What are the symptoms of the omicron COVID-19 variant?

It’s too early to know for certain how the omicron variant of the novel coronavirus behaves, but one small early study and multiple anecdotal reports suggest with cautious optimism that the strain may cause more mild symptoms than other variants such as delta, experts said. 

A digitally generated image of a semi-transparent red coronavirus cell with a blue glowing omicron sign inside. 
A digitally generated image of a semi-transparent red coronavirus cell with a blue glowing omicron sign inside. Andriy Onufriyenko/Getty Images

A report released Saturday from South Africa’s Tshwane District Hospital Complex at the center of an outbreak in Pretoria revealed that across two weeks, the majority of COVID-19 patients did not need supplemental oxygen. Most COVID-positive patients were admitted to the hospital for other medical, surgical or obstetric reasons and were found to be infectious after a required test.

The report took a close look at 42 patients in the COVID-19 ward on Dec. 2 and found that only 13 needed supplemental oxygen. The hospital confirmed that almost all cases were omicron; some cases weren’t tested for the strain. “It is essential to recognize that the patient information presented here only represents the first two weeks of the Omicron wave in Tshwane,” the study authors said. “The clinical profile of admitted patients could change significantly over the next two weeks, by which time we can draw conclusions about the severity of disease with greater precision.”

“Promising, but we certainly don’t know for certain,” UCSF epidemiologist Dr. George Rutherford said of the report. “We need to stay the course. Let us figure this out. Don’t jump to conclusions. We’ll navigate through these waters, just as we’ve navigated through other waters. People need to get vaccinated and get boosted.”

Mild symptoms have also generally been observed in cases emerging outside southern Africa, said UCSF infectious diseases expert Dr. Peter Chin-Hong. “In a recent report from the European CDC, of the first 70 cases of omicron in Europe, 50% have no symptoms and 50% have very mild symptoms,” he explained. “In the U.S. cases so far, most have been very mild.”

Fatigue, headache and body aches, symptoms that are common with the flu, are being reported by patients who tested positive for omicron, Chin-Hong said. “Some of the symptoms are very subtle,” he said.

Other symptoms typical with strains such as delta were less prevalent in the South Africa cases, including “no loss of taste or smell” and “less shortness of breath,” said Chin-Hong, referring to anecdotal reports on omicron cases from Dr. Angelique Coetzee, a private practitioner and chair of the South African Medical Association. 

What’s more, in the first glimpse of hospitalized patients with omicron emerging from South Africa, hospitalizations have not increased dramatically, Chin-Hong said.

“And those who have been admitted to the hospital have not been very ill,” he said. “Most have been in the general wards, not in the ICU, and most have not required oxygen. Admitted omicron patients have been hospitalized for a much shorter period than delta or previous other variants.”

Chin-Hong shared this information with the caveat that researchers are in the early stages of understanding the variant and it takes two to three weeks to really start seeing the impact of any surge of cases or hospitalizations.

In its online resource “What we know about omicron,” the Centers for Disease Control and Prevention has not made any statement about omicron causing milder disease. 

“More data are needed to know if Omicron infections, and especially reinfections and breakthrough infections in people who are fully vaccinated, cause more severe illness or death than infection with other variants,” the CDC said.

The CDC did say there’s indication that it may spread more easily than the original SARS-CoV-2 virus. “How easily Omicron spreads compared to Delta remains unknown,” the CDC said. “CDC expects that anyone with Omicron infection can spread the virus to others, even if they are vaccinated or don’t have symptoms.”

The first U.S. case of omicron was identified in San Francisco on Dec. 1, and since then, cases have been reported across the country. Twelve Alameda County residents who attended a wedding in Wisconsin last week tested positive for COVID-19, and five of them have been diagnosed with the omicron variant, health authorities said Friday.

The Alameda County Department of Public Health said genomic sequencing data that identifies the variant is not yet available for all 12 cases. 

State and federal officials have urged people not to panic as more information is gathered on the variant.  

“We are not surprised by this,” Gov. Gavin Newsom said last Wednesday when the first U.S. case was identified in California. “This was predicted.”

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