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What to expect as the omicron variant rages in Spokane

FILE - A medical technician performs a nasal swab test on a motorist queued up in a line at a COVID-19 testing site near All City Stadium Dec. 30, 2021, in southeast Denver.   (David Zalubowski)
FILE - A medical technician performs a nasal swab test on a motorist queued up in a line at a COVID-19 testing site near All City Stadium Dec. 30, 2021, in southeast Denver.  (David Zalubowski)

The third season of the coronavirus pandemic has brought with it a new variant so transmissible that if you don’t know anyone who has tested positive at this point, think again. You do.

Omicron now makes up the vast majority of detected variant samples sequenced at labs statewide. And while the new variant has been called more “mild” than previous ones, it’s important to understand what that means.

“Mild” means your case didn’t land you in the hospital, said Eric Lofgren, epidemiologist and professor at Washington State University.

So even with omicron, you could still get sick, which doesn’t necessarily mean you are “consequence-free” or won’t have to stay out of work.

“People are experiencing long-term symptoms of COVID even when they had a mild case,” Lofgren said. “It just hung around, and they’re experiencing genuinely long-term effects in their ability to take walks and climb stairs and participate in things and that can potentially be a life-changing experience.”

The vaccines, which have been in use for more than a year, remain good at keeping people out of the hospital and from dying.

If you are over 35 years old in Washington state and unvaccinated, you are 11 times more likely to be hospitalized with the virus than fully vaccinated people your age.

Omicron seems more effective at evading vaccine protection, though, as the number of breakthrough cases continues to increase.

In Washington, reported breakthrough cases have reached the highest levels during the pandemic and have increased by 43% in the past few weeks alone, the state reported. Breakthroughs are to be expected, as no vaccine is 100% perfect.

But the timing of omicron and the vaccination coverage of the communities it’s spreading through also are factors.

Vaccination rates remain low in some counties and communities. Other parts of the world don’t even have vaccine access. Omicron has the ability to spread faster than any previous variant. This is all at a time when some people are shirking masks and distancing and few, if any, lockdown measures are in place in the United States.

In Spokane County, 53.6% of the total population is fully vaccinated, meaning they’ve received both doses of a COVID-19 vaccine.

“We have a lot of opportunities for transmission and enough people vaccinated that there is selective pressure on the virus to be able to create breakthrough cases,” Lofgren said.

Health officials are encouraging booster doses to help increase immunity, which wanes over time.

If a vaccine is like a blueprint that shows your immune system how to create antibodies and fight off the virus, the booster is like a follow-up meeting or email for your immune system to get a quick refresher on how to do the job.

“It helps strengthen the effectiveness of the vaccination,” said Dr. Heather Brennan, a family physician with Kaiser Permanente.

Reinfection continues to be possible, and relying on natural immunity is a gamble. How long natural immunity lasts depends on myriad factors, and health officials encourage everyone to get vaccinated, regardless of prior infection.

Preliminary studies are finding that the risk of reinfection is higher with omicron than with the delta variant.

On the other hand, people who have had the virus and then get vaccinated could have an even more robust immune response. No one can know for certain how strong their immune response was from a natural infection, and vaccines have produced more consistent antibody levels.

This is why health officials and epidemiologists, like Lofgren, recommend a person who’s had the virus also get vaccinated.

Last week, Dr. Anthony Fauci said the new variant “will find just about everybody,” due to how infectious it is. That doesn’t mean you should run out and try to get it, however.

In fact, health experts, including Lofgren, advise against this, especially as hospitals are already full.

A variant as contagious as omicron comes with a scary math problem – even if people aren’t getting as sick, enough people infected still means a certain percentage of folks will need hospital or ICU-level care.

“If something is half as dangerous, but you get twice as many people sick, you’re in the same place you were when you started,” Lofgren said.

Put differently, “a very small number multiplied by a very big number can still be a very big number,” he added.

In less vaccinated areas like Eastern Washington and North Idaho, where case counts are increasing rapidly and hospitalizations are beginning to follow that same trajectory, any increase in patients going to the hospital is going to stretch an already strained system.

“When you combine health care workers out sick with surges of infections that need health care workers, you start straining that system very quickly,” Lofgren said.

Washington hospitals are as close to crisis as they’ve been all pandemic for many reasons, but in Spokane County, staffing is the main problem. With staff out for COVID, there are fewer caregivers to look after patients. Even if there are enough beds, without caregivers, those beds are meaningless.

This affects all parts of health care, not just COVID. The governor halted nonurgent surgeries and procedures last week for the next four weeks. Patients who likely had already been awaiting surgeries to be rescheduled will have to wait even longer.

Emergency rooms are overflowing, and hospitals are having to keep patients there while they wait for enough staff to bring a patient to a hospital floor.

Many people in the hospital aren’t there for COVID, and capacity never really dropped between the delta and omicron waves because all those delayed surgeries and appointments were rescheduled.

That trend has continued, and now more COVID patients are also seeking care.

This is where Eastern Washington is situated in its omicron wave and will remain for at least a few weeks.

So, what happens next?

Much like the past two years, the answer is “I don’t know,” Lofgren said.

It’s clear that globally and nationally, vaccine hesitancy – those who won’t get the shot – coupled with vaccine inequity – those who can’t get the shot – put the virus’ future trajectory squarely in the “unknown” category. A new variant is possible.

“The conditions that created the omicron variant still exist and are still capable of creating other variants,” Lofgren said.

What’s happened in other countries and statewide modeling show that the omicron wave should be faster than the delta wave, and cases are predicted to peak first in Western Washington, then in Eastern Washington.

Spokane County Health Officer Dr. Francisco Velázquez said some models show omicron peaking in early February, although he cautioned that those models could change.

The hope with a virus like COVID-19 is that it will eventually mutate to a less viral form that is much milder, something like the common cold.

The problem, of course, is timing.

“That’s not guaranteed to happen on anything resembling the timeline we want it to happen,” Lofgren said. “The thing we should take away from this pandemic is that viruses don’t respond to our timeline.”

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.

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