As the Omicron blizzard sweeps across the country, so many questions have emerged. My comments here are based on available scientific data and, where indicated, on my clinical experience with the latest surge.
Here are a few key points we can safely say we know about the Omicron variant:
It is Highly Transmissible: Omicron is so highly contagious that no level of vaccination or prior infection will fully prevent transmission. The vaccines and prior bouts of COVID do help people resist serious illness, but their effect begins to wane after 3 months. Vaccine booster shots, despite the very high antibody levels they produce, begin losing their effectiveness after 10 weeks.
The peak of infectivity, as measured by the amount of live virus in nasal swabs, occurs between 3-6 days after the onset of symptoms or the first positive test.
The Omicron variant spreads readily outdoors. It does not require prolonged interpersonal contact, and is less impacted by the wearing of face masks or physical distancing than previous variants. Respiratory droplets can travel as far as 27 feet, and may stay airborne for as long as 15 minutes in still air. The CDC now recommends N95 and KN95 masks as masks of choice. Cloth masks alone are not likely to be effective.
A study from Japan, not yet published, gives evidence—not just opinion—about the infectivity of the Omicron variant. The data show this: the peak of infectivity, as measured by the amount of live virus in nasal swabs, occurs between 3-6 days after the onset of symptoms or the first positive test. Infectivity probably starts before symptoms, as has been true for other variants.
Live viruses persist for 10 days after symptom onset or first positive swab, and then rapidly fall off. The CDC’s recent guidelines recommending just 5 days of quarantine are misguided and not based on this new evidence. Please note this in making personal and family decisions.
Omicron May Manifest Differently Than Older Variants: Sore throat and stuffed nose are the usual symptoms of infection with Omicron in people who have some degree of COVID immunity. People lacking COVID immunity tend to be much sicker. At this time, if you think you have a cold, there is a 50% chance you have COVID-19. Get tested. Rapid antigen tests may yield false negatives, so if you have symptoms, get a PCR test, and repeat it in 48 hours if the test is negative but symptoms persist.
If you test positive, notify anyone and everyone with whom you’ve been in contact. The exposure is likely to have occurred 4-5 days before the onset of symptoms, and you probably became infectious to others within 48-72 hours after exposure.
Omicron May Not be as “Mild” as it Seems: The reported decrease in severity of Omicron compared to previous variants may be due to two factors: (a) Most people in the US already have some degree of protective immunity (from prior infection, vaccines, or both), (b) Omicron grows more readily in the upper respiratory passages and less readily in the lungs, when compared to previous variants.
This growth pattern decreases the likelihood of severe pneumonia. But it may not decrease the likelihood of neurological problems, including the so-called “Long COVID” with its associated cognitive dysfunction. The virus can enter the brain directly from the nose.
At this time, if you think you have a cold, there is a 50% chance you have COVID-19. Get tested.
Anti-Viral Nasal Sprays Appear to Be Somewhat Protective: Heparin-based products do work to prevent viral attachment, but they need to be used regularly and frequently (about every 4 hours) in situations where exposure might occur. This includes living with someone else who is not as careful as you are. I recommend heparin as a nasal spray taken before and after any type of brief encounter with other people, and every 4 hours during longer encounters.
The nasal mucosa is the main portal of entry for the virus into your body. The mucosal cells contain the highest co-concentration of the factors needed for SARS-CoV-2 to enter. The nose acts like an incubator in which the virus multiplies and from which it is inhaled into the lungs. Preventing or limiting viral entry into the nose has the potential to prevent or reduce systemic disease
In July 2020 I designed a nasal spray containing low-dose heparin which is produced by compounding pharmacies. The concentration in this spray is 100 units per spray, which should be more than enough to saturate the virus, even when diluted by nasal secretions. At the low dose used, heparin does not kill the virus; but it prevents viral attachment to the lining of the nose. It is safe, simple, and stable. (Read Preventing COVID With Nasal Sprays).
Monoclonal Antibodies Do Not Work Well for Omicron: Sotrovimab, the only monoclonal with demonstrated effects against Omicron, is limited in its availability. Pfizer’s new anti-viral drug, Paxlovid, which was 89% effective at preventing hospitalization, also has very limited distribution. Paxlovid has a short lifespan in the body, so it is administered with another antiviral called Ritonavir, which interacts with many commonly-prescribed drugs. This makes it unsuitable for many people.
Paxlovid works by inhibiting a coronavirus enzyme called 3CL-protease or the main protease. As I discuss in my free online Coronavirus Guidebook, there are many natural products that inhibit 3CL-protease. Among these are the flavonoid quercetin, and the herbs Andrographis paniculata and Houttuynia cordata. Specific protocols are available from my office and have been updated for 2022.
On our website, you’ll also find a new document called Pandemic Year Three: A Critical Update, that provides a broader context for understanding what comes next as we enter the third year of the COVID pandemic. Contact us at: firstname.lastname@example.org
Leo Galland, MD, is an internist in New York City, specializes in the evaluation and treatment of patients of all ages with complex chronic disorders. He is internationally recognized for developing innovative nutritional therapies to treat autoimmune, inflammatory, allergic, infectious and gastrointestinal disorders and has described his work in numerous scientific articles and textbook chapters.
A graduate of Harvard University and New York University School of Medicine, Dr. Galland is board-certified in internal medicine. He is listed in Leading Physicians of the World and America’s Top Doctors. In 2017, Dr. Galland was awarded the Albert Nelson Marquis Lifetime Achievement Award by Marquis Who’s Who. Dr. Galland is a pioneer in studying the impact of the gut microbiome and intestinal permeability (“leaky gut”) on health and disease. He is the author of several ground-breaking popular books including The Four Pillars of Healing (1997), Power Healing (1998) and The Allergy Solution (2016).