COVID update 1/3/21 It's Omicron time. A different beast, obviously way more infectious clinically but with an apparent good opportunity towards early resolution either spontaneously or with appropriate early medical management. We are seeing incredible amounts of newly infected patients daily, most of who won't be recorded due to at-home testing. The application of antibiotics, steroids, inhalers, and other interventions seems to do the trick for most patients within 48-72 hrs. We still refer for antibody infusions when appropriate and saw two immediate resolutions of worsening illness within both patients shortly afterward. We expect further antibody infusion supplies through this week from the Federal Government. In addition, the new antivirals will be arriving. A separate comment about all medical anti-viral interventions relative to Omicron is in order. As it is so infectious (2x greater than Delta) and so rapidly reproducing (2x greater than Delta??) ... keeping in mind the incredible infection rate (3x greater than previous strains) and reproduction rate 23,000% higher than previous strains) of Delta what is the likelihood any will work? My best guess is they will be less effective. Whether you believe in HCQ, Ivermectin, Paxlovid, or Lagrevrio the reproduction rate coupled to the rapid onset of symptoms may render these less effective. On the other hand, we are seeing classic low-intensity interventions including antibiotics, steroids, and inhalers appear to be working extremely well, and I might add anecdotally, even better. So the antivirals may not in the end be that important. We shall have to see. The next 3 weeks are going to be very crazy with a lot of infections, shutdowns due to staffing issues, potential short-term shortages, travel hassles, etc. They will dissipate and we shall move on. Be wise in your choices. This wouldn't be the time to go on a cruise or try that 'death-defying stunt'. Health care options will be limited and you will get trapped on the ship. Be safe. Noel R Williams MD
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