As a public service, we republish the following public post by Ho Ching on her Facebook page yesterday (10 July 2022). She cautions that the Omicron virus has mutated into possibly more infectious and more severe forms.

The Omicron is different.

In the past, Covid infection (or vaccination) can help prevent reinfection (or infection) at a high level, for months.

The conventional wisdom was that even with new variants, like the Alpha or Delta, we should be protected against reinfection for some 3 months or more.

With the Omicron, be prepared for repeated reinfections, and sooner than 3 months.

Already, we have reports that some people could be reinfected by BA.2 only about 20 days after their BA.1 original Omicron.

HoChing quote7.22
So how long should we feel safe from a reinfection?

This depends on time, new sub variants, and the individual.

We probably can presume we are relatively safe from a reinfection for 2-4 weeks after an infection, with the protection waning with time, and the emergence of new variants or sub-variants.

Individuals with impaired immune system would likely see lower protection against reinfection, and faster waning of protection.
"For the moment, vaccinated elderly folks are still facing the highest risk, even though this is much reduced compared to the unvaccinated elderly.

So for the elderly, go for the 2nd booster, when due some 3-5 months after the 1st booster. Healthy elderly can go for their 2nd booster after 5 months from their 1st booster, but immunocompromised elderly should consider going earlier."
There are already anecdotal reports of folks being infected and reinfected as many as 3 times just this year from the Omicron, possibly different sub-variants.

True, the infection illness tended to be milder with each repeated infection.

And the reinfections were probably by the newer sub-variants, as the Omicron appears to be evolving new potent sub-variants within a few months.

A study of 1,300 reinfections in Qatar showed that none were acute enough to need hospitalisation for ICU care, and none died.

However, reinfections can still be severe, with high fever, body aches, headaches, bad sore throat and coughs and other severely miserable symptoms.

So what can we do?

First, vaccination and boosting do provide better protection than from infection, esp for the Omicron.

So continue to vaccinate or boost after an infection, say after a month or more.

For the moment, vaccinated elderly folks are still facing the highest risk, even though this is much reduced compared to the unvaccinated elderly.

So for the elderly, go for the 2nd booster, when due some 3-5 months after the 1st booster. Healthy elderly can go for their 2nd booster after 5 months from their 1st booster, but immunocompromised elderly should consider going earlier.

Other older adults 50 and above, and seniors in their 60+ and 70+, should also consider going for their 2nd booster too.

Folks who have been infected, could check and go at the date which is the later of 1 month after infection, or 5 months after 1st booster.

What else can we do as the BA.5 sweeps the world, and edges out both the BA.2 and BA.4?

The usual for the individuals - mask up in indoor and crowded places.

And presume we may be Omicron infected whenever we have infection or respiratory symptoms.

Infection symptoms are general ones like fever, headaches, body aches, nausea, etc.

Respiratory symptoms range from sneezing spasms to sore throats and runny nose.

The newer ART test kits appear to be more sensitive to the Omicron variants, possibly bcos they have been developed later and so could match the Omicron better. They are also cheaper.

So do ART tests before going to meet lots of people, just to make sure we are not a silent potential superspreader. Many people who do such precautionary tests got a shock when they saw the twin lines with a dark thick test line as they had no symptoms and were feeling fine.

Also don’t assume we are fine when we test ART- after symptoms show. Many symptomatic cases tested ART+ 1-3 days, sometimes 4 days after their symptom onset. So stay away from others, esp the vulnerable whenever we have symptoms.

And it looks like the 1st Omicron infection could be quite miserable, esp for the BA.5.

High fever, fatigue, headaches and body aches with bad throat for days.
And often, the thick ART test line continues to appear well past day 7 from 1st ART+ date.

And the BA.5 also appears to be worse for younger people and kids, compared to the earlier covid variants in 2020/2021.

For the early covid infections, infants could see a passing infection as short as 1 day, with very mild symptoms.

For the BA.5, we could see such infants and toddlers being miserable with sore throat and other discomfort for over a week. And they continue to test ART+ up to 9-10 days.

For infants and toddlers, or even teens and young adults, the danger to watch for is high fever for more than 2 days. 40C is the limit, beyond which organs may start to see physically serious damage.

This should be treated as an emergency if infants and toddlers have high fever for more than 2 days.

Don’t wait for seizures to happen before bringing an infant or toddler with prolonged high fever to see a doctor. Meanwhile, try to wipe the infant or kid with a damp towel or a fever cool pack to help reduce the temperature.

Young adults who typically shake off a covid infection mildly and quickly for the non-Omicron infections, could have a really miserable time, even if they don’t have acute illness that needed hospitalisation.

Get the oximeter ready too, and the thermometer.
The Omicron BA.5 (and BA.4) appears to be able to grab tighter to our lung tissue, much like the Delta. So be prepared for possible lung damage and poor oxygen intake.

If the oximeter reads less than 93%, call a doctor.

If the oximeter reading drops below 90%, this is an emergency. Go to an A&E quickly ro call an ambulance. Vital organs will start to be oxygen starved and see damage happening when blood oxygen starts to fall below 90%.

This is esp important, bcos we know covid can lead to silent pneumonia where the patient feels well even when their oxygen levels go below danger levels.

This is unlike normal pneumonia, where patients will feel breathless early.

For covid cases, by the time patients feel breathless, the patient may be far gone for help.

[note: The BA.1 is practically extinct since March this year, overtaken by BA.2, that is now currently being pushed out by BA.4 and BA.5.
Wherever we see BA.4 and BA.5, we are already seeing BA.5 outpacing BA.4, to become dominant.
And we are now starting to see a new offshoot of BA.2 which may yet challenge the BA.5.
So in this swirl of successive Omicron waves, we need to be mindful that any of the new variants or sub-variants can turn nasty even as they are more infectious. ]

Ho Ching was CEO of Temasek Holdings for 17 years and is the spouse of Prime Minister Lee Hsien Loong. She posts frequently on her Facebook page here.

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