‘Be Vigilant’: What In-Home Care Providers Should Know About the Omicron Variant

The World Health Organization (WHO) on Friday officially designated the COVID-19 variant Omicron as “a variant of concern.” The U.N. agency on Monday followed that up by warning the global risk from Omicron is “very high” based on early evidence, noting the variant could have “severe consequences” as far as future surges.

While there’s still much to learn about Omicron, its emergence is yet another reminder that the pandemic is far from over for home health and home care providers. Additionally, it may be a glimpse at what the post-COVID world may look like without additional intervention.

“Be vigilant,” a LeadingAge spokesperson told in-home care providers in a message shared with Home Health Care News. “The pandemic is not over.”

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Home-based care operators had already been preparing for a challenging winter prior to the discovery of the Omicron variant, first detected in South Africa with cases later confirmed in Scotland, Spain, Canada and other countries. Many were feeling relatively optimistic about the next few months as well, with the worst of the Delta variant largely behind them and staff-quarantine numbers starting to go down.

“The number of clinicians on quarantine has peaked,” Amedisys Inc. (Nasdaq: AMED) President and COO Chris Gerard said on a recent earnings call. “And entering Q4, we’re seeing the [quarantine] number decline rapidly to less than 1%, which is also encouraging.”

If Omicron ends up being anywhere near contagious as Delta, it could upend the current outlook. And it’s only a matter of time before the COVID-19 mutation makes its way to the U.S., according to President Joe Biden.

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“Sooner or later, we’re going to see cases of this new variant here in the United States,” Biden said, speaking Monday from the White House. “We’ll have to face this new threat just as we face those who have come before it.”

Delta was first detected in India in late 2020. By August, it had spread to over 160 countries.

Despite targeting Omicron as high risk, WHO says it’s unclear whether the variant is more transmissible compared to Delta and previous COVID-19 mutations such as Alpha, Beta or Gamma. The agency similarly says it’s uncertain whether Omicron causes more severe disease compared to infections with other variants.

Dr. Anthony Fauci, Biden’s chief medical advisor for the pandemic, said it could be two weeks or more before further information about Omicron’s transmissibility and severity come to light. Early patterns, however, suggest Omicron likely spreads more easily, he said.

“If you look at the pattern of what’s going on right now in southern Africa — particularly in South Africa — when you have a spike of infections, they are very heavily weighted toward this new variant, the Omicron,” Fauci said during a Sunday TV appearance. “Therefore, you have to presume that it has a good degree of transmissibility advantage.”

The Delta variant accounts for nearly all coronavirus cases in the U.S., according to government statistics. At the start of last week, new daily COVID-19 hospitalizations nationwide were up 20% compared to the first week of November.

In the background

As Omicron looms large, in-home care providers are still trying to figure out how they’ll be affected by two main federal vaccine mandates — one from the U.S. Centers for Medicare & Medicaid Services (CMS) and another from the Occupational Safety and Health Administration (OSHA).

Enforcement of the OSHA mandate, which applies to employers of 100 or more workers, has been suspended after a federal appeals court reaffirmed an earlier legal challenge. Under the CMS mandate, health care workers who deliver services for certain Medicare and Medicaid providers must be fully vaccinated by Jan. 4.

Health care workers in 10 states are excluded from the CMS mandate after a federal judge in Missouri issued an order on Monday partially blocking its implementation. The 10 states — Alaska, Arkansas, Iowa, Kansas, Missouri, Nebraska, New Hampshire, North Dakota, South Dakota and Wyoming — filed a lawsuit against the Biden administration on Nov. 11.

If it proves to be as dangerous as Delta, the emergency of Omicron could strengthen the case for vaccine mandates. Broadly, vaccination, personal protective equipment (PPE) and proper infection control practices are three of the most important tools in-home care providers have to counter COVID-19 spread, the LeadingAge spokesperson emphasized.

“Focus on infection control and prevention,” the spokesperson said. “Be sure you’ve got sufficient PPE. Get vaccinations and boosters. One of the primary lessons we’ve learned during the pandemic is to stay abreast of information from public health officials. Now, more than ever, we’ve got to keep close watch on what experts tell us — listen and heed their guidance.”

It is too early to know whether the Omicron variant is resistant to current COVID-19 vaccines, Fauci said.

The saga around the Build Back Better Act, the Biden administration’s social spending package, is also in the background. The U.S. House of Representatives passed Build Back Better on Nov. 19, but key holdouts have slowed the legislation’s momentum in the Senate.

If enacted, Build Back Better would set aside $150 billion for home- and community-based services (HCBS). Funds would specifically be used to reduce waiting lists for in-home care services and improve pay for low-wage HCBS professionals.

Those objectives could prove critical in taking on another COVID-19 variant, according to the Partnership for Medicaid Home-Based Care (PMHC).

“As we continue to learn more about the Omicron variant, PMHC members urge Congress and the Biden administration to continue efforts to enact the Build Back Better Act to increase federal resources that will enable increased consumer access to home- and community-based services so that older adults, people with disabilities and individuals with complex medical needs can safely receive care at home,” a spokesperson for the organization told HHCN.

In response to Omicron, several countries have increased travel restrictions.

Additionally, Pfizer and Moderna announced they are preparing to reformulate their shots, if necessary.

“The best protection against this variant or any of the variants out there is getting fully vaccinated and getting a booster shot,” Biden continued, adding that Omicron “is a cause for concern, not a cause for panic.”

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