Dr. Jason Bowling talks about what we know about BA.2, sometimes called “Stealth Omicron,” the latest vaccine questions and a new study linking COVID-19 to erectile dysfunction.
What should I do if the home COVID-19 test is positive?
Most of the at home tests are rapid antigen tests. With the amount of COVID transmission we’re seeing in our community right now, a positive test is very likely a true positive. You need to self isolate, stay home for five days, continue to monitor for symptoms, and inform other people you may have been around in the two days prior to your positive test that they may have been exposed because you potentially could have transmitted it to other people.
What should I do if the home COVID test is negative but I have been exposed?
If you’ve been exposed to COVID and have a high-risk exposure, like a household member, then a negative at home test … One of the challenges of at home tests is the sensitivity is a little bit less than the PCR test you’d get at a walk-in clinic or other places. It is still possible that you could have COVID.
If you don’t have any symptoms, it’s possible that you just monitor for the time period that you would for isolation afterwards and be careful because you could still have COVID. You could also consider getting a PCR test as a backup. It is possible to have a false negative with an at home test.
What do we know about BA.2, what some are calling “Stealth Omicron”?
We’re still learning a lot about the subvariant of omicron, BA.2. It has been nicknamed “stealth omicron” which I don’t think is a very good nickname. That’s related to some PCR tests and how they detect omicron. But that doesn’t really impact the more important things that we want to know about. Does it have any difference in clinical manifestations, severity, is it more transmissible, are there any differences with vaccine protection? All of those things we still don’t know.
I will say that it’s very closely related to omicron, which is the predominant strain we’ve been dealing with. It’s likely that there aren’t significant changes like what we’ve seen with different variants, because this is a sub variant, it’s actually very closely related to omicron. So if there are differences, they’re more likely to be slight differences than the bigger differences we’ve seen between different variants.
I’ve had delta and omicron. Do I really need a COVID-19 vaccine?
If you’ve had delta and omicron, then part of the answer of do you need the vaccine is in that question. If you’ve already had both, it shows the main issue: that you can still get re-infected even with a natural infection. So if you had both, there is the potential, unfortunately, that you could get another variant moving forward or get re-infected with the same variant if enough time passes.
Natural immunity provides some protection, but only for a very short time period, and the protection doesn’t seem to be as strong as the protection that we see with vaccines. The protection from vaccines lasts longer, too, from the studies that we have so far.
How do I know if I have long COVID and how do I treat it?
We’re still learning a lot about long COVID. It’s also called post-COVID conditions. The definition used by the CDC is when people have symptoms that last for four weeks or longer after their initial symptom onset with COVID. It covers a broad range of symptoms both physical and mental. Common ones you’ve probably heard about are fatigue, brain fog. Some people have ongoing shortness of breath when they’re doing activities, or cough. There’s a whole host of other symptoms people can have with long COVID.
The first thing to do if you think you might have it is to talk to your doctor. The first thing they need to do is make sure there’s not another reason why you might have that. During this COVID pandemic, some people haven’t had as much opportunity to see their doctors for regular checkups. So they might have things like uncontrolled diabetes, uncontrolled high blood pressure, other things that can cause symptoms like fatigue. So you want to make sure those are addressed first.
If your primary care doctor doesn’t find another reason for it, they could look at referring you to a long COVID clinic, and there are more of those coming up as we’re trying to learn more about this syndrome. There’s also ongoing research into long COVID so we can learn more about it and the best ways to manage it.
How long do I wait to get vaccinated or boosted after having COVID-19?
The CDC recommends that you wait at least your symptoms have improved, you’re back to baseline and you’re outside of that isolation time period so you’re not a transmissible risk to other people when you get your vaccine. That being said, there’s probably some protection from natural immunity for a couple of months afterwards.
What I’ve advised to many people is to wait about a month. That gives most people time to get back to their baseline, and you’re still within the two to three months of protection that we think people have after a natural infection. So then you’ll get the vaccine protection, which will really boost the protection that you get from a natural infection.
When should you take an adult or child with COVID-19 to the ER?
Fortunately most people who get COVID have milder disease, and so they can be at home, they should be self-isolating, but it’s really important to monitor symptoms. Warning signs that you may need a higher level of care are if you have shortness of breath, chest pain, new confusion or changes in how you’re thinking, if you’re unable to wake up or stay awake, those are all warning signs. Any other severe symptoms or signs that you see might need to be seen by a primary care doctor or even seeing an urgent care clinic or ER, depending on how severe those symptoms are.
You should contact your health care provider if you do have COVID and you have any questions so they can help with that. Fortunately most people can manage this at home, but it is important to continue monitoring symptoms to look for those severe signs that say you might need to go to the ER.
Does omicron cause the same complications (long COVID, MIS-C, etc.) as the other variants?
We’re still learning about omicron because it’s a newer variant so we’ll need more time to see some of the longterm consequences, but at this time all signs point to having the same risk for long COVID and the post-COVID conditions as the other variants. We haven’t seen significant changes other than increased transmissibility, relatively milder acute courses compared to delta and some of the other variants, but the risk of inflammation still remains.
Some people with post COVID or long COVID have those symptoms even after very mild or asymptomatic COVID infection. So signs would right now point to the fact that it’s probably the same risk with omicron as the other variants, but obviously we need more time after this omicron has become known to us and we can see what those longterm risks are.
