“All those who want to live should get vaccinated.” Is it enough to protect yourself from the Omicron?

Proven content

– Suppose you are sitting on the roof and throwing stones at passers-by. Sometimes you hit someone, sometimes you don’t. This is our “classic COVID-19”. Now, imagine that there are half as many passersby, but you are throwing handfuls of stones. This, in a very simplified manner, illustrates what the less virulence, but the increased infectivity of the Omikron variant is all about – we talk with virologist Emilia Skirmuntt and Dr. Maciej Zatoński, MD, about the “worrisome variant”.

1. Experts admit that Omikron shows similar symptoms to the previous variants so far. – In fully vaccinated people, less typical symptoms of infection may appear more often, mainly from the gastrointestinal tract – says Dr. Zatoński
2. They also reassure that vaccines offer protection against severe disease, but are less effective against Omikron infection.
3. Experts say what could help contain the pandemic
4. You can find more about the coronavirus on the TvoiLokony home page

Zuzanna Opolska, Medonet: “It is more contagious than the previous variants”, “it causes a milder form of COVID-19”, “eludes antigen tests” – what about Omikron is true?

Dr. Emilia Skirmuntt, virologist: It’s definitely more contagious. Does it cause a milder form of COVID-19? I think it is too early for a definite answer. Initial cell line and animal studies show that yes, but if we look at the symptoms of an Omicron infection, it resembles a Delta infection. In contrast, antigen tests still detect the Omikron variant only at the onset of the disease with reduced sensitivity. And while at the very beginning they may not show a positive result, a few hours later they do.

Maciej Zatoński, MD, PhD, ENT doctor: I think we need to clarify something else. There is a difference between the clinical symptoms that in the case of Omikron infection are comparable to the symptoms of infection with other variants, from what percentage of infected people will have full-blown COVID-19. The severe course of infection with the Omikron variant will have the same consequences for us as individuals as in the case of other variants. We cannot always directly translate the indicators observed at the population level into what the effects of the disease will be for us as patients.

Are the symptoms of Omikron infection really similar to the symptoms of Alpha or Delta infection? There is talk of a scratchy throat, extreme fatigue, a much less common loss of smell and taste …

Emilia SkirmuntA: Some studies show that the loss of smell and taste may not be there, but again we’re talking about preliminary analyzes. Anyway, let’s remember that the loss of taste and smell did not appear in all those infected with the previous variants. It concerned about 1/3 of cases.

Maciej Zatoński: To simplify it, we can say that in animal models we observe a lower affinity of the Omikron variant for lung tissue. However, in humans it is difficult to say – the symptoms are in most cases comparable. Preliminary data show that fully vaccinated individuals may experience less typical symptoms of infection, mainly from the gastrointestinal tract, such as nausea, vomiting, and diarrhea.

1. See also: I had contact with a person infected with Omikron. What’s next? [WE EXPLAIN]

Time for a question that is bothering everyone – to what extent do vaccinations protect us against Omicrons?

Emilia SkirmuntWe know that this is a variant that can escape our immune response after contracting COVID-19 and vaccination. Six months after vaccination with the second dose of Pfizer, protection against Omikron infection drops to approx. 30%, in the case of Moderna to approx. 40%, while in the case of AstraZeneka and J&J it is practically non-existent. However, heavy mileage protection still exists.

I have the impression that people unnecessarily “fix” on antibodies, which after each vaccination for each disease drop at some point. In fact, antibodies are the first line of defense, but our immune system doesn’t stop there. We also have B and T lymphocytes that protect us from the severe course of COVID-19.

Maciej Zatoński: We rarely say that in the case of COVID-19, the correlation of protection, i.e. the relationship between the presence of antibodies and protection against infection, is not fully defined.

The rest of the conversation is under the video.

It’s interesting – I have friends who check their antibody levels regularly …

Maciej Zatoński: I think you can better “invest” your money.

Emilia Skirmunt: Especially as for COVID-19 there is no standardized antibody test. Each laboratory performs tests differently, applies different standards, and there is no point in comparing the test results with each other.

If I understand correctly, then considering that Omikron is more contagious than its predecessors, what we fear most is paralysis of health care and an increase in health debt, especially in countries such as Poland?

Maciej Zatoński: I will explain the risks associated with the Omicron pictorially. Suppose you are sitting on a roof and throwing stones at passers-by. Sometimes you hit someone, sometimes you don’t. Hitting means getting seriously ill. This is our “classic COVID-19”. Now, imagine that there are half as many passers-by (fewer people have a chance to become seriously ill), but you throw stones faster and by handfuls (this is the equivalent of greater contagiousness). This is the firepower of Omikron – if the number of infections is growing rapidly, even though a smaller percentage of people have full-blown or severe COVID-19, we still have to take into account more patients who need help in hospitals. This is the direct impact of pathogens with greater infectivity on the course of the pandemic.

