COVID Help Desk: Does it matter to know whether I have the omicron or delta COVID variant?

Each week, the Houston Chronicle’s health team works to answer frequently asked questions about COVID-19 and how it’s affecting our local community. This week, we dig into what to do after a positive test, how severe omicron is for kids and why variants matter. What should I do if I test positive for coronavirus? It’s best to have a plan in place before you get the bad news. Where will you quarantine? What will you eat? As of Monday, people with confirmed or suspected cases of COVID-19 need to isolate themselves for five days, down from the previous 10-day requirement. According to the Centers for the Disease Control and Prevention’s new guidelines, the five-day isolation period must be followed by another five days of diligent mask-wearing. HOUSTON DOCTORS: CDC's new COVID isolation recommendation 'absolutely follows the science' The best-case scenario is to spend those five days alone in a space with your own kitchen and bathroom. But if that is not possible, that’s OK. It is possible to quarantine safely in shared households, so long as you take precautions, said Dr. Linda Yancey, an infectious disease specialist at Memorial Hermann. When using a shared kitchen or bathroom, uninfected members of the household should wait at least 15 minutes for viral particles to settle out of the air after an infected person has used it, said Yancey. While COVID is overwhelmingly transmitted through air droplets, not surface contact, it is still a good idea to wipe down any shared counters, sinks and toilets after that 15 minute waiting period is up. Circulation is your friend. In any shared space where it is not possible to completely separate an infected person, open windows and doors to increase the flow of fresh air when possible. Once you’ve settled on a plan for keeping your household safe, it’s important to share your status. Be sure to report your positive test to your employer and anyone you interacted with in the few days before and after you started showing symptoms, said Dr. Hana El Sahly, professor of molecular virology and microbiology at Baylor College of Medicine. If you were asymptomatic, tell your contacts about your positive test results. Lastly, El Sahly added, “If you are not vaccinated, please consider getting an mRNA vaccine after your recovery.” What do we know so far about the severity of omicron in kids under 5? It’s still too soon to tell how omicron may differ from the delta wave among pediatric populations. More kids seem to be coming down with omicron, but it’s unclear whether that is due to its ubiquity or its severity, said Yancey. “Is it everywhere or does it hit kids harder?” she said. Like other states, Texas has seen pediatric admissions spike with the emergence of omicron. Seventy-six kids were hospitalized for COVID in the Houston area as of Wednesday, nearly five times as many as a month ago. In the Dallas-Fort Worth area, pediatric COVID hospitalizations are up fourfold since last month. The best way parents can protect their young children is by getting vaccinated and boosted, said Texas Children’s Hospital Pathologist-in-Chief Dr. James Versalovic. Boostered parents are less susceptible to the virus, he said, and therefore less likely to pass it to their child. On HoustonChronicle.com: Can't find a COVID test in Houston? Here's what to do. Children under 5 may not become eligible for vaccination until the spring of 2022. Pfizer’s vaccine for kids ages 6 months to 5 years hit a stumbling block in trials, the company said. The modified dose was safe, but ineffective. Is it helpful to know which strain of COVID you have? It takes scientists three to four days to map the genes that distinguish one COVID variant from another. Since the variant sickening any given patient can’t be ascertained in real time, doctors instead go by overall community prevalence of the different variants, said El Sahly, of Baylor. In Houston, they can reasonably assume that almost any new adult case is omicron. Pharmacy PCR tests and at-home testing kits can’t distinguish omicron from other strains. In fact, unless you are a patient at Houston Methodist Hospital, it is unlikely you’ll find out which variant you have if you become infected in the Houston area. That’s because Houston Methodist has one of the few laboratories statewide with the resources to perform genome mapping to find and track COVID variants as they emerge. Scientists at the Molecular Diagnostics Laboratory are tracking each person who tests positive for omicron to see how they fare relative to patients who had earlier strains of the virus. But their efforts are more likely to affect the big-picture fight against COVID than any one individuals’ treatment. “Omicron has mutations that make it resistant to commonly used monoclonal antibodies,” said Dr. Randall Olsen, medical director of the Molecular Diagnostics Laboratory. By gathering genetic information on omicron, scientists can predict how it may mutate in the future, Olsen said, which can help scientists improve vaccines and monoclonal antibody therapies, and inform changes in public health guidelines. As of Monday, Texas has run out of one of the key monocolonal antibody treatments used to fight omicron in people who are not hospitalized for the virus. It remains in very limited supply at Houston-area hospitals, and is being reserved for recent organ transplant recipients and people with congenital illnesses. The monocolonal antibody shortage won’t affect treatment for those admitted to the hospital with COVID, however, said Yancey, of Memorial Hermann. Hospitalized patients may receive supplemental oxygen, corticosteroid therapy and intravenous antivirals, she said, no matter the variant. nora.mishanec@chron.com

COVID Help Desk: Does it matter to know whether I have the omicron or delta COVID variant?

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