Omicron variant and the immunocompromised

[Lindaan]

Is the Omicron variant less dangerous for the immunocompromised than the Delta variant?

[seelel]

There are a few things worth mentioning here:

Firstly, the word, 'immunocompromised' is a very broad term. If we narrow it down to CLL and then include W&W, in treatment, and post treatment, we are all still immunocompromised. But we can be immunocompromised to different degrees regardless of where we are on our CLL journey.

The next point then is, how effective was the vaccine for us? Some have no measurable antibodies, some have a few, and some have adequate quantities.

One of the primary differences between Delta and Omicron is that the Delta takes up residence in the nose and lungs and Omicron predominantly the mouth and bronchi. This is the reason that milder disease is being reported for most people with Omicron. Whether that translates into milder disease for us with CLL is yet to be seen. You would think so, but we have to watch this space...........

[oryoki in reply to seelel]

Do you have a reference about Omicron being predominantly in the mouth and bronchi? I find the Hong Kong University report med.hku.hk/en/news/press/20... with the tissue samples from the bronchi but no mention of mouth tissue.

[seelel in reply to oryoki]

The South Africans identified a month or so ago that with the Delta variant, the standard PCR test had high efficacy in the nose, but reduced efficacy in the mouth. But with the Omicron variant they found high efficacy in the mouth, but up to 30% reduced efficacy in the nose. Hence the conclusion that Omicron doesn't replicate as much in the nose as it does in the mouth.

The question was asked then, shouldn't the PCR test be modified for Omicron? It seems that the manufacturers were reluctant to make the change, so we are left with a percentage of false negatives with swabs from the nose when testing for Omicron. I'm not sure why we don't change to swabbing the mouth for Omicron.

[Country_est in reply to seelel]

Just had a PCR test here in the UK and the swab was both mouth and nose.

[mrsjsmith in reply to Country_est]

Yes and just checked mine and it’s also for both. Assume seelel is getting confused with the lateral flow that has changed to nose only swab. Or are they different in Australia.

Colette

[AussieNeil Partner Administrator in reply to mrsjsmith]

I've read the same information as Seelel about Omicron preferentially growing in the mouth rather than the nose, but couldn't find it. Different countries may use different PCR tests.

[mrsjsmith in reply to AussieNeil]

Thank you Neil,

Oh dear something else to worry about if the new single swab lateral flows are not as effective as the originals. Allegedly 8 million being sent around the country this week.

Colette

[LeoPa in reply to Country_est]

With the same stick? Hopefully in that order 😂

[Phil4-13 in reply to LeoPa]

LeoPa, 🤔 Something to think about! 😀 Sandrs

[bkoffman CLL CURE Hero]

We don't know yet.

[Newdawn Administrator]

Anecdotally and from personal experience, I have a sense Omicron is a very different proposition to Delta. Even on this site we are hearing of markedly different and milder experiences from omicron infection.

My family have been on daily testing with lateral flows over the past 9 days and have found them very accurate. It recommends swabbing the throat and one nostril. The PCR that I did was also 5 seconds around each tonsil area (seems a very long period and most don’t observe it) and swabbing one nostril.

Newdawn

[mrsjsmith in reply to Newdawn]

Newdawn the most recent box I received are for the nose only and have a much shorter swab. A couple of friends have commented that they prefer not swabbing the throat ( I don’t mind ) so it sounds as though there are still two types in circulation, assuming you didn’t have a large stock you are using up.

Colette

[Newdawn Administrator in reply to mrsjsmith]

I’ve just tested with a Flowflex which are the newest batch sent to us Colette. They’re the standard issue long swab. I hate swabbing the throat but would prefer to if there’s a question of accuracy.

Newdawn

[mrsjsmith in reply to Newdawn]

Curious mine are also Flowflex and for nostril only and the liquid is already in the tube, unlike the original.

Colette

[Soundsinamotion in reply to Newdawn]

How are you feeling? Has your covid experience been pretty mild for you and your family? Hoping you are back to negative soon and can go on with your life ❤️

[Newdawn Administrator in reply to Soundsinamotion]

I’m doing well thank you and registered a second negative LFT today. I’m thankful to have been well vaccinated when this ‘hit’ because I’m sure it converted a potentially nasty infection into a much milder (but nonetheless unpleasant) one.

Newdawn

[Soundsinamotion in reply to Newdawn]

I’m so happy you’re doing better. Makes me feel a bit safer with my father who has multiple comorbidities. He just got his 3rd booster like 3 weeks ago.

[Floxxy in reply to Newdawn]

I'm delighted to hear that you are on the mend. X

[Dinasantos in reply to Newdawn]

Happy to see you are feeling better.Do you mind sharing how many vaccines you had and which ones?

Thank you

[Newdawn Administrator in reply to Dinasantos]

I’ve had two Astra Zeneca vaccines and a third Pfizer. My last one was 5 weeks before contracting Covid.

Incidentally, a spike protein test after the first 2 vaccines showed I hadn’t made any antibody response at all (0.4 to be exact).

Regards,

Newdawn

[Dinasantos in reply to Newdawn]

Thank you

[LeoPa]

I read somewhere that omicron multiplies 70 times faster in the bronchi but 40 times slower in the lungs. I also read that the milder symptoms reported in the UK are due to the high level of vaccination of the elderly and immune compromised and the virus spreading mainly among younger folks who are not that much at risk. Given that we have half of the population unvaccinated in Slovakia we are going to be the perfect testing ground for comparison. In a few weeks we will see whether our hospitals will see many more admissions and deaths than the hospitals in the UK per million population.

[MichaelFinn in reply to LeoPa]

Yes I read similar in The Guardian, it was 70x more quickly in the bronchial tissue but 10x more slowly in the lungs (Hong Kong study). than the original variant.

It gives us hope of milder disease but it was also pointed out that it wasn't just speed of replication but immune response, in particular cytokine storm that determined severity of disease; also that delta, which proved to be more pathogenic, replicated more slowly in the lungs than the original.