COVID-19: ‘We don’t really know what Omicron is going to do in terms of Long-COVID,’ doctor says

Dr. Ellen Eaton, University of Alabama at Birmingham Division of Infectious Diseases Associate Professor, joins Yahoo Finance for an update on the COVID-19 pandemic, Omicron's spread amid a test shortage, and the impact on travel this holiday season.

Video Transcript

- Real world situation here in New York that I think people are experiencing nationwide. You go to get a PCR test but they're so backed up you don't get the results for five days. What good is that?

ELLEN EATON: Yeah. Absolutely we're seeing that here in Alabama. We have struggled with access to testing at various stages, most recently with Delta. And we're seeing it again.

In addition I'd like to bring up that a lot of individuals in my community are relying on rapid testing, which is important. They're coming up with a positive test and staying home. But those numbers are not contributing to our case counts because those individuals have not been able to get a PCR. The health department does not have access to that data. So I do worry that we're also seeing under-reporting, under counting of the true burden of our infections here. But certainly the PCR test limitations are slowing down our progress in the pandemic in the deep south as well.

BRIAN CHEUNG: Dr. Eaton, it's Brian Cheung here. I wanted to ask about the trend that we've seen with omicron, at least in South Africa. Because it seems encouraging on one hand that the precipitous drop in the amount of cases that they've experienced might suggest that we could go through this wave faster than we have the Delta wave. Now that's even despite the fact that the record numbers that we're seeing right now are in light of perhaps some of the under counting that you just kind of highlighted. Is there any indication based off of what you're seeing on the ground that might be the case? That this could fall perhaps a bit faster than we had expected?

ELLEN EATON: Yeah. We're hopeful that this blows through quickly with minimal damage. I'll say in Alabama we went from having one case of detected omicron to having 73% of our COVID cases being omicron within a matter of days. So that just shows we went from almost no cases to the vast majority being omicron. I should say the 73% was before the holiday weekend. We know there's delays in reporting and surveillance over the holiday. So I imagine the vast majority of COVID here in Alabama and the deep south is omicron as well.

Now we did see Delta move through pretty quickly. But I want to point out that areas like my state that have low vaccination rates, we never had a drop off in cases. In the summer before Delta we did. But after Delta our numbers really [INAUDIBLE] hundreds of cases a day. So Delta surge did pass relatively quickly on the order of months, but we were still dealing with new Delta cases until omicron came into our community in the last couple of weeks.

So for those of us who have a largely susceptible unvaccinated community like Alabama, where 50% are still unvaccinated, I'm not as confident that this virus, this new variant will blow through as quickly. I imagine we'll see low levels of continued transmission that contribute to a fair number of hospitalizations over a period of time. That's really important because we're in flu season. So any transmission, any severe disease is going to compete for resources. And our resource limited hospitals, community hospitals across the black belt deep south who are already strapped for ICU beds, ventilators. You add flu season, you add a new variant of concern, it could do a lot of damage in states like mine who have little public health infrastructure and low vaccination rates.

- Doc I want to talk about the over the counter antigen tests. And New Yorkers if you're watching, they've got them right now at the Walgreens at 70th and 2nd. I lucked out. I just happened to go in there and I was able to get four. They're limiting how many you can buy. So that's eight tests.

What's the appropriate use for people who are vaccinated and healthy of that testing regimen? Like for instance we used those over the counter tests before we got together with family over the weekend for Christmas to make sure none of us were testing positive. How accurate is that? And what's the appropriate way for those of us who might have those tests to use them?

ELLEN EATON: Yes. So this is something that we are all struggling with, especially when there are limited tests. You have four tests how do you use the most wisely? First of all I want to remind everyone that these are not a stand alone strategy. Testing alone is not enough.

You need to be vaccinated, you need to boost yourself. You need to make sure all the children in your home are vaccinated. When you're in public spaces airplanes, airports, when you're in large gatherings wear your mask. But add that test if you're going back to an area like a workplace or school after traveling over the holidays or being in a gathering over the holidays. It's a great time to test yourself before you go back to the work force, go back to school, go back to a child care center. You may work with children who are unvaccinated.

Certainly if you're a health care worker and you work in a hospital or a clinic and you've been at some New Year's Eve gatherings, you've been with family. Especially if those family are unvaccinated or coming from an area where there's high transmission like my community. It's a great time to use that test before you go back to the workplace so that you don't inadvertently bring your infection from the holiday gathering to your office.

BRIAN CHEUNG: And then lastly the CDC guidance that shrinks the amount of time that those who are health care workers need to isolate themselves if they were exposed or did test positive, shrinking that amount. Do you feel that's inconsistent with the science? You've seen some nurses associations kind of taking a stand actually against that CDC recommendation.

ELLEN EATON: This is a very controversial topic. I will say for myself as someone who is fully vaccinated and boosted and my peers who are in the same situation, that breakthrough infections I've seen have been very mild. And in fact my colleagues have been ready and willing to get back to work sooner than the previously required long isolation period. 10 days.

So for that group I think it could be helpful. But then you have another group who may be unvaccinated, they may be immunocompromised, they may have a loved one at home who still really struggling with their own infection. There are so many considerations to take into account. I should also bring up we don't really know what omicron is going to do in terms of long COVID. We're seeing mild upper respiratory type infections, colds in people that are fully vaccinated who have breakthrough infections.

But we don't know what they'll look like in a month. Will they have fatigue? Will they have headaches? Will they have long COVID symptoms where they're going to need more time off work? And these are the things that we're really trying to understand, to identify, to lay out some policy for our health care workers.

I should also say a lot of hospitals need these health care workers. A lot of clinics you mentioned the lines for PCR test, ER lines, how are we going to staff these clinics, these hospitals, these ICUs, if a large number of our workforce is out after a coronavirus infection in themselves or their family? So I do understand the need, the desire to shorten that isolation period.

But again so many considerations with a variant that's still very novel. Omicron is a very novel strain. We're still learning how it's going to infect individuals who are vaccinated, health care workers, unvaccinated, and also immunocompromised health care workers in our midst.

- We appreciate all the medical community's doing. When they throw that ticker tape parade at the end of all of this here in New York City, Dr. Eaton, I hope you are among the individuals that we are thanking. Dr. Eaton, Ellen Eaton is a University of Alabama at Birmingham Division of Infectious Disease associate professor. Thank you for being here and taking time out of what is a very busy schedule for you.