Right now, the omicron variant of Covid-19 is top of mind. It's bringing up a lot of new questions about masking, testing, dining, and entertainment; schools, with in-person versus distance learning. Kris Ehresmann, director of infectious disease epidemiology, prevention, and control at the Minnesota Department of Health, returns to Wellness Wednesday to shed some light.

Jill Riley: What do we know now about the omicron variant?

Kris Ehresmann: We know that it is highly infectious and moves very, very quickly, with case numbers doubling every one and a half to three days. We've seen evidence of that [throughout] the United States, and certainly here in Minnesota. Another thing that we are seeing with omicron is that there is evidence of a reduced proportion of individuals with very severe disease, so that that's positive.

One thing to note with that is that because there's so much more transmission, even if there are fewer people who acquire severe disease, our healthcare systems remain overwhelmed just because there's so many more people getting sick. But the initial evidence is that there's a reduced proportion of severe disease. There have been some animal studies in mice and hamsters suggesting that it is milder because it's focused more in the nose, throat, and windpipe rather than in the lungs.

We are seeing cases in individuals who've been vaccinated as well as individuals who have had prior infection, so this variant does have some immune-evading properties. But in those individuals, it does tend to be milder disease. And we also know that there is lower effectiveness of some of our monoclonal antibodies, so that really limits some of the options that we have. So all in all, I think the thing that people probably notice the most about omicron is just how quickly it moves, and how fast it infects people. That's what we've been seeing with our high case numbers.

The CDC is recommending kind of upping our masking game, going from the cloth masks, really trying to get yourself an N95 or KN95. I've heard of KF 94. There are all these different levels. What is your reaction to that: cloth masks versus N95?

I think it's important for people to recognize that since the beginning of the pandemic, the virus has mutated and evolved, and so these variants that we're dealing with, each one is kind of different from what we dealt with before. Cloth masking has, up until this point, been a really effective measure. But with omicron and its increased transmissibility, we really need to up our game with masking. So the CDC has put out some new guidance and has recommended that the N95 Or KN95, those are just the higher-quality masks that that is really the preferred or recommended mask.

So if you have cloth masks, you can certainly double mask. You can use a surgical mask with a cloth mask. You can do things to double-mask to add to protection if you don't have access to N95 or KN95. But certainly masking is is so important. I just but I just want to emphasize that it isn't that cloth masks weren't effective before, because there have been many studies that show how effective they've been. It's just that as this virus mutates, we have to adapt. And so adding that stronger mask, that N95 or KN95, that's necessary now because of the changes in the virus.

Testing has been another hot topic. Where do we stand in the state with people able to get tests? And on top of that, what kind of test is the best test to get with this omicron variant?

With the surge in the cases that we're seeing, we have seen our demand for testing just go through the roof. Despite efforts to increase testing accessibility, I still think it's pretty challenging for people to find testing. In terms of what's the best test, I think the best test is the one that you have access to. And the reason that I say that is that our goal with testing is really to identify people who are positive quickly so that they will isolate. So it's really important that you get tested if you have symptoms or you know you've been exposed, and so the best test is really the one you have access to.

The reason that people have been talking about what test works better with omicron is because certainly, the rapid tests are really valuable because they give you an instant result. You don't have to wait for those results, and that's really important for a lot of situations. But we know that those antigen tests are not as sensitive as the PCR tests, and so it's important to recognize that if you have done an antigen test and you're negative, that is not a free pass. You need to recognize that you probably need to do a follow-up test.

The other thing that's really important is that you need to use the tests in the way that they have been designed, and so you need to follow the instructions. There has been some talk like, “Well, I think that you can detect more virus in your throat, and so even though this is a nasal test, we're gonna do a throat swab.” No, you have to use it in the way that it was designed.

I think the bottom line, though, is that if you can get a test, whatever tests you have access to will be the best test for you. The other thing I'll just mention is: don't wait for a test. If you have symptoms, you need to isolate right away regardless of whether or not you've been able to get a test. There's a lot of things circulating, but you can't say, “Well, I don't know if it's really omicron, it doesn't matter.” People don't want to get whatever you have. Whether or not you have a test, make sure that you isolate right away.

Here in the U.S., does it seem we're at a peak with omicron? Individual cities have their masking mandates, individual school districts have gone to distance learning, some are remaining in person. What are we keeping our eye on with a timeline here?

We are certainly monitoring the cases as they come in, and we've seen [that] different countries have seen different trajectories. So for instance, with South Africa, the upward peak was really fast; it took three weeks to peak, but they're five weeks after their peak, and they still haven't returned to pre-peak levels for omicron. So it's taking them a long time to come back down. The U.K. appears to have [had] a quicker descent. So it really kind of remains to be seen. Our cases are continuing to increase at this point for Minnesota, so we haven't necessarily peaked, unfortunately.

When it comes to the effectiveness of the Covid vaccine against the omicron variant: the course is still for people to get out and get vaccinated and and to get boosted, right?

Oh, absolutely. Yeah. We know that the vaccine is less effective against omicron than it's been against earlier variants. The vaccines were developed to protect us against the ancestral strain, and we've gone through multiple mutations since that time, but looking at data from the United Kingdom, you know, they found that for individuals who were boosted, they still had almost a 90% protection against hospitalization following that booster dose. I think that's pretty amazing. I mean, obviously, we would all like it if being vaccinated meant we didn't have a chance of even developing any illness, but ultimately, the goal is that we don't need to be hospitalized and we don't die and amazingly, the vaccines with the boosters still offer really good protection against that.

So at this point, really the name of the game is prevention of severe illness.

Right. We have definitely, since the vaccines were first introduced, moved into an era where our goal is to prevent severe illness and they continue to provide us with the means to do that.

Every Wednesday morning at 8:30 CST, Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Wellness Wednesday is hosted by Jill Riley and produced by Anna Weggel and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License. This week's photo is by Daniel Foster (CC BY-NC-SA 2.0). The image was altered: it was cropped, filtered to greyscale, and supplemented with a logo.