Short-term thoughts on Omicron re: boosters and testing

Dear Friends, 

 

I hope that you are staying well. I am reaching out to provide an overview of information on protecting yourselves against COVID-19 this holiday season. This message is a bit long— we’ve broken it into different sections, and I encourage you to jump to the ones that you have questions on. 

 

In my role as House Chair of the Joint Committee on Public Health, I have spent the past two weeks meeting with epidemiologists, infectious disease physicians, hospital leaders, and medical directors of companies that are conducting primary research related to COVID-19. Their message has been consistent: limits on indoor gatherings and mask mandates for indoor and public venues are strong tools we have to complement our efforts in increasing the number of people who are vaccinated and boosted. This is consistent with recommendations from the Centers for Disease Control and Prevention and the Mass Medical Society. 

 

As I am sure many of you have seen, we are being asked to take steps to prevent the spread of COVID-19 that are different from what we were asked earlier in the year and in the weeks leading up to Thanksgiving. The good news is that if we are willing to take what might feel like 2   steps back now, on the other side of this surge we will be able to take 3  steps forward. We are not back to square one or December of 2020. We have more tools at our disposal to navigate this time of year safely and make better choices based on the health of our loved ones. We have always known it would be a little stop and go-it’s time to take a modified pause.

 

Omicron Variant: 

 

The Omicron variant has now overtaken the Delta variant as the dominant form of the coronavirus in Massachusetts. What we’re seeing in Cambridge, a higher rate of infection than the statewide average, is concerning. The Omicron variant has added even more uncertainty, and confusion for some,about how to navigate life after being vaccinated for COVID-19. 

 

Vaccines:

 

The good news is that for most individuals, the first COVID-19 vaccines were really good at keeping us relatively healthy and safe from the original COVID-19 virus. COVID-19, like all viruses, wants to live, so it looks for hosts to keep it alive. Initially, the vaccines did a good job keeping viruses out of the vaccinated population. The evolution of the COVID-19 virus has led to the Omicron variant and increases in breakthrough cases in people who are fully vaccinated. While these breakthrough cases are happening, our vaccines are still helping to prevent the most severe COVID-19 sickness, hospitalizations, and deaths.

 

Booster Doses:

 

The COVID-19 virus has continued to mutate— welcome Omicron. This virus managed to disguise itself well enough that data has shown that your original dose(s) do not provide the same level of protection against the Omicron variant as against previous variants. The good news is that data continues to show that a booster shot has proven to give good protection from severe illness. 

 

Takeaway: all of the reasons you were motivated to get your first vaccine series should motivate you to get a booster. 

 

The really good news is that we have data that shows us that we can continue to be vigilant and protect ourselves and others. Getting the booster protects your health and keeps those around you safer, including those who will suffer longer term health consequences or not survive if they catch this virus.   

 

COVID-19 Testing:

 

It is my hope that, if you are able, you will use COVID-19 tests as a tool to ensure you and your loved ones can stay safe and healthy. While testing is not a substitute for being vaccinated or getting the booster, it can help lower the risk of unwittingly spreading the virus while gathering indoors and spending time with extended family over the holidays. 

 

The best advice I’ve been given about understanding Omicron is that we are still in the early stages of really knowing what the impacts of the variant will be in regards to severity of illness, hospitalizations, and how easily it will infect individuals with our current vaccines. In conversations with two of the major mRNA manufacturers, their data shows that a booster is necessary for protection against Omicron, as you have probably also heard in the press. Through my conversations, one of the common themes was about the importance of making COVID-19 rapid tests accessible for widespread use, as well as ensuring that people have the knowledge they need to know when and how to use the tests. 

 

PCR vs rapid testing: 

 

There are currently two major types of tests used to identify if a person has a COVID-19 infection: PCR tests and rapid antigen tests.

 

  • PCR tests: these tests have been the gold standard that many of us have been signing up for, waiting in long lines for, and then waiting anywhere from 1-3 days for our results.  (depending on where you were tested). These are very sensitive tests that can detect trace amounts of the virus, before you are contagious and long after your incubation time of being able to infect others. The PCR test should be used if you have symptoms or were a substantial or close contact to someone with COVID-19. The challenges are:

 

  1. For many, PCR tests are difficult to access
  2. The results take too long to be the most useful and they don’t tell you where you are in the window of being contagious and spreading the virus.  (Most people who still have a positive test 30-90 days later are not actually contagious).  We will continue to have to think about how to use these in tandem with rapid tests moving forward.   

 

  • Rapid Tests: If you are planning to gather inside with people who DO NOT live with you, rapid tests can add an extra layer of protection. By having everyone take a test, you are protecting each other. By having everyone take a test, you are protecting each other. Here are some tips on when and how to use them. I know they are not easy to find right now—but that will soon change. Here are some ways to think about using them:
    • Take the test on the same day and BEFORE you plan to gather with others & ask people coming to visit you to do the same. The whole test takes about 3-5 mins to set up and 15 minutes to wait for the results.  Consider taking the test an hour or two before the gathering.  
    • Make sure to follow instructions on collecting the sample closely as this can impact the accuracy of the test.
    • Rapid tests give you a snapshot of whether or not you have enough virus (if any) to spread at a specific moment in time. If you plan on staying with people or having people stay with you, you should consider taking another test 24 to 36 hours after your first test to improve your confidence that you are not infected. 
    • Because no tests can be 100% accurate, if you are experiencing symptoms, it is safest to avoid gatherings regardless of a negative rapid test.
    • You can learn more about rapid tests here.

 

A test is only a snapshot of your COVID-19 status at the time that you take it. It’s possible, especially with rapid tests, to test negative during the early stages of infection. As always, if you test positive, you should isolate and inform your healthcare provider. For more information on self-testing, visit the CDC website: https://www.cdc.gov/coronavirus/2019-ncov/testing/self-testing.html

 

Rapid tests are a welcome tool in our fight against COVID-19. When used properly and in combination with other tools, such as getting your COVID-19 vaccine and booster, wearing your mask properly, and practicing good hygiene, we have the opportunity to limit the spread of COVID-19 this holiday season.

 

Last week, the Governor announced that the state is distributing 2.1 million rapid tests to 102 communities across the state. The City of Cambridge has received 46,000, which will be given out to individuals living in public housing, the senior center, and community based programs. We know that rapid tests are hard to find over the counter right now. This will change come January. I share your frustration and look forward to an abundance of more affordable and accessible tests soon.

 

Maximizing your protection against COVID: 

 

The surge of COVID-19 infections that we are seeing can feel deflating. What we need to keep in mind is that we are not where we were a year ago— we have vaccines and boosters that can be very helpful when it comes to protection against the virus. A properly-fitting KN95 mask or surgical mask with a cloth mask over it protects us, and we can access rapid tests. 

 

While individually we have more tools, COVID-19’s impact across our communities and society will continue to be painful. As much as we were hoping this would look different with a strong 2-dose vaccine, with the emergence of Omicron, that means that the good news is that boosters work and masks work. Think of this as hitting pause — if we can all do it at the same time, it might feel like taking 2 steps back, but that means in 8-10 weeks we can take 3 steps forward. 

 

I hope that you have a happy and healthy holiday season. I hope that this information helps you and your loved ones to minimize the risk associated with any holiday gatherings that you are planning to have this year. 

 

Sincerely, 

Marjorie 

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