Dr. Marc Siegel: What I tell patients who get Omicron despite three vax shots

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Many people who are vaccinated, boosted and had COVID before are getting it again — and they are furious. They no longer believe the doctors or the president. Several of my patients have come to me (via televisit) feeling I let them down by pushing them to get the vaccine and then the booster only to find themselves sick with Omicron.

What can I tell them?

For one thing, I can reassure them that their shots weren’t wasted: They were far less likely to get very sick with COVID after receiving the vaccine and even less so with a recent booster. 

I can and do also tell them that though I wish they hadn’t gotten Omicron, they are now protected not only against another bout of Omicron but also against the more dangerous Delta. I can tell them what the Biden administration isn’t: All immunity, no matter how you get it, matters.

I can tell them what the Biden administration isn’t: All immunity, no matter how you get it, matters.

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Experts have wondered if Omicron’s much-milder symptoms are the result of a naturally milder virus, patients with immunity through infection or vaccination or a combination of all three. Of course, there are person-to-person variations, depending on underlying disease and immune status, but most scientists agree: The more immunity of any kind to COVID, the better.

A South African study released Friday has cheering news: Researchers found about a quarter of Omicron’s reduced risk of hospitalization or death, compared with Delta, is the result of the variant’s traits, with the rest of the risk reduced mostly by immunity.

Dr. Marc Siegel

Not only that, but multiple studies have shown that the Omicron variant itself affects the upper airways far more than the lungs, even as it’s much more transmissible than any other variant. This is exactly what happened in the later stages of 1918 Spanish flu pandemic, according to John M. Barry, author of "The Great Influenza: The Epic Story of the Deadliest Plague in History," who spoke to me about it on SiriusXM’s Doctor Radio this week.

There is no guarantee that the same will happen now, but it would behoove our public-health leaders to make the comparison, as opposed to the constant fearmongering.

The obsession with testing and isolation is counterproductive not only because we lack readily available home tests, but also because the virus is now almost everywhere, and isolating yourself if you aren’t sick does little to decrease the amount of virus circulating in the community.

One reason President Joe Biden’s poll numbers are dropping is most Americans recognize that he overpromised on the vaccine. Vaccines have two essential purposes: to prevent spread and to decrease severity. And though the mRNA vaccines clearly decrease severity of infection, especially with a recent booster, they clearly are doing little to prevent spread. This makes the mandate argument even more unconvincing — why mandate a vaccine that doesn’t prevent spread of the pathogen?

One reason President Joe Biden’s poll numbers are dropping is most Americans recognize that he overpromised on the vaccine.

Dr. Kakoto Iwasaki, world-renowned Yale immunologist, told me that she is working on a vaccine to prevent infection altogether by blocking uptake in the nasal passages. Now this might be a vaccine worth mandating to certain groups in the name of public safety, but it’s several months away at a minimum.

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In the meantime, all we have is the cruel rhetoric against the unvaccinated and the consequences of the overpromising of a life-saving vaccine by drug companies, the media and politicians.

And the public is left not believing in any of them — or, for that matter, in doctors like me, who have been on the front lines saving lives but then all too often inhale the dogma of reproach.

"May I never see in the patient anything but a fellow creature in pain. Grant me the strength, time and opportunity always to correct what I have acquired," said the greatest physician-philosopher of them all, Maimonides. We can echo that sentiment by telling our patients what we still don’t know, rather than flogging them with what little we do.

Marc Siegel, M.D., is a clinical professor of medicine and medical director of Doctor Radio at NYU Langone Health and a Fox News medical analyst.