The Omicron Phase – Practice Practicalities What do you need to know to provide the best possible healthcare to your patients? 1. 2. 3. 4.
The characteristics of the illness Self-care and safety Preventing the illness Rationing care ( Identifying those who can care for themselves and providing the resources do they need to do that, to minimise their anxiety whilst maximising their vigilance for progression. Maximising support for those most at risk. ) 5. Tools to support care – Monitoring, IT and funding 6. Therapeutics in the community – what works and how to access it 7. Post illness care ( Long covid, and death in the community.) Appendix 1 Phases of the Omicron Response MOH Appendix 2 Quick Guide to the Covid Clinical Care Module
The characteristics of the illness. The most common symptoms reported are cough, runny/stuffy nose, and fatigue. UKHSA have reported that Omicron cases were less likely to report loss of smell and taste and more likely to report a sore throat than Delta cases, however, the latter finding could be incidental. The most common symptoms reported in early data were: cough; runny/stuffy nose; and fatigue. The COVID Symptoms Study (by health science company Zoe and Kings College London) reports that headache and sneezing are also common symptoms of Omicron infection. Preliminary information suggests no difference in symptoms between vaccinated and unvaccinated cases of COVID-19 infection but milder and shorter duration of illness in vaccinated cases. (link to ZOE study.) Symptoms reported in paediatric cases in South Africa have included fever, vomiting, diarrhoea and convulsions. 25-50% of infections may be asymptomatic – as case numbers rise, the safest bet is to treat everyone as if they had covid. Omicron is highly infectious, with an expected R number of 3.9 ( 2-3 times that of Delta. ) Self-Care and Safety It is still worth “red” streaming those with respiratory infections to take extra precautions, and reduce mixing with people with no respiratory infection. PPE guidance is clear. https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19information-specific-audiences/covid-19-personal-protective-equipment-central-supply/covid-19-infectionprevention-and-control-recommendations-health-and-disability-care-workers An N95 mask and eye protection is ideal in poorly ventilated spaces and with the highest risk circumstances. In well ventilated spaces a hospital grade surgical mask / well fitting triple layer cloth mask protects you and protects those you are in contact with. Regular hand washing and wiping of surfaces is helpful ( Omicron survives as viable virus for longer than delta.) The MOH guidance indicates that when the clinician is wearing a surgical mask, and patient wearing a surgical mask, all but the highest risk activities put the clinician at a level 1 (out of 4) risk of exposure, and in the event of contact with Omicron in those circumstances no stand down from work would be required, subject to testing and monitoring being put in place.