Omicron: Doctor explains how to think about new CDC guidelines and COVID-19 symptoms

Dr. Manish Garg, an emergency medicine physician & co-founder of the World Academic Council of Emergency Medicine, joins Yahoo Finance Live to discuss the latest CDC guidelines amid the coronavirus pandemic's latest surge and ongoing testing issues.

Video Transcript

JARED BILKRE: US passed another COVID milestone, reaching a new high with the seven day average reaching 267,000. And on Tuesday, that number was 512,553 daily new cases. And to break down everything on the COVID front, we want to bring in Dr. Manish Garg. He is the Emergency Medicine Physician and Co-Founder of World Academic Council of Emergency Medicine. Doctor, thank you for joining us here today.

I understand you're based in New York City. You're in the thick of it, along with me here, and a lot of other people on our staff. There's a lot of frustration around the testing situation and just the CDC guidelines. And we can get into all of that. But what's your ground level assessment of the way things are right now in New York?

MANISH GARG: Hi, Jared. Hi, Karina. Thanks for having me back on the show. Wish you a wonderful new year. Yes, Jared, it's difficult, right? We are seeing increased case counts. We're seeing increased hospitalizations. We're seeing sadly, increased deaths. We are at over 267,000 cases, right? And this shatters the 251,000 that was in January 2021.

So we know very predictably, that after we have this high level of case counts, you're going to see in one to two weeks more hospitalizations and more deaths. So particularly, we want to make sure that we protect all of the vulnerable folks that are there. I'm seeing it right now. Our staff is seeing it. It's been two years. People are pretty tired. I'm sure the folks are pretty tired at home.

And it's important to know that in New York City where we're seeing it, we're seeing almost 100% Omicron. But around the country, the CDC has now reissued a statement that said, it's about probably 75% Delta, and 25% Omicron that's out there. So we really are seeing a dual wave.

We know that as an airborne virus in the wintertime when folks are back together, Thanksgiving, Christmas, New Year's, it's important that we keep each other safe. And so we are seeing that right now. And it's concerning.

KARINA MITCHELL: And Dr. Garg, that's probably why we're seeing such a rise in hospitalizations as well, correct? Because the CDC did revise down those guidelines. But also, they revised their guidelines regarding the isolation policy. And so someone who tests positive after five days are then cleared to sort of move around. They need to wear a mask.

And that has raised a lot of eyebrows. It's created a lot of confusion. Some people argue that it was more a business decision than a scientifically based one. And the CDC now basically says, that they base their decision on the comfort level of people, and how much they could tolerate. Let's listen to a bite.

ROCHELLE WALENSKY: Many people are asymptomatic, or only mildly symptomatic, especially those who have been vaccinated or boosted. And so they may very well not be able to or willing to comply with 10 days worth of isolation. So this was really a way to tell people, make sure you isolate in those first five days when you're maximally infectious. And then of course, wear a mask for those last five days to make sure that you don't spread anything that might be left over to others.

KARINA MITCHELL: So basically, you know, the crux of this message is that, we're not sure how much people could tolerate, and so we are reducing this isolation policy to five days. How do you feel about this change? Are you in line with it? Do you agree with it?

MANISH GARG: Well, I understand the science, Karina. And I think the take home is that this provides a way to get asymptomatic for resolving symptomatic employees back to work using the science. But I think this strategy is the minimum time that we should use. We should not think of this as a five day strategy, like what's being said.

It should be thought of as a 10 day strategy, wherein, the five days, you're really looking at isolation or quarantine. And then in the following five days, you're really trying to do your best to make sure that you're wearing a mask, and you're trying to keep safe from others so that you don't infect others. I think what's important here, Karina, is that you use a humanistic and thoughtful approach with these guidelines.

Labor issues are very delicate, as you brought up. You know, there are issues from the employer side, right? They want to keep society running. On the employee side, there's a real human toll, right? It's been two years of this pandemic.

I can only talk about it from my standpoint. 48 trainees that I'm charged with, these are just beautiful lovely people. They're self-sacrificing. They want to help out their communities. They're the front line doctors who are caring for folks in New York City during this pandemic. These are my mentees. You know, so for them, I'm accountable to them and their families.

So here's how I view the guideline as a practical approach. I try to break this guideline and put it into tiers. If you are minimally symptomatic, or no symptoms in tier one, then it makes sense for me to get you back in as soon as I can get a person back in. If you had a lot of symptoms, but then resolved very quickly, then I can also get you back in looking in that five to 10 day range. But if you're not feeling better, or your symptoms are pretty stable, then we really should keep you out as best as we can. And I think that if we do that, especially with that last group, we can use a very thoughtful approach that's very humanistic, and hopefully, can provide a little bit of guidance, particularly with the employers as they're trying to take care of their incredible employees who have really, really endured a lot right now.

JARED BILKRE: And Doctor, a lot of the previous assumptions have been I guess, taken another look at. And some of these decisions are getting revised with what we've been seeing with the CDC, and et cetera. But on the testing front, it's clear that we're way behind the curve here, people waiting for up to a week still to get results, lines around the block. And meanwhile, how much are these vaccine passports really helping things?

Because we've seen travel bans in the US, international ones rescinded on the logic that we're not going to stop the flow here. So are vaccine passports-- is that something that is being revisited right now? What's your personal opinion there?

MANISH GARG: It's obviously very complicated, Jared, and very nuanced. I would say that if we have ways that we can assess-- I mean, I guess the way I think about it is, we've been running in a traffic pattern, if I use that analogy, we've been using roundabouts everywhere. And in a multi-lane roundabout, instead, we should probably go back to some of these traffic lights. We should be looking at some things where we have the data to understand where international sites are dangerous, where our own US counties are dangerous.

I mean, for example, we have over 50 counties right now that are at or above their threshold for capacity. And we can identify what places need a yellow light, or what places maybe need a red light in those districts or those counties, where maybe we need to stop having indoor dining. Not for a long period of time, but just for like a week or two while we get through this Omicron wave. Maybe we need to really tighten up on some of the international travel.

I think these, Jared, are becoming really, really important aspects. I mean, we talked about China. You know, China is you know, for all of the challenges that we have politically with China, they've been doing a pretty great job. They've gone from 175 cases in that area to 150. It's not no cases. But they've done a really great job when you compare what they're doing with what we're doing here.

And so we really can probably try to institute a few more of these traffic light ideas. And I think maybe with the international travel, I think the vaccine passports is probably a good strategy. I know that that meets a lot of folks who are very critical of any type of freedom challenge. But I think it is better for us from a public health standpoint to make sure that we're protecting our people, and we're protecting the international society.

JARED BILKRE: Yeah, and I think a more nuanced approach is warranted, just as long as the one-size-fits-all is kind of understood that that was a temporary measure at the time. Have to leave it there. Really appreciate your thoughts on all of this. Always great to talk with you, Doctor Manish Garg, Emergency Medicine Physician and Co-Founder of World Academic Council of Emergency Medicine.