Omicron in RI: First patient identified

Omicron has been detected in RI, according to an announcement this afternoon from the office of Governor Daniel McKee. “The individual who tested positive is a person in their 20s who lives in Providence County and recently returned from travel in New York. The individual completed a primary vaccination series and had no record of a booster shot. Contact tracing on this case is ongoing,” the statement said.

Classified as a “variant of concern” by the World Health Organization and assigned the Greek letter “Omicron” as a mnemonic, the variant (also known as “B.1.1.529” in the PANGOLIN nomenclature) of the SARS-CoV-2 virus that causes COVID-19 was first detected in South Africa in a specimen collected on Nov 9 and has since been observed worldwide, in the US first on Dec 1 and in 22 states as of Dec 8, according to an early release issued yesterday in the flagship Morbidity and Mortality Weekly Report (MMWR) by the US Centers for Disease Control and Prevention (CDC). The CDC said that of 43 Omicron patients so far identified in the US only one had been hospitalized (for two days) and none had died. (See “Omicron virus ‘variant of concern’: More transmissible, unknown if otherwise more dangerous”, by Michael Bilow, Nov 26, 2021.) While the scope of the threat may not be assessed for a few more weeks, the CDC warned that “Mutations in Omicron might increase transmissibility, confer resistance to therapeutics, or partially escape infection- or vaccine-induced immunity.”

In general, viruses mutate frequently but most mutations have no practical effect while a few mutations can give the virus a reproductive advantage, which first happened with the variant designated as “Alpha” (B.1.1.7) and later with the variant designated as “Delta” (B.1.617.2). (See “Don’t Panic: Explaining coronavirus mutations”, by Michael Bilow, Dec 26, 2020.) Despite the heightened concern about Omicron, the CDC said, as of the week ending Dec 4, nationally the Delta variant is currently estimated to account for 99.9% of infections because its significantly greater transmissibility allowed it to supplant prior variants.

The statement from his office quoted Gov. McKee: “We fully expected that Omicron would eventually be detected in Rhode Island as it has been in our neighboring states. I want to be clear: Rhode Island is prepared. This is not cause for panic.” The statement also quoted RI Department of Health (RIDOH) Director Nicole Alexander-Scott: “Given the recent findings of the Omicron variant in our region, it is not at all surprising that we have identified this case in Rhode Island.”

“The case was identified through the ongoing genomic surveillance program coordinated by RIDOH’s State Health Laboratories,” the statement said, quoting Alexander-Scott: “I want to thank the staff at our State Health Lab who have been working diligently to sequence more test results than ever before. Together, we can keep each other safe and healthy throughout the holiday season.”

Both McKee and Alexander-Scott emphasized that the best protection measures against the Omicron variant are the same as against the Delta variant: get vaccinated including a booster shot if eligible, practice proven public health measures such as wearing a face covering indoors and in crowded public places, maintain physical distancing, use proper ventilation, and be tested regularly. The statement said: “COVID-19 vaccine helps protect against the Omicron variant of COVID-19. However, booster doses are particularly important in providing additional protection. Everyone older than 5 years of age should get a primary series of COVID-19 vaccine. Everyone older than 16 should get a booster dose. (If you got Pfizer or Moderna for your primary series, you should get a booster dose at least six months later. If you got Johnson & Johnson [Janssen] for your primary series, you should get a booster dose at least two months later.)”

The statement said that Gov. McKee “will be announcing a comprehensive set of actions early next week to address the increased number of COVID-19 cases and alleviate pressures on our hospital systems while at the same time keeping our schools open for in-person learning and preventing economic disruptions to our small businesses. The comprehensive set of actions the governor is focused on are vaccination, testing, masking and staffing capacity. The governor is continuing to meet with his whole of government team over the weekend to finalize the executive actions he will undertake.” Although McKee said at his regular weekly press conference on Thursday that he was reluctant to resume restrictions from earlier in the pandemic such as lockdowns or indoor masking mandates, he was clear that all options were on the table.