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DHHS Chief Medical Officer discusses latest Omicron variants

Department of Health and Human Services

Gwendolyn Glenn: The latest Omicron variants of the COVID virus BA4 and B5 are proving to be more transmissible, leading health officials to predict a surge in the near future. In North Carolina, emergency room visits for COVID are up by 5.5% and so are hospitalizations, with 971 people being treated currently for the virus, according to recent reports. New COVID cases continue to rise in recent weeks statewide, with more than 25,500 new cases reported the week of July 2nd, an increase of more than 1,000 from the previous week. They were down by just over 100 new cases this week. But state health director and DHHS Chief Medical Officer Dr. Elizabeth Tilson says the number of new cases can be misleading.

Elizabeth Tilson: We know that documented case count is an undercount. A lot of people are using home tests, which is great. A lot of people don't get tested. That's okay as well. And so we use that, our case data, as trend data and not an absolute — knowing that's not an absolute number.

Glenn: Any idea what percentage of people are using home tests and how many are coming back positive? Because I know, as you said, most people are not reporting those outcomes.

Tilson: That's right. And we do know it's a blind spot. Home tests are not reported to public health. So we know it's an undercount and that's okay as we move more into this kind of endemic living with COVID, we really want everybody to have a supply of home tests at home. So if they have symptoms, they can go ahead and do that test right away, and then they'll know. They'll need to isolate, they'll know to do those measures to prevent the spread to other people.

Glenn: Well, let's talk about the variants BA4 and BA5. Are they dominating the cases and if so, what percentage of cases?

Tilson: Right now what we're seeing is BA5 is starting to be the more dominant variant — about 68% or so is estimated about what's circulating in North Carolina. And BA4 is about another 15% in there. So between BA4 and BA5, it's probably close to about 80% or so.

Glenn: Explain — what are BA4 and BA5? And are they more severe in terms of the symptoms?

Tilson: Well, we're estimating is maybe about 12% or 13% more transmissible than prior variants, but also they can escape immunity. So they can escape immunity from waning vaccines and boosters, and then waning protection from past infection as well. The good news, though, is we are not seeing any major signs of increased severity, of increased hospitalization, or death with this variant. And that's probably a combination of some having to do with this variant, but more so because now at this point, almost everybody in North Carolina either has a vaccine, a booster or a past infection. Most everybody has some level of immunity at this point, which is great and is helping to really blunt the severity of new infections.

Glenn: And with these two variants. BA4 and BA5, are you seeing more people getting boosters, getting vaccines?

Tilson: Well, we're still seeing a slow but steady increase in people getting vaccinated, getting boosted. We aren't seeing a sharp increase with that. And so what we really want is people to have that information, to understand what is going on, and have a plan for treatment, especially if they're high risk. If they get infected, how are they going to access treatment? And we have a treatment finder on our website. And then again, for them to think also about another layer of protection -- when and where they might want to think about wearing a mask as an added layer of protection.

Glenn: With these two variants — and there has been talk about Omicron targeted boosters — what are you hearing in terms of Omicron targeted boosters and vaccines?

Tilson: Current vaccines and boosters greatly reduce your risk of severe illness, hospitalizations and deaths. Now, yes, it is true — people who are up to date on the vaccines can get infected with COVID. However, the vaccines currently available are very protective against severe illness, hospitalization and death. What we are hearing from the FDA is that the boosters that will be available in the fall — ahead of what we expect will be a fall and winter surge — will likely have some of those Omicron strains in there in order to be able to provide better protection over the winter.

Glenn: And looking toward that surge, what are state officials doing to prepare for it?

Tilson: We worked very closely with the General Assembly to allow for those flexibilities that will help us respond to a surge without needing to stay in a state of emergency. Second, continuing to be sure that people keep up to date with their vaccines and boosters and that when those more Omicron-specific ones are available, we'll be sure that they're readily accessible, that they're across the state and that people understand when they are available.

Glenn: So, on August 15th, the state of emergency ends, correct?

Tilson: That is correct.

Glenn: Does that take anything away — any tools out of your box to battle the surge or things that you could do under the state of emergency? How will that affect how you guys respond to this?

Tilson: We won't lose any of those critical tools by sunsetting that state of emergency.

Glenn: You know, this is summer travel. A lot of people are traveling and especially by taking flights with masks not required on flights. What's your advice, recommendations, for those who are traveling and concerned about these variants being more transmissible?

Tilson: So first and foremost, they should absolutely be up to date on their vaccines and boosters. Second, it would be good for them to test, test before they travel, test before they come back so they're aware if they're positive. Third, if people are concerned, wearing a well-fitting high grade mask like an N95 or KN95 does give protection to the person who's wearing that mask. That's an additional layer of protection that people can use, especially if they are on a plane or traveling with other people.

Glenn: North Carolina State Health Director and Chief Medical Officer Dr. Elizabeth Tilson.

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Gwendolyn is an award-winning journalist who has covered a broad range of stories on the local and national levels. Her experience includes producing on-air reports for National Public Radio and she worked full-time as a producer for NPR’s All Things Considered news program for five years. She worked for several years as an on-air contract reporter for CNN in Atlanta and worked in print as a reporter for the Baltimore Sun Media Group, The Washington Post and covered Congress and various federal agencies for the Daily Environment Report and Real Estate Finance Today. Glenn has won awards for her reports from the Maryland-DC-Delaware Press Association, SNA and the first-place radio award from the National Association of Black Journalists.