Recovered from Omicron? Don’t bet on lasting immunity, says UCSF doctor

Written by Danielle Chiriguayo, produced by Robin Estrin and Bennett Purser

People queue in line at a coronavirus disease (COVID-19) testing site, as the Omicron variant threatens to increase case numbers after the Christmas holiday break, in the Lincoln Heights neighborhood of Los Angeles, California, U.S. December 27, 2021. Photo by REUTERS/Bing Guan.

In LA County, one in five people who tested for coronavirus got a positive result this past week, and hospitalizations have increased since Christmas. But early research suggests Omicron doesn’t attack the lungs like Delta and earlier COVID variants, which means people aren’t getting as sick, especially those who are vaccinated. 

Dr. Robert Wachter, chair of UCSF Department of Medicine, suggests cases will continue rising over the next few weeks, which prompts concerns for hospitals being overwhelmed.

“The big question is going to be how much milder Omicron is than the prior variants, and how much disconnect there is between this massive number of cases and hospitalizations,” Wachter explains. “Hospitals can get overwhelmed with tons of COVID patients. They can also get overwhelmed if doctors and nurses can't come in because they all have COVID. And we're starting to worry as much about keeping our staffing up as caring for the patients.” 

Because of the potential for millions of Americans to be out of commission due to COVID-19, the CDC recently changed its guidance on isolation. It advises that COVID-positive people only need to isolate for five days as opposed to 10. Wachter says their rationale can be traced to ensuring there’s a workforce that can maintain essential services, including at hospitals and airports. 

But he points out there has been pushback on the new guidance, since some people are still infectious after day five. It may push the CDC to change its guidance again, potentially in accordance with new California rules that mandate a COVID test after the five-day isolation period. 

Wachter adds that problems also exist with COVID tests — some people are testing positive and are no longer infectious. He notes that PCR tests can detect even the tiniest amounts of coronavirus inside the body, while generally, antigen tests can tell whether someone is infectious at that moment. 

But he adds that Omicron differs from other variants in that people who have it can start to get sick and/or be infectious within days. 

Does Omicron recovery mean immunity? 

Similar to other variants, people who recover from Omicron can receive immunity. But the duration and strength of that protection remains unclear. 

“You'll probably be in a place where pretty much everybody has some level of immunity. And the question is whether we're going to have a good … March, April, May, but then that immunity wears off and people with low levels of immunity are susceptible again, or that immunity is long-lasting. The people who are counting on their infection to be their immunity forevermore, I still think are making a bad bet.”

He recommends that unvaccinated people who have caught COVID should still get vaccinated because it will provide a higher and longer-lasting level of immunity. 

Although nothing is guaranteed, Wachter is hopeful that COVID might reach an endemic level in the spring, where stories about bad bouts of infection will exist but won’t reach the level seen in months prior.