than in crowded places on the ground such as airports and shopping malls, Omicron is rapidly spreading just as more travelers take to the skies for year-end holidays and family reunions. “Business class may be safer than more densely packed economy cabins”, said David Powell MD, physician and medical adviser to the International Air Transport Association, which represents almost 300 carriers worldwide. As before, passengers should avoid face-to-face contact and surfaces that are frequently touched.  People sitting near each other should try not to be unmasked at the same time during meals, he said.

Powell, former chief medical officer at Air New Zealand Ltd., spoke with Bloomberg News last Tuesday about flying during the pandemic. Here’s some of his advice to reduce risk:

  • Be fully vaccinated and boosted.
  • Aircraft in flight have outside air coming through the cabin giving great protection.
  • When in airports and congested boarding and deplaning, keep social distancing.
  • Because of airflow in the cabin, leaving the middle seat vacant has little value.
  • If it makes you feel safer, open your overhead air vent to circulate air around you.
  • Much about the risk to children on planes is unknown. Wearing masks will help.

 440. More information is being revealed about the Omicron variant.

         Q:  If we get exposed to Omicron, will monoclonal antibodies help us get cured?

         A:  From what we are learning, no!  Amelia Nierenberg, a writer for The New York Times published an article last week.  “Omicron seems able to evade some monoclonal antibodies, which have been used to treat severe Covid cases. At least one major New York City hospital has stopped prescribing some of the drugs because they no longer appear to work against the new variant.” She wrote.  GlaxoSmithKline has reported that its formulation, called sotrovimab, will probably remain effective. Medications that rein in dangerous inflammation, such as dexamethasone, will also work.”  She also stated the Associated Press had reported that this Omicron variant accounted for 73% of new infections in the U.S.  The only vaccines that appear to be effective against catching the Omicron variant in the first place are the mRNA products manufactured by Pfizer and Moderna and reinforced by a booster.  Moderna has just released laboratory data showing that its booster shot significantly raises the level of antibodies against Omicron.

To be sure, there have been numerous reports of breakthrough Omicron infections for people who have been fully vaccinated, and even boosted. But the early evidence suggests that infection is much less likely if you are fully vaccinated and boosted with Moderna or Pfizer.  The vaccines from AstraZeneca and Johnson & Johnson, and those manufactured in China and Russia, will probably not protect against Omicron infections. But they will likely prevent those who are infected from getting seriously ill.