The newly detected Omicron variant of the novel coronavirus has three questions looming around it: How severe is it? Is it more transmissible than Delta? How much protection does COVID-19 vaccination provide against it? The answer to all these questions has so far been unsatisfying.
People and governments across the world are anxious as more data is collated, blood samples are tested, hospitalisations are tracked and patient records are combed through. South African physician Dr. Angelique Coetzee, who was the first to alert about a possible new SARS-CoV-2 variant, has pointed out that Omicron has mild symptoms and the infected person could be treated at home.
Prior to the emergence of the Omicron variant, scientists and doctors had earlier labelled the Delta variant as being the most dangerous.
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While it is still not established where Omicron first emerged, on November 25, South Africa, followed by Botswana a day later, announced they had detected a new variant whose mutations were different from the dominant Delta variant.
This prompted immediate air travel curbs on southern African countries from several European and Asian countries, a decision that has been criticised by both South Africa and Botswana.
Globally, 373 Omicron cases have been detected in 29 countries so far, according to WHO data. Nine nations reported the cases of the new variant on December 1. India is the 30th country to report the new strain.
What experts have to say on Omicron?
Dr. Ashish K. Jha, Dean of the Brown University School of Public Health told India Today that the new variant looks “very transmissible”, at least in South Africa, and it may be more transmissible than the Delta strain.
“I have seen lots of stories of mild cases; I hope it turns out to be mild. We will know soon. On the vaccine question, we don’t have data yet, but we have lots of reasons to be concerned,” Dr. Jha said.
He added that vaccines will not stop working completely, but they may not work as well. “In a week or 10 days, we will get more data. We don’t need to make any presumptions right now,” Dr. Jha added.
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Talking about whether Omicron will outstrip Delta or is it too early to presume that, he stated, “Unfortunately, it’s a little too early to say-lots of reasons to consider. We see variants all the time. Most of them aren’t a problem. This one has many concerning features that means we have to take Omicron very seriously. I don’t think there’s any reason to panic; I think we’re going to manage our way through it, but it could end up being quite a serious variant.”
Answering the question on if this strengthens the case for a booster dose, Dr. Jha said that it makes the case. “Nobody thinks that vaccines will stop working completely. In a week or 10 days, we will know whether vaccines will be a little less effective or a lot less effective. Lab studies will start giving us some answers. Either way, a booster will help, particularly for high-risk people,” he noted.
Dr. Jha also highlighted that travel bans don’t work. Travel protection, and not ban, may work for countries like South Africa where the caseload is high.
Dr. Randeep Guleria, chief of New Delhi’s All India Institute of Medical Sciences (AIIMS), is of the opinion that because Omicron has got over 30 mutations in the spike protein region — the region the SARS-CoV-2 virus uses to attach itself to a host cell — it can give the virus the potential to develop an immunoescape mechanism, thereby, the efficacy of vaccines against it needs to be assessed critically.
“The new variant of coronavirus reportedly has got more than 30 mutations at the spike protein region, and therefore, has the potential of developing immunoescape mechanisms. As most vaccines [work by] forming antibodies against the spike protein, so many mutations at the spike protein region may lead to a decreased efficacy of COVID-19 vaccines,” Dr. Guleria told news agency PTI.
Emphasising that surveillance of international passengers is of utmost importance, he said, “We must ask everyone to religiously follow COVID-19-appropriate behaviour and not let their guards down. Also, it has to be ensured that people get both the doses of vaccine and those who have not yet taken the jab are encouraged to come forward to take it.”
Also Read: EU says Omicron may become dominant in Europe in months
Meanwhile, a preliminary study by South African scientists has denoted that the newly detected Omicron strain could be associated with a higher risk of reinfections.
The study, based on data from the country’s health system, stipulates the first epidemiological evidence of the new variant’s ability to elude immunity from prior infection. The study paper was uploaded to a medical preprint server and has not yet been peer-reviewed, AFP reported.
“We find evidence of increased reinfection risk associated with the emergence of the Omicron variant, suggesting evasion of immunity from prior infection,” said Juliet Pulliam, director of the South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis.
“Recent reinfections have occurred in individuals whose primary infections occurred across all three waves, with the most having their primary infection in the Delta wave,” she said in a series of tweets.
Furthermore, the World Health Organization (WHO) expects to have more information on the transmissibility of the new Omicron variant of the coronavirus within days, its technical lead on COVID-19, Maria van Kerkhove, said in a briefing on Wednesday.
That was faster than the “weeks” the WHO had predicted last week that it would take to assess the data available on the variant after designating it a “variant of concern”, its highest rating.
Whether the variant is more transmissible or evades vaccines, these are some of the major questions that still need answering.
Vaccine developers have said it will take about two weeks to assess whether their shots are effective against Omicron.
van Kerkhove argued that one possible scenario could be that the new variant may be more transmissible than the dominant Delta variant. However, even if it does become more transmissible, there is still a lack of clarity whether it will make people more ill.
Also, WHO itself is at the moment trying to understand the efficacy of the existing vaccines against Omicron. Its chief scientist, Soumya Swaminathan, for instance, has said that the agency believes vaccines will work against the new strain. But some pharmaceutical companies do not share this view. Pharma major Moderna Inc.’s CEO, Stephane Bancel had recently come on record to say that the existing Covid-19 vaccines are unlikely to be as effective with the Omicron variant as they have been with other variants of the virus.
The WHO has also pointed out that blanket bans on flights to and from southern Africa will not stop Omicron from spreading.
“The idea you can just put a hermetic seal on some countries is not possible. I can’t see the logic from an epidemiological or public health perspective,” said Mike Ryan, WHO’s emergency director.