The highly transmissible COVID-19 omicron variant — while not yet confirmed in El Paso — may already be in the area, local infectious disease experts said.

Between updates to quarantine guidelines and rising questions about at-home tests and mask recommendations, El Paso Matters asked local and state infectious disease experts to clarify what El Pasoans need to know to protect themselves in the coming days and weeks.

The fall surge in COVID-19 cases in El Paso likely caused by the delta variant peaked in mid-December and has been declining for a couple of weeks, but experts are anticipating another increase.

Health experts, including the U.S. Centers for Disease Control and Prevention, anticipate an increase in cases in the coming days and weeks due to the new variant of SARS-CoV-2. Omicron was identified in November in southern Africa, according to the CDC. The first case in the United States was detected in California in December and has now been detected in most of the country, including Texas.

Dr. Ogechika Alozie, an infectious disease specialist and CEO of Sunset ID CARE, said people should be concerned about omicron. But he said while it is more transmissible than the delta variant, it is less virulent. He said that means people who are contracting omicron are not getting as sick because the virus is not replicating in the lungs.

“I think that’s important (because) it potentially can’t give you that deep, sick pneumonia that really eventually leads to the lethality and the long-term morbidity,” Alozie said. “It just doesn’t make people as sick intrinsically.”

Alozie and Dr. Armando Meza, chief of infectious diseases at Texas Tech Physicians of El Paso, said El Pasoans should consider several factors in deciding whether to attend New Year’s celebrations or other large indoor gatherings.

Alozie said individual risk factors should be taken into consideration, including whether the people gathering are fully vaccinated and boosted.

“I’m not sure that if you are not vaccinated or boosted that hanging out with people you don’t know is the smartest decision,” Alozie said.

Alozie said outside settings are less of a risk, but for indoor gatherings it is better to avoid people whose vaccination status is unknown.

He also said there is not a large risk with a family gathering where everyone is vaccinated except for children under the age of 5, because children in that age bracket typically do not get severe symptoms if exposed.

“It’s about, what’s your risk? How old are you? What are your comorbidities and who are you engaging with?” he said.

Meza said a lot of the initial recommendations from the start of the pandemic still apply, such as wearing a face covering, social distancing and assessing the environment of indoor gatherings or celebrations, particularly proper ventilation. He said outside gatherings, if possible, are recommended.

He said being exposed to new people, which includes people who may be visiting from out of town, could pose a risk.

“Exposure to new people means that (even) if you have a family member coming from out of town — for as much as you have known them in the past — they are new to your environment,” Meza said.

Meza said if someone thinks they were exposed to COVID-19 during a gathering, they should get tested as a precaution. If people are not sure they will be around fully vaccinated individuals, he recommended taking a test before and after any possible exposure to a new environment.

Mask recommendations

Health experts say protection against omicron requires well-fitting masks that provide a high degree of filtration.

“When we talk about masking, it’s not the Snoopy mask. It’s not a bedazzled mask. It’s not a homemade garter around your face. We have to be talking about, at the very least, double or triple-ply masks or surgical masks,” Alozie said.

Alozie said the KN95, N95 or KF94 masks will provide the best protection.

He also said kids at school should be wearing proper masks.

“We’re talking about masking (in schools) as if the Snoopy and Power Rangers and Spiderman masks are protective,” Alozie said. “They’re not, and especially as you’re coming to omicron season, those masks are not going to cut it and we’ve again been saying this for a long time.”

Meza said he recommends surgical masks for regular use and N95 masks for higher risk environments such as working in hospitals.

Meza said the key to the mask is consistency.

Dr. Gary Sheppard, an internal medicine specialist and president of the Harris County Medical Association, said he’s reemphasizing mask guidance in the wake of omicron spread.

He said it’s vital to wear a mask inside buildings in public settings, and outside when there are more than a few people and spreading out is impossible. That applies even for people who are fully vaccinated, Sheppard said.

