Nepal has reported 27 Omicron cases as of January 7. As new cases surge amid concerns if the country could witness an explosion of infections driven by the super contagious Omicron variant of coronavirus, experts say the daily numbers could just be the tip of the iceberg. The Post’s Drishna Sthapit met Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital, to find answers to some of the top Covid-19 questions.

The interview has been condensed for clarity.

What should we expect in the days and weeks ahead?

We can expect a rise in breakthrough infections because of the Omicron variant. A breakthrough case is when a person tests positive after being fully vaccinated. A vaccinated person can also spread the virus. Chances of reinfections are also equally high.

How accurate is a rapid antigen test?

A positive result in a rapid antigen test guarantees that one is infected but it doesn’t indicate the variant. To identify if it is the Omicron variant, we perform genome sequencing on the S-gene negative case to compare it with the blueprint of Omicron.

Is a negative test result reliable?

There could be some inaccuracies in polymerase chain reaction tests (PCR) or antigen tests.

Can I know if I tested positive for Omicron from a PCR test?

We can suspect that it is Omicron. In the PCR test, we analyze the different genes of the virus. It has been found that the S-gene has undergone many mutations. Because of this, it doesn’t match with the PCR and the result shows S-gene negative. When we look at the other genes, we can confirm that it is coronavirus but with one gene mutated, we can say that it is a new variant. Since the Omicron variant is spreading worldwide, we consider the S-gene negative case to be an Omicron infection.

What should I do after I test positive for Omicron?

Firstly, you should get rid of the phobia. We have already experienced two major waves. Research and trends in different countries show that though Omicron can spread at a lightning speed, there are fewer severe cases and hospitalization chances.

If you get infected, you should follow the Covid-19 guidelines. You should isolate yourself and regularly check your oxygen saturation levels. Studies have also shown that recovery is faster with Omicron.

Should I retest after the isolation period is over? How long can there be a positive result even after the isolation period?

We cannot say anything regarding Omicron as of now. As per previous experiences with the earlier variants, even after a few weeks, there can be a positive result. It is because PCR testing cannot identify if the virus is active or not. It only picks up the virus’s gene. Studies have shown that the coronavirus (earlier variants) becomes inactive after 10 days but can still be detected in the body. I think it will be a similar case with Omicron too. That is why we don’t recommend getting tested after the isolation period is over.

I am not vaccinated. What should I do if I have had contact with someone who tested positive for Covid-19? When should I test?

Testing is necessary to contain the virus. One should quarantine for 14 days and get tested five to six days after coming in contact.

Do I need a negative test following quarantine?

It is better to get tested after the quarantine period. Our aim is to control the spread of the virus.

I am vaccinated. What should I do if I have had contact with someone who tested positive for Covid-19?

People who are vaccinated are less likely to develop a critical condition. Nevertheless, vaccinated people can spread the virus, so one should quarantine and get tested. We have to say this because many people have still not been vaccinated and are vulnerable.