Indirect effects are an additional problem, including health debt that is a harvest of “clogged” hospitals, lack of staff, delays in diagnosis and treatment of noncovid patients. According to all available data, the number of excess deaths in Poland in the last two years is the highest in Europe. Such an excess has not yet been recorded since World War II.

1. See also: 100 COVID-19 victims in Poland. “There is one way to save people”

Isn’t the lack of restrictions on New Year’s Eve, that is, as we heard “the imposition of standards in a civilized manner”, a sign of irresponsibility?

Emilia Skirmunt: It is difficult for us to comment on politics.

So what restrictions do you think is a “must” for today? Italy has returned to the obligatory wearing of masks in the open air …

Emilia Skirmunt: Perhaps at mass open events it makes sense. We know that one of the main ways to break the viral transmission chain is to limit social contact, so more and more countries are introducing or lowering occupancy limits. The problem is that stringent restrictions cannot be imposed indefinitely. Because people stop listening.

So maybe a “stick” for the unvaccinated, about whom Emmanuel Macron says “they are not citizens, they are irresponsible people”, and Karl Nehammer locks them up at home?

Emilia SkirmuntA: These are tough decisions that need to be considered case by case. What can work in France or Austria, will not necessarily work in Poland.

In that case, let’s stop for a moment on the example of Israel, which is considering lifting the restrictions and introducing the Swedish model to achieve herd immunity – can it succeed?

Emilia Skirmunt: At the very beginning of the pandemic, the “Swedish experiment” did not exist, as Sweden itself became acutely aware of. Today, however, we are in a different place – we know much more about the pathogen itself, we have vaccines, we have drugs and we cannot close ourselves indefinitely. Israel, which had very hard lockdowns, is trying to lift the restrictions politically. It is risky, but it can work … We are talking about a country that is a world leader in the implantation of society. And the first country to start administering the fourth dose of the COVID-19 vaccine, which is not a scientifically backed solution.

Maciej ZatońskiA: As Emilia said, Israel has a very large number of vaccinated populations, plus a relatively low number of covid deaths and a very good healthcare system – so is at a point where you can start cutting coupons from success. Will this prevent anyone from getting sick and dying from COVID-19? No, but at the moment there is no other country where you can dare to take a similar step without dramatically exposing large numbers of the population to health loss.

Great Britain and Germany decided to introduce compulsory vaccinations for medical personnel. Isn’t it worth extending the vaccination obligation to other groups? If so, what are they?

Maciej Zatoński: Let me put it this way: everyone who wants to live should get vaccinated.

Unfortunately, this is an argument that many who want to live do not find their way. Therefore, let us consider whether to force and whom?

Emilia Skirmunt: If I have to choose, I will select teachers, nursing home workers, uniformed services, working in trade, services or transport.

Maciej Zatoński: It’s a difficult discussion – I personally am a huge opponent of forcing people to do anything. For me, if the medical staff is unvaccinated, it is a failure of education and a triumph of irresponsibility. Fortunately, in the overwhelming majority of countries in the world, the vaccination rate among healthcare professionals is the highest of any professional group.

1. Editors recommend: «Omicron Wave in 10-14 days». What awaits us? Sad forecasts for Poland

I recently spoke to an unvaccinated nurse who said that if vaccination is imposed on healthcare professionals, she will leave her job …

Maciej Zatoński: Hopefully as soon as possible.

Emilia Skirmunt: Unfortunately, I have to agree – Poles do not trust science and scientists. It seems to me that we have to wait for a generational change in thinking.

Maciej Zatoński: On the other hand, it’s also a matter of building a system with consequences. In many countries, a doctor who infects his patient with hepatitis B virus (hepatitis B) or HIV because he or she has not reported an infection that he or she knew about or has not been vaccinated – ends his career immediately, often with a lifelong ban on the profession. On the other hand, in Poland, medics who endanger the life and health of others often do not bear any consequences.

And how do Poles in the UK approach vaccination?

Emilia Skirmunt: I’m afraid the same as in Poland. Although the British government tries to encourage the Polish community abroad, she does not always want to listen. This applies especially to the new Polish emigration.

