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Atrium Health Wake Forest Baptist infectious disease doctor predicts 'tough' several weeks with Omicron variant

Dr. Christopher Ohl, an infectious disease expert with Atrium Health Wake Forest Baptist says getting a booster shot is even more important with the omicron variant.

WINSTON-SALEM, N.C. — Dr. Christopher Ohl, an infectious disease expert with Atrium Health Wake Forest Baptist, says with high COVID-19 case numbers and tests in demand, the next 2-4 weeks will be rough for the Piedmont Triad.

Ohl says the CDC estimates Omicron represents more than 50% of the COVID cases circulating in the area.

"One of the reasons why the numbers are so high, is because of breakthrough infections and that's breakthrough infections in people who have been previously infected in the past with the different variant and with people who've got their initial vaccine series but haven't been boosted," Ohl said.

According to Ohl, out of 100 who have been boosted and exposed to Omicron, about 15 will get the virus. 

"The unvaccinated population is going to have just as difficult of a time with Omicron as it did with our prior viruses," said Ohl. "Now, these are the people who are more likely to have more serious infections. These are the people who are more likely to end up in the hospital, and frankly, these are the people who are more likely gonna die."

The mortality rate for the unvaccinated, according to Ohl, is between two and four percent. He said those who are immunocompromised and those who were previously infected (but not vaccinated) will also struggle. 

"So if you're exposed to Omicron and you're relying on a previous COVID infection to keep from getting sick, it's not going to work, you're going to get COVID and you're going to get symptoms that even though you may be more likely not to be hospitalized, it's gonna be pretty, pretty bad, cold or flu," Ohl said. 

Most monoclonal antibody treatments are not as effective against Omicron, except for one which is in short supply, according to Ohl. 

"For the next few weeks, we'll all be rationing these, and it's gonna be mostly immunocompromised people, particularly severely immunocompromised people, who will be getting them," said Ohl.

COVID-19 Update | Dec. 30, 2021

Dr. Christopher Ohl — infectious diseases expert — provides his weekly update on #COVID19 in our region. In this week's update, Dr. Ohl answers questions about: 🔵 the #OmicronVariant ⚫️ What mask you should use 🔵 New CDC quarantine and isolation + MORE! Watch his full update ⤵️

Posted by Atrium Health Wake Forest Baptist on Thursday, December 30, 2021

RELATED: Highest one-day number of COVID-19 cases reported in North Carolina

The Forsyth County Health Department says lots of people are getting tested right now. There is also a high demand for at-home tests.

"The sensitivity of the home kit for Omicron is a little bit reduced, but it remains unclear whether that really is significant enough to not use them," Ohl said. "And I still think they're a useful tool, to have in our communities, and our populations for people to use to self-test and so I wouldn't throw them out."

However, health officials aren't able to get a full picture of case numbers without at-home tests, which do have to be reported to the health department.

"Knowing the amount of tests that we have across the board that are turning positive right now, our numbers are so big that (...) those extra test numbers probably wouldn’t make a big dent in the overall epidemiological number," said Maura Trimble, Communicable Disease Public Health Nursing Supervisor with the Forsyth County Health Department. 

Trimble says if you test positive, contact your doctor. 

"We don’t have the ability to set up a platform for individuals to submit those tests but I would say though that the guidance says if you’re doing an at-home test, be in contact with your primary care provider, and if they’ve ordered that test and that physician is required to report to the health department," Trimble said. 

Dr. Ohl said hospitals are always busy around this time of year because of flu season, but they are now busier than three weeks ago. However, he noted that hospitalizations are not going up as fast but it make take another week or more to determine if the trend will continue. 

"If Omicron replaces Delta, Omicron is less likely to result in hospitalization, particularly in people who've been vaccinated, vaccinated and boosted, (...) or previously infected," Ohl said. "So between immunity of the population and a virus that tends to behave a bit differently, hospitalizations, I don't think, are going be quite the problem they were, at this time last year."

ICU numbers, according to Ohl, have not been as high but that may change in 10-14 days. Right now, 90-95% of people in the hospital with COVID are unvaccinated. 

"So for those people who are vaccinated, it's a pretty contagious cold and so that's something we're gonna have to live with for a little while, but what it means is, particularly for the vaccinated population, that it's going to be less severe, and it's going to be in more of an annoyance and (...) have an impact on your activities. So it's gonna be a pain, in the fact that you may not be able to do what you wanted to do during the time, while you're infected," said Ohl.

RELATED: 'It was really gnarly' | At-home tests more popular as COVID-19 cases surge