Omicron:

Public Health Response

Dr.K.Kolanda Swamy.
MBBS, MAE, DPH, DIH, DBE,
PG in Global Health (Japan),
PG in HFW Management.

05-12-2021 Public Health Expert in Infectious Diseases Control,

Immunisation, MCH and Disaster Management.
 Omicron
• The variant was detected during the second
week of November 2021 in South Africa

• Designated as a variant of concern and named

as Omicron by WHO on November 26th
Why Omicron may become a major challenge?

• Characterised by very high viral load and therefore the transmissibility is

very high

• Breakthrough infections among vaccinated people do occur

• Re-infections among those already infected is yet to be assessed in detail

• Severity of the disease by Omicron, than the earlier variants is also yet to

be assessed in detail
What needs to be done to avert a Third Wave?
• To ensure the RTPCR tests detect the Omicron variant

• To do genotyping of passengers coming from High Omicron

prevalent countries and contacts of Omicron positive cases

• Random sampling of genotyping to be continued

• Number of genotyping laboratories and their capacity to be

augmented for continuous monitoring of COVID-19 variants
Can travel restrcitions and screening prevent
Omicron transmission ?
• No. Why?
• Asymptomatic persons

• Transmissibility before and after the symptoms

• Inability of the RTPCR or any other Lab Test to capture all

positive cases

• It can only help in monitoring and delaying the transmission

Then, where should we focus?
Seven Principles for Transmission Prevention
1. Vaccination including a booster dose preferably with
killed whole virus preparation

2. Universal wearing of Face Mask

3. Frequent Hand Wash

4. Disinfection of surfaces frequently touched by hands

Seven Principles for Transmission Prevention
5. Social distancing – Avoid crowded places particularly
closed and contained spaces

6. Physical distance – two meters

7. Good ventilation by opening doors and windows and

additional pedestal fans and exhaust fans
Which is the most dangerous commonly prevalent
microorganism for Health Care Personnel?

• Multi Drug Resistant M.tuberculosis

• Please ensure face mask in health care setting for

patients, visitors and Health Care Personnel.
 Case Management
• Availability of oxygen and oxygen administration devices

• Availability of medicines

• Control of co-morbidities

• Mucor mycosis prevention and management

• Booster dose for all Health Care Personnel

• 6 months after second dose preferably with killed whole virus preparation
Three High Risk Situations (WHO)
 Overlapping Situations

Three Cs
1.Crowded Places
2.Close Contact Settings
3.Confined and enclosed spaces
WHO Recommendations on Natural Ventilation
in Health Care Facilities
 WHO Recommendation-1

• To help prevent airborne infections, adequate

ventilation in health-care facilities in all patient-care

areas is necessary.
 WHO Recommendation-2
Minimum hourly averaged ventilation rates for Natural Ventilation

• 160 litres/second/patient (hourly average ventilation rate) for

airborne precaution rooms (with a minimum of 80 litres /second
/patient)
• 60 litres/second /patient for general wards and outpatient
departments
• 2.5 litres/second/m3 for corridors and other transient spaces
without a fixed number of patients
 WHO Conditional Recommendation-3

• When designing naturally ventilated health-care facilities,

overall airflow should bring the air from the agent
sources to areas where there is sufficient dilution, and
preferably to the outdoors.
 WHO Conditional Recommendation-4
• For spaces where aerosol-generating procedures associated
with pathogen transmission are conducted, the natural
ventilation requirement should, as a minimum, follow
Recommendation 2.
• Should the agent be airborne, Recommendations 2 and 3
should be followed.
 Please remember

• Protection by PPE will be complete only when first

level administrative controls and second level
engineering and environmental controls are properly
in place.

Note: PPEs are not deep sea diving suits

 The first level of Infection Control

Administrative Controls

• Measures taken to ensure that the entire system works effectively.

• implementing proper procedures for triage of patients
• detecting infections early
• separating infectious patients from others
• transporting the patients safely
• educating the patients and staff
• designating responsibilities clearly and correctly
• communicating with all relevant partners.
 The second level of Infection Control
Environmental and engineering controls

• Cleaning and disinfection of the environment

• Spatial separation and

• Ventilation of spaces in the building

 The third level of Infection Control
Proper Personal Protective Equipment

• Further decrease of the risk of transmission is personal

protection, which is the provision of the
• Proper Personal Protective Equipment (PPE)
• (e.g. masks, respirators).
 Ventilation Methods

• Natural Ventilation

• Mechanical Ventilation

• Hybrid (mixed-mode) ventilation.

 Basic Ventilation Criteria
• Ventilation Rate
• the amount and quality of outdoor air provided into the space
• Air Flow Direction
• the overall airflow direction in a building and between spaces
should be from clean-to-less clean zones
• Air Distribution or Air Flow Pattern
• the supply of air that should be delivered to each part of the
space to improve dilution and removal of airborne pollutants
generated in the space.
Well Ventilated Ward in an Infectious Disease Hospital
Installation of High Efficiency Particulate Air (HEPA) Filters

• When appropriately selected, deployed and maintained, single-space

air cleaners with HEPA filters (either ceiling mounted or portable)
can be effective in reducing/lowering concentrations of infectious
aerosols in a single space.

• The effectiveness of portable HEPA filters will depend on the airflow

capacity of the unit, the configuration of the room including
furniture and persons in the room, the position of the HEPA filter
unit relative to the layout of the room, and the location of the
supply registers or grilles.
Installation of High Efficiency Particulate Air (HEPA) Filters

• To be effective, recirculation of all or nearly all of the room air

through the HEPA filter should be achieved, and the unit should be
designed to achieve the equivalent of ≥2 ACH.
• Health-care facilities that choose to use HEPA filters should follow
the manufacturer’s instructions, including on recommended
cleaning and maintenance procedures for HEPA filters, otherwise
portable HEPA filters can lead to a false sense of security as their
performance decreases due to filter loading.
 Offices, Schools, Work Places, Shops
• In all workplaces, schools, offices, shops there should be fresh,
clean air.
• WHO recommends an increased ventilation rate through
natural or mechanical means, preferably without recirculation
of the air.
• In case of air recirculation, filters should be cleaned regularly,
especially for jobs that place an individual at a medium or high
risk of exposure to COVID-19.
 Exhaust Fans
• Installation of exhaust fans
• care is needed because the fans need to be installed so that the air is
released directly outdoors.
• The number and technical specification of exhaust fans will
depend on the size of the room and the desired ventilation rate.
• Positioning the exhaust fan should be done so that it is not close
to the ventilation air intake.
• A reliable electricity supply is required for the exhaust fan.
 Fans

• Fans fitted on stands are very useful

in directing air movement in such a
way it enhances air exchange

• Wall mounted fans are also useful

Thank you