Maciej Zatoński: It is true that Poles are one of the least vaccinated national minorities in Great Britain and for me personally it is a reason to be ashamed. I myself am a volunteer at a local vaccination center and when I look at the list of unvaccinated people, it contains almost only Polish names …

I wonder if, given that a third booster dose of the vaccine is recommended six months after vaccination, the definition of a fully vaccinated person should not be changed?

Maciej Zatoński: Laws and regulations are always one step behind what we know in the scientific world. For me, a fully vaccinated person is one who has received a single dose of vaccine + dose of mRNA, two doses of mRNA + dose of mRNA, two doses of vector preparation + dose of mRNA, or has had COVID-19 and received an mRNA booster. And so I know that people are outraged: “Jesus Mary, three doses”, but a weakening immune response after vaccination is not unusual. The standard, full course of vaccination against hepatitis B includes a minimum of three doses. Likewise with many other diseases.

Emilia Skirmunt: And a three-dose vaccination against hepatitis B gives us immunity for several dozen years, when a smaller number of doses means immunity for only a few months. In the case of vaccinations against COVID-19, the situation may be similar, but we will find out about this only after some time, by observing the vaccinated population.

1. Also read: When should I take the booster? The new recommendations shorten the break

There is more and more talk about intranasal vaccines – when can we expect them and will they actually be better than needles?

Emilia Skirmunt: At the moment, the third phase of clinical trials is underway and so far everything indicates that they can provide high protection against infection. I think the realistic deadline is the end of next year – now it is no longer a matter of 10 years, but several months, which is a great achievement.

Maciej Zatoński: However, it is too early to speculate whether they will be a better and safer solution. Time will tell. Second-generation covid vaccines, vaccines that protect us against influenza and COVID-19 at the same time, or vaccines that potentially work against all known and future variants of the coronavirus are also currently being researched. Thus, the landscape of the pandemic arsenal of weapons is evolving.

Medicines for COVID-19 also have a place in it. Which patients can they help and are they effective against Omicron infection?

Emilia Skirmunt: We know that a drug based on the so-called monoclonal antibodies given in people at risk of severe COVID-19 do not work for Omikron. However, paxlovid, molnupiravir, i.e. drugs that can be administered at home in the first phase of the disease, still work.

Maciej Zatoński: I think it’s worth looking at them from an effectiveness point of view, especially since we talked about vaccines before. The effectiveness of these drugs varies between 30 and 50% in reducing the risk of hospitalization due to COVID-19. However, their toxicology, i.e. side effects, both temporary and long-term, are not yet as well understood. Thus, the effectiveness of treatment so far is much lower than that of prevention. Besides, it’s not like we’ll go to a prescription pharmacy, buy the drug and get COVID-19 over. We are talking about expensive drugs administered to patients at risk.

Emilia Skirmunt: Let’s also not forget that people at risk are often taking other medications on a permanent basis that may interact with COVID-19 medications. For example, nirmatrelvir, an agent that inhibits viral replication, and ritonavir, which may interact with statins, blood thinners, and some antidepressants.

Finally, let’s consider what 2022 will bring in combating the COVID-19 pandemic. More waves, new variants of the virus, collapse of health systems, and maybe we’ll finally catch our breath and say goodbye to the masks?

Emilia Skirmunt: I would love to know … The last two years of the pandemic have shown all of us that it is really difficult to predict a possible scenario. I myself was convinced that we have a lot of time until the next variant appears. I was wrong – in November, Omikron was first detected, a variant even more infectious than Delta, and with the increasing number of infections, the appearance of another variant is very likely.

On the positives, as we said, we have more and more tools to help us control the pandemic, as evidenced by the Novavax protein vaccine or other drugs. I think that the most important thing today is global cooperation – richer countries must not leave poorer countries to themselves. The African Omikron, like the Delta, which first appeared in India, is a harvest of inequality in access to vaccines.

Maciej Zatoński: Consider that the number of vaccine doses produced by all manufacturers is many times greater than the number of people in the world. So it would be possible to vaccinate everyone many times – but this is not the case. To date, over 3 billion people have not received a single dose of the vaccine! Therefore, if we talk about the fact that the more infected, the greater the chance of mutation, then responsible behavior would dictate, even in our best interests, that people in less prosperous countries should also be vaccinated.

Emilia Skirmunt: If we are able to do this, we will bring the pandemic under control, and perhaps by the end of this year or the beginning of next year, we will start to get back to normal. And if not… then we will have more waves, not even every year, but only a few times a year.

This may interest you:

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2. Omicron is not as gentle as we think. Experts: there is something to be afraid of
3. When will Omikron dominate Poland? Dr. Fiałek gives specific dates

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