He said a tight fit is important for masking, ensuring it rides snugly at the chin and cheeks, and can be adjusted with a nose pinch strip inside. He said masks secured either with ear loops or over-the-head straps will work.

“I have to wear N95s when I’m seeing patients, and some people like to tease me that I look like a chipmunk,” Sheppard said. “It fits around my jaw and pushes my cheeks up, because it’s a good, snug fit.”

To ensure the masks are purchased through a verified seller offering legitimate protection, there’s a list on the CDC website, or offers through the nonprofit Project N95. The CDC has guidance to identify counterfeit respirators.

It’s difficult to vet masks bought online. Sheppard said some red flags for the public looking to buy masks might be going to first-time sellers or websites that don’t match the link. Another sign the public should be wary of is if they see N95 respirators “on sale,” since they are in high demand.

Surgical masks and double-layered fabric masks still offer protection from the virus, Sheppard said, but are less effective than respirators. He said double masking with a cloth and surgical mask can offer more protection and may help with the fit to prevent large gaps. For people with smaller faces or beards, Sheppard recommended a mask brace, which can help create a better seal.

He said cloth masks offer the least protection but emphasized that a mask is better than no mask. 

He said he understands people are frustrated with pandemic restrictions but said the efforts to vaccinate and masks are ways to prevent continued overload on hospitals and burnout of medical workers.

“Please wear your mask,” Sheppard said. “It’s not a political statement, it’s simply science. It’s saying that I care about myself and I care about my fellow Americans.”

Conflicting quarantine guidelines

On Monday, the CDC shortened the recommended isolation and quarantine guidelines from 10 days to five days for those who had tested positive for COVID-19 and are asymptomatic. After the initial five-day quarantine, the CDC recommends wearing a mask around others for five days.

El Paso Health Authority Dr. Hector Ocaranza disagreed with that suggestion. He issued a statement this week saying that people who test positive for COVID-19 should follow the original CDC guidance, which was to isolate for 10 days.

“We need to look carefully at how we can implement and adapt these new recommendations to our community considering all factors, positive and negative, particularly our community’s vulnerability and other variables that could have immediate local effects,” Ocaranza said.

Meza and Alozie said the CDC’s decision to shorten the quarantine window is an effort to minimize the impact on the workforce, but people who test positive for COVID-19 need to take certain factors into consideration regarding the quarantine window.

Meza said the main consideration is whether people who test positive also have symptoms for COVID-19. 

If they have symptoms, they need to be more careful because transmissibility is higher. He said symptoms mean the virus is replicating in large numbers and can spread to someone else more easily.

He said if someone tests positive and has no symptoms, they need to consider if they are exposing someone who may be at a high risk of getting sick. If that potential is there, then they have to be careful regardless of whether they have symptoms or not, he said.

Meza said symptomatic individuals should be quarantined as long as they are symptomatic. If someone is not symptomatic, but there is someone at home who is at high risk, he said they should still quarantine to avoid exposing someone who could get severe complications.

Alozie said if someone tests positive for COVID-19, they definitely need to remove themselves from other people and quarantine, but he also thinks the CDC needs to adopt a “test to stay” strategy.

He said that would mean that if someone tests positive, then they should quarantine and then use an antigen test on the fifth day. If the test is negative they could return to work. If they test positive then they would stay home until getting a negative antigen test result.

Meza and Alozie said at-home COVID-19 tests are helpful.

Alozie said the advantage of the at-home tests is the quick result.

“They allow you the ability to test rapidly, test quickly and to test multiple times,” he said.

Meza said people who may not like to do the tests on themselves at home can still opt for the PCR tests available at testing sites.

Danielle Prokop contributed to this story.

Cover photo: The Don Haskins Recreation Center in West El Paso has seen heavy traffic this week from people coming for post-Christmas COVID-19 tests. (Angela Saavedra/El Paso Matters)