As it sweeps across America, the Omicron variant has proven to be the most widespread and contagious of all COVID-19 strains. In just a little under two months, during December 2021 and January 2022, Omicron cases soared from less than one percent of all cases to ninety nine. Since its peak in mid-January 2022, the overall number of cases has decreased, yet United Stateds Omicron deaths still remain high above those in other countries. And with the effectiveness of rapid tests — antigen or antibody — having been undermined by Omicron, and with COVID-19’s previous signature symptom, a loss of taste and/or smell no longer being a guarantee, Omicron is now presenting a unique obstacle in the midst of the COVID-19 pandemic.

Despite its high contagiousness, Omicron is significantly less fatal than the Delta variant. An infected person is 40% less likely to be hospitalized as opposed to Delta, and the UK’s rate of hospital admissions for Omicron has been only a third of what it was for the Delta variant. 

However, Omicron’s status as a milder strain of COVID-19 can often be misleading, especially when being compared to the flu. Even these so-called mild variants could cause cases that lead to long COVID-19 — when symptoms last weeks to months longer than the average case. Whether Omicron increases the risk for long COVID-19 is still unknown due to the disparity in gathered data. However, what is known is that the severity of a case does not determine someone’s chance of long-term symptoms — even asymptomatic cases have been known to result in long term COVID-19 symptoms. 

Similarly to the way it can potentially lengthen the symptoms of COVID-19, Omicron cases also have a tendency to reveal symptoms faster. Data suggests that the variant can be spread to others as soon as a single day after a person contracts it themselves, as opposed to the conventional belief that the infection period is a few days prior to and after symptoms develop. 

“Early data suggests that antigen tests do detect the Omicron variant but may have reduced sensitivity,” noted the FDA in a statement. Even rapid COVID-19 tests have proven to be generally accurate and effective at detecting the Omicron variant. However, some tests are less effective and more likely to give false negatives, especially Quidel QuickVue. This is an antigen tests, designed to detect certain proteins in the virus. Within the Omicron variant alone, there are dozens of mutations and counting, some of them to the proteins detected in rapid tests, which makes inaccurate rapid test results even more possible now.

Antibody tests are designed to detect antibodies that your body has released in response to a COVID-19 infection. However much like symptoms, antibodies can take several days to form after exposure and can remain for a while after recovery, which could lead to incorrect results in the form of both false negatives and false positives. False negatives can result because of a low viral load, or the amount of the virus present in your body, which is typically lowest directly after infection, and highest in the week after symptoms become evident. False positives are quite rarer at .05%, and usually occur due to antibodies being detected some time after infection and recovery, or rapid test batch flaws. 

President Biden’s plan to distribute COVID-19 tests to America is already in effect. The Federal Government has purchased a billion at-home tests to distribute, and as of January 19th, 2022, 500 million free COVID tests will be available at covidtests.gov. Four tests will be sent to all valid residential addresses upon order. Although the CDC cannot reimburse you for the costs of previously bought tests, the Biden Administration requires private health insurers to cover the costs of up to eight at-home COVID-19 tests, per person, per month. And courtesy of Siemens Healthineers, 50 million free tests will be distributed to community health centers and rural locations.

If this sounds too good to be true, that’s because it is. In many parts of America, rapid tests can be difficult or impossible to acquire. In addition, test coverage only applies to people covered by private insurance companies, with the exception of Medicare. The U.S. averages over half a million cases a day, and on January 27th, 2022, alone, almost 1.6 million COVID-19 tests were used. And that’s on a decreasing trend of both tests used and positive cases.

In addition to the scarcity of rapid tests, another common concern is how the Omicron variant affects the reinfection rate. Reinfection on its own is rare with risk of just under 2%, and resistance to reinfection is increased even more so by prior infection, as well as boosters. Rapid mutations and an extraordinary transmission rate offset the lower fatality rate of Omicron when the sheer amount of new cases per day continues to test the limits of the healthcare system. Vaccines and booster shots are now being offered and encouraged at every turn, but refusing them means could mean that you are now 20 times more likely to die of COVID-19. 

“If you look after two doses of vaccine, and you wait at least three months, your protection against infection or hospitalization goes down to about 30% to 40%. If you get that booster dose, in essence, a third dose, your protection against hospitalization, jumps back up to what it had been, if not higher, so about 75% to 80% protection against infection and hospitalization. Notice I didn’t say 100%,” said Dr. Gregory Poland, professor at Mayo Clinic. 

Omicron’s status as a milder strain of COVID-19 can often be misleading, especially when being compared to the flu. Even these so-called mild variants could cause cases that lead to long COVID-19 — when symptoms last weeks to months longer than the average case.