Have you ever heard someone with COVID-19 say, with all the confidence in the world, “I had Omicron?” They knew for certain their recent illness was caused by the Omicron variant; not alpha, not beta, not delta, but Omicron.” Really? How do they know that? 

Well, they don’t! They’re just saying what the doctor told them, or they’ve heard on TV that Omicron is the variant currently causing people to be sick. But “the doctor said I have Omicron, and he oughta know.” Yes, maybe the doctor should know, but he/she really doesn’t. The test done in the doctor’s office was positive for COVID-19, but that’s all it tells you. Rapid antigen tests done at home in the doctor’s office detect only the antigen produced by the virus. They don’t tell you if it’s from Omicon or any of the other variants. So if the doctor said you have Omicron, he’s relying on information he got from the CDC or more likely, saw on the TV news.

But you say, “the doctor even did that special PCR test that took a couple of days to get back! It was positive, too, and that proves I had Omicron!” Well, there you go again—polymerase chain reaction tests confirm you had COVID-19, true, but just like rapid antigen tests, they can’t tell you what variant you had, either! 

“But can’t you tell by the symptoms I had? I heard you could.” Well, that’s a maybe. If you’re fully vaccinated, and it’s been at least two weeks since you had a booster shot, if you test positive for COVID-19, you can assume it’s caused by the Omicron variant. In early December, 2021, only 0.7% of COVID-19 cases were caused by Omicron. By late December, 2021, the same month, the percentage had increased to 73.2%. The Omicron variant has continued to be the dominant offending mutation throughout the winter and spring seasons this year.

“How do I know what variant caused my case of COVID-19, and is it important to know that information?” You don’t know, and no, it’s not important. Treatment is the same regardless of variant. Knowing which variant you have is important only for epidemiological purposes—it tells the experts what variant is currently dominant and alerts them to any concerns that particular variant may cause. 

To determine the type of strain, the CDC does “genetic sequencing.” Using a percentage of positive tests chosen at random, the procedure identifies the variants currently dominant. There are thousands of positive tests submitted so a large sampling gives the CDC specific information on the current strain. Once the CDC determines the variant, those results are reported to physicians, hospitals, public health officials, and the media. 

“Does knowing the strain of COVID-19 matter?” For most people, no, it doesn’t. Low or average risk people should recover from COVID-19 without problem regardless of causal variant. High risk patients, however, need to know because if Omicron is the cause, a specific monoclonal antibody treatment is available for it.

COVID-19 can be caused by alpha, beta, delta, gamma, and omicron variants. The symptoms are frequently worse with delta and Omicron variants, and milder with alpha, beta, and gamma.  COVID-19 does appear to cause milder symptoms in vaccinated and boostered patients, while the unvaccinated experience the full effect—fever, cough, body and muscle aches, headache, fatigue, runny nose, sore throat, GI symptoms, and loss of taste or smell. 

“Overall, doctors say it’s not vital for you or most other COVID-19 patients to know what strain of the virus you have. However, it doesn’t hurt to ask.” The next time someone tells you they have Omicron, you have my permission to ask them how they know that, and tell them what you now know. 

Reference: Miller K, How to know what strain of COVID-29 you have. Prevention 2021 Dec 21.

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