Ask the Pharmacist

Q. Omicron has sure taken hold of the province in the last few weeks. Is there anything new you can report on it?

A. Yes, once Omicron was detected in Ontario, it has wreaked havoc in most communities. As was predicted, it is far more contagious than any of its predecessors. It seems to affect the majority of people to a similar degree as a bad cold might which has left many wondering why are we still fussing and worried about contracting Covid.

However, though it does appear to be less severe than the Delta variant, Omicron still poses a significant health problem for some and this risk is not just limited too the very old and the already sick among us. Though this is not too different from other viruses that haunt us every fall and winter, there are very few viruses that are as contagious as this one which is why Omicron has been such a stressor on our health care system.

While most of us will have a strong enough immune system and the appropriate antibodies from the vaccine to fight off the virus and manage the symptoms at home there will be more than a few of us who will need to seek medical attention. Though it is believed that a smaller percentage of people will require hospitalization with Omicron, the problem lies with the sheer number of people affected by this coronavirus. There are numerous reports of Omicron affecting many workplaces with staff calling in sick leaving the business shorthanded and thus forced to reduce hours and services.

The other reason we need to care about Omicron is that some who get ill, even if it’s just a mild case, will go on to develop Long COVID syndrome which can lead to months (or possibly years) of extremely poor health. We stated in a previous column that two doses of Covid vaccines offers some protection but getting that booster dose increases your protection significantly (from 30-40% effectiveness after 2 doses to 70-75% effectiveness after 3 doses). Yes, people with 2 or 3 doses of Covid vaccines are still able to contract Covid-19.

People may be second guessing and wondering why we should be still prioritizing the vaccines if we can still get the virus. It appears that the majority of patients requiring medical attention are once again the unvaccinated. This shows that the vaccines do more than help prevent you from getting infected. They also work at reducing the severity of the disease in your body.

Recently, Ontario updated its public health measures regarding Covid-19. This is based upon evidence that shows we are most contagious the 2 days before we get sick and the 3 days after our symptoms arrive. It is not surprising that many are unsure what to do or who needs to isolate after a close contact gets Covid-19. Below is a summary that is up-to-date for the time being;

  • For those individuals that are fully vaccinated and in good health, it is now required that you isolate for 5 days from the onset of your symptoms. All household members must also isolate along with you, whether they have symptoms or not. Once the five-day isolation period is over, providing the symptoms have improved during the last 24 hours, you may then resume activities as long as the usual public health measures are met such as masking and physical distancing. If however, the symptoms have not improved for a minimum of 24 hours, then isolation must be extended until that criteria is met.

 

  • For anyone who is immunocompromised or is unvaccinated or partially vaccinated, the isolation period is increased to 10 days with the same stipulation that symptoms must have improved over the previous 24 hours. It is important to reiterate that everyone in the household must isolate until the 5 or 10 day requirements have been met.
  • If you are a health care worker or volunteer in health care setting and are symptomatic, you must not return back to work/volunteer for 10 days (this may change soon if staffing shortages put our ability to care for others in jeopardy). You may return after a 7 day isolation IF you have a negative PCR test or 2 negative rapid tests taken on day 6 and 7 of the isolation period.
  • If you are a close contact of a symptomatic individual but do not live with him/her, you do not need to isolate but rather you need to self monitor for symptoms for 10 days and avoid high risk settings and other vulnerable people during these 10 days.

Since Omicron has shown to be more transmissible, many experts are suggesting a switch to an N-95 mask to give you and others more protection, especially when in crowded indoor places. As the name implies, these masks provide 95% or better protection. They are also made to provide a much better seal on the face compared to other masks. It compares very favourably to surgical masks which can offer up to 60% protection from virus particles.

Also, you may notice that some people that wear the surgical masks will show gaps on the sides of the mask which further decreases the protection offered. The protection from surgical masks can be improved by layering a cloth mask overtop which should both improve the fit on the face (thereby decreasing those gaps) and increase the protection by adding another layer of filtration. It is not known what the level of protection is provided by cloth masks as there is such a variety of them. It is undeniable that we should not be relying solely on cloth masks at this point in time in the pandemic.

The downside with the N-95 masks is 3-fold;

1. They can be a little more uncomfortable to wear. The snug fit that provides you with a good seal and therefore better protection can tug at the ears a little more.
2. They are not as readily available to purchase.
3. They are more expensive than surgical masks. That being said, a N-95 mask can be re-worn and you could get up to 10 days from each mask. The surgical masks, however, should be discarded after each use.

Many are questioning what we know about fourth doses while we are still in the midst of administering third doses to people. Ontario is already making fourth doses of mRNA vaccines available to people that are more at risk such as those who live in long-term care homes, retirement homes, Elder Care lodges or other congregate care settings as long as 84 days have passed since their last dose.

Lastly, for those wondering how long after a COVID infection they should wait before seeking a booster shot, Dr. Kieran Moore (Ontario’s Chief Medical Officer of Health) suggests 30 days would be optimal provided there has been a sufficient interval since your second dose.

As more time passes, we will continue to learn more and hopefully pass this along in an easily understandable fashion. We look forward to eventually being able to report that we are nearing the end of this pandemic that began two very long years ago. For more information on this or any other topic, contact your pharmacist.