Omicron Variant Symptoms: What to Look For

On Saturday, January 8, 2022, the DOH recorded 26,458 positive cases, an all time high.  The country's positivity rate for COVID tests jumped to 43.7%.  Cases are skyrocketing and the most likely explanation is that the new variant, Omicron, has arrived.  

Standard COVID tests tell you your status, but they don't tell you which variant you have.  Patients and doctors alike are scrambling to distinguish between the Omicron variant symptoms vs. previous strains.

Are Omicron variant symptoms different from Delta variant symptoms?

The symptoms of Omicron are more similar to Delta than they are different.  Several symptoms overlap, such as fatigue, cough, and body aches.  One major difference is the loss of smell and taste.  This symptom appears far less common with Omicron.  Around 12% of Omicron cases report anosmia (loss of smell) compared with almost half of patients infected with previous COVID strains.  

What does the typical Omicron case look like?

As with earlier variants, most COVID patients have a mix of symptoms that resolve within a week or two and usually don't require hospitalization.  Data from the world's largest ongoing COVID study suggests that the five most common Omicron symptoms are:

  • Runny Nose
  • Sneezing
  • Headache
  • Fatigue
  • Sore throat

These symptoms are based on self-reports from people using the ZOE Covid tracking app.   There are also many anecdotal reports of patients having a scratchy throat.  Overall, Omicron infection appears to cause more upper respiratory symptoms.

"We are seeing more and more studies pointing out that Omicron is infecting the upper part of the body. Unlike other ones....who would be causing severe pneumonia," said WHO Incident Manager, Abdi Mahamud.  "It can be good news, but we really require more studies to prove that."

Is Omicron Mild?

Most reports of "mild" illness are anecdotal.  More research is needed to get the full clinical picture. Some early studies suggest the Omicron variant symptoms are less severe than Delta.  But the World Health Organization cautions against using the word mild:

"While Omicron does appear to be less severe compared to Delta, especially in those vaccinated, it does not mean it should be categorized as 'mild,' " said WHO director-general, Tedros Adhanom Ghebreyesus.  "Just like previous variants, Omicron is hospitalizing people and it is killing people."

A lot of our initial data comes out of South Africa, where the Omicron variant was first identified.  The South African population is young and has a high level of immunity.  We may see very different outcomes in countries where the population is older or has low rates of vaccination.

Will Omicron hit the Philippines harder?

Some health experts suggest the severity of symptoms will depend on underlying health conditions and vaccination status.  That does not bode well for the Philippines, where a large number of people suffer comorbidities and are unvaccinated.

Diabetes is prevalent here, and research shows that COVID-19 is much more severe in diabetes patients.  Moreover, the Philippines has a low vaccination rate of around 33 percent.  Both factors put Filipinos at a higher risk for severe infection with Omicron.

Low rate of vaccination among seniors

The vaccination rate is even worse for senior citizens.  Only 25% of elderly Filipinos are fully vaccinated.  Less than a quarter of a million seniors have received a vaccine booster  Booster shots provide a critical layer of protection against Omicron, especially for vulnerable populations. The slow vaccination roll out leaves millions of elderly Filipinos at increased risk of severe illness and death.  

Low rate of vaccination among children

The Philippines has been slow to approve COVID vaccination in children. In late December, the FDA finally authorized the use of Pfizer-BioNTech in children aged 5 to 11.  However, it could be several weeks before the vaccine roll out, since the country has yet to procure child-size syringes.  

Filipino children may pay dearly for the government's poor planning.  Initial data suggests that children are 20 percent more likely to be hospitalized by Omicron than other coronavirus strains.  The pressure from both sides-unvaccinated children and seniors-could overwhelm the Philippine healthcare system once Omicron hits in earnest.

Are Omicron variant symptoms different for vaccinated people?

Most COVID vaccines offer little protection against getting infected with Omicron.  But vaccination does appear to make Omicron symptoms less severe.  Most vaccinated patients present with symptoms similar to a bad cold:  body ache, headache, sneezing, runny nose, and a scratchy throat.  

So, what does Omicron look like for unvaccinated people?

"For unvaccinated people, the symptoms of Omicron look a lot like Delta," said Dr. Daniel Griffin, chief of infectious diseases at ProHealth. "If we have a patient who's younger, if we have a patient who's vaccinated, if we have a patient who recently recovered from Delta, we're tending to see very mild disease with Omicron.  But people who are fresh, with no preexisting immunity, it's hard to see that the virus is milder."

Does Omicron cause more stomach upset or fatigue than other variants?

Some of the top Google searches for Omicron symptoms are related to stomach upset.  However, the CDC's list of symptoms has long included nausea, vomiting, and diarrhea.  So, why the uptick in searches?  Health experts have a few theories.

For one, fewer patients are experiencing anosmia, a disconcerting symptom of the original variant.  Milder symptoms, like nausea, become more noticeable because patients aren't preoccupied by a sudden loss of smell.  Also, Omicron patients are more likely to experience a stuffy head.  The phlegm they produce can cause stomach irritation if swallowed.

Fatigue is a symptom of all COVID strains.  It's actually more common than the 'classic' symptoms of cough, fever, and anosmia.  How do you distinguish fatigue from just being tired?  COVID fatigue usually comes on suddenly and lasts for 5-8 days.  But some people develop "post-viral fatigue,"  a condition where exhaustion continues for weeks after infection.

Incubation period: How long before Omicron variant symptoms appear?

Omicron is our quickest variant yet.  It only takes about three days from exposure to symptom onset. By contrast, Delta took about four days.  The original coronavirus took six. A faster incubation period means you become contagious faster.   That's part of why Omicron is spreading so fast. Health officials also have less time to test, trace, and isolate positive patients, making it harder to control the outbreak.

What should I do if I develop symptoms?

Get tested.  If you can't get a test due to the shortage, assume you are positive and isolate at home.  For mild symptoms, a virtual doctor can assess your condition at home so you don't expose others. For severe symptoms, such as difficulty breathing or shortness of breath, seek medical attention right away.