Kirby Kruger

Director of North Dakota Department of Health’s Division of Disease Control Kirby Kruger talks about the newest COVID-19 variant, Omicron.

While the first Omicron case in the United States has just been confirmed by the California and San Francisco Departments of Health in an individual who traveled from South Africa recently, North Dakota has yet to identify any Omicron COVID-19 cases here.

That doesn’t mean the new variant of concern is not here, but the state is doing fairly robust whole genome sequencing at 5 to 10 percent of its PCR tests on any given day, so if it is here, it should begin showing up soon.

But even if the new variant of concern is spotted here, the director of North Dakota Department of Health’s Division of Disease Control Kirby Kruger would have much the same health recommendations for people to follow that he’s already been urging. The same guidelines, in fact, that the CDC has continued to recommend. These are to:

— Stay socially distanced or wear a mask if that’s not possible.

— Wash your hands before eating, or after touching any high-contact surfaces such as light switches and door knobs.

— Stay home if you’re sick or have any symptoms of COVID-19.

— Avoid crowded indoor spaces with poor ventilation.

— Get vaccinated, if you haven’t already.

— Get a booster shot if you were vaccinated six or more months ago with Modern or Pfizer or two or more months ago with Johnson and Johnson.

“Vaccination is still the best tool we have to reduce the risk of infection and severe disease,” Kruger said. “And the other part of this is, for individuals who have started their vaccination series or have completed their vaccination series, the CDC has now recommended booster doses for all adults.”

Upper Missouri District Health Unit is offering a walk-in COVID-19 and flu vaccination clinic at the old airport hangar from 3 to 6 p.m. every Thursday. The COVID-19 vaccine is free.

Testing and surveillance measures don’t have to change for Omicron, Kruger added. The existing process already in place is sufficient.

North Dakota’s lab can run between 400 to 480 whole genome sequencing samples in a given week. That arranges from 5 to 10 percent of the weekly number of PCR tests, depending on how many tests there were. That compares favorably to the sequencing rate of other states, Kruger said.

In addition, 17 to 20 randomly selected samples are sent to the CDC each week, where they do some whole genome sequencing as well.

Omicron poses a lot of questions at this point, Kruger said, to which there are not yet definitive answers. The variant has more than 30 mutations on the spike protein that the mRNA vaccines focused on for developing immunity.

Will that make it more transmissible?

Will the virus cause more severe disease?

Those are the big questions Kruger and other health department officials will be seeking answers to in the coming days.

“To say the least, we have a lot to learn about this variant,” he said. “Public health and health care officials throughout the world c continue to study this. There certainly is going to be more information evolving and emerging as we learn more about this in the coming weeks.”

Vaccine effectiveness will be something that’s closely watched in coming days, Kruger added, but he believes they will provide at least some protection against Omicron.

Epidemiologists say the complexity of the immune system means that two years and a few vaccines later, that a new variant won’t mean it’s back to square one.

“That may sound counterintuitive given the ‘vaccine escape’ language floating around,” Katelyn Jetelina writes in her blog, Your Local Epidemiologist. “Immune escape is not a binary (yes/no) event. We are not going to start from square one. This is because vaccines and our immune systems are made with mutations in mind.”

Vaccines induce a polyclonal response from the immune system, prompting it to create antibodies of different shapes and size that can connect all across the entire range of the spike protein.

So, while mutations can obviously erode the effectiveness of the antibodies your immune system learned due to the vaccines, that doesn’t mean at least some of them won’t be able to attach.

While the virus mutates often, it, too, has an important constraint. It cannot evolve so much that its spiky protein no longer acts as a key to get in, and that means at least some features our antibodies can recognize are likely still part of the spike.

This is another reason why boosters at this juncture are being recommended by epidemiologists, Jetelina explains.

“They restimulate the immune system and increase the number of antibodies so more can attach,” she said. “To a lesser but important extent, boosters also generate a much broader level of immunity. In other words, boosters can develop antibodies against more parts of the virus.”

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