The WHO has said that while Omicron — the newest Variant of Concern (VoC) flagged by it — may be able to spread more easily, it has so far not been linked to any Covid-related death anywhere in the world. The global health agency has said that while it studies the impact of the variant, vaccines remain the best bet against its spread. India has administered the first shot of a Covid vaccine to more than four-fifths of its eligible population with more than 50 per cent of them having completed both doses. Health authorities are now pushing to swiftly cover the unvaccinated. The UT of Puducherry has made Covid vaccination compulsory for all residents while Himachal Pradesh is on the cusp of achieving 100 per cent coverage of its eligible population. As the world works on its response to Omicron, here’s what we know about the variant and how the fight against it is shaping up.
Is The Omicron Variant Milder Than Delta?
A South African doctor who was one of the first to suspect that a new variant of the novel coronavirus could have appeared on the scene has said that all cases linked to Omicron that she had handled were “very mild”.
While symptoms were different from the ones associated with earlier variants, Dr Angelique Coetzee said that the initial patients who had come to her had none of them needed to be admitted to hospital and they could “treat these patients conservatively at home”. She said that the most common symptoms for the Omicron variant were extreme fatigue and body aches and headache. “Most of them are seeing very, very mild symptoms,” she had said.
But the general view among experts is that it is still early days to conclude that this variant causes a milder illness. The first cases in South Africa were encountered among university students and younger people are seen as having better immunity than high-risk groups.
The World Health Organisation (WHO) Chief Scientist Dr Soumya Swaminathan has said that the global health body could not at this stage say that Omicron was a mild variant, despite the reports of milder infections. Experts point out that small factors can make a big difference in how a pathogen impacts a population and that more extensive real-world information is needed to come to a conclusion about how much of a worry Omicron can pose.
It has also been pointed out, including by Swaminathan, that the world is “in a different situation to a year ago”. More people have by now either contracted an infection and recovered or have been vaccinated against the novel coronavirus, which means they have developed some sort of immunity against the virus.
Swaminathan said that while WHO cannot immediately rule that Omicron was a milder variant, any knee-jerk reaction should be avoided. “We need to be prepared and cautious, not panic,” she told a Reuters conference.
But Isn’t Omicron Able To Evade Antibodies?
The more than 30 mutations that Omicron is found to pack in its spike protein — the region on the surface of the novel coronavirus that allows it invade and latch on to human cells — points to an ability to escape antibodies, but scientists say the variant may not be able to entirely blunt every protection gained from previous infection or vaccination.
Most vaccines are primarily designed to train the human immune system to identify and attack this spike protein. Hence, any significant changes that it may undergo via fresh mutations will make it difficult for vaccines to attack the spike protein.
Swaminathan noted that while Omicron “does seem to be able to overcome some of the natural immunity from previous infection”, the evidence so far suggests that vaccines do seem to be having an effect.
“The fact that they’re not getting sick… that means the vaccines are still providing protection and we would hope that they would continue to provide protection,” Swaminathan said.
In fact, South African Health Minister Joe Phaahla said that following the initial cases, the majority of hospital admissions linked to Omicron were among people who were not vaccinated. That, experts say, gives cause to be optimistic that vaccines are still effective.
Will We Need Vaccine Boosters To Guard Against Omicron?
The WHO has been batting against booster shots for Covid-19 when the vast majority of people in poorer countries are yet to receive their first doses of a vaccine. But advanced countries have moved quickly to ramp up delivery of additional doses of Covid-19 vaccine amid the emergence of Omicron.
While she did not rule out the continuing effectiveness of the existing jabs, Swaminathan also pointed to the possibility that extra doses would better prime the immune response to Omicron. “It’s possible that the vaccines will work. It’s possible that you may need initially an extra dose to boost immune response,” she said. A WHO technical advisory group is assessing whether vaccines would need to be upgraded to successfully counter the new variant.
A scenario where the novel coronavirus keeps mutating and is yet unable to completely beat the impact of vaccines would suggest that it has entered a stage of endemicity. In such a situation, cases would keep getting reported but the virus would be unlikely to fuel a surge of infections and hospitalisations as was witnessed in earlier waves.
Ugur Sahin, the CEO of BioNTech, the company that has collaborated with Pfizer to roll out an mRNA shot against the novel coronavirus, told the Reuters conference that it would take them relatively less time to adapt their vaccine against Omicron and the wait was to see how urgently an upgrade was needed.
“I believe in principle at a certain timepoint we will need a new vaccine against this new variant,” Sahin said. On the need for annual vaccine boosters, Swaminathan said “the WHO is preparing for all scenarios”.
But while she was of the opinion that “natural infection acts as a booster”, South African scientists have reportedly found that Omicron may pack a “substantial ability” to reinfect people who have already had Covid as compared with past variants.
How Fast Is Omicron Spreading?
Reports at the end of the first weekend in December said that Omicron has spread to almost 40 countries, including the US. At least five cases of the variant have also been reported in India after Botswana and South Africa health authorities first flagged to the world in the last week of November.
On December 3, the WHO said the variant had been detected in 38 countries, up from 23 two days earlier, and that initial assessments suggest that Omicron is more contagious than the Delta, which at present is the dominant variant and is behind 99 per cent of all cases globally.
“We do see an increasing growth rate, we see increasing numbers of Omicron being detected,” said the WHO’s Covid-19 technical lead, Maria Van Kerkhove, adding that “there is a suggestion that there is increased transmissibility”. But she underscored the need to ascertain whether “it’s more or less transmissible compared to Delta”.
If Omicron is able to outcompete the Delta variant and become the dominant strain worldwide, as has been anticipated by some, that could lead to a need for upgrading vaccines and treatments against the novel coronavirus. But for now, the WHO has advised against any drastic moves, including the imposition of any travel bans, as has been implemented by some countries.
As Van Kerkhove pointed out, while South Africa may have been the first to report Omicron, it need not be where it first emerged. Experts have said that Omicron’s detection is due in large part to South Africa’s genomic sequencing infrastructure, something that most other countries lack. “Some of the earliest cases of this particular variant may very well not be in South Africa,” Van Kerkhove said as she noted that the sequencing of a backlog of Covid cases from November could change the picture.
What Should Be The Response To It?
Expressing regret that South Africa has been penalised for reporting the emergence of Omicron, which was thanks to “the excellent genomic sequencing and surveillance” in the country, WHO Chief Scientist Swaminathan said she agrees that the variant may not even have arisen had countries in Africa received access to more vaccines.
“There is a clear relationship between inequity in access to vaccines and the development of variants,” Swaminathan said.
Van Kerkhove and Mike Ryan, the executive director of the WHO’s health emergencies programme, have stressed that current vaccines are the most effective measure to slow transmission of the virus. Dr Amesh Adalja, an infectious diseases specialist, was quoted as telling NBC that while breakthrough infections or reinfections may “become more common with this… it’s probably unlikely that you see severe breakthrough infections become common in healthy people” who get infected with Omicron.
The Indian SARS-CoV-2 Genomics Consortium, or INSACOG, which is tasked with tracking the evolution of the novel coronavirus in the country, too, has noted in a bulletin that “low levels of neutralising antibodies from the current vaccines are unlikely to be sufficient to neutralise Omicron, although the risk of severe disease is still likely to be reduced”.
INSACOG said that along with “vaccination of all remaining unvaccinated at-risk people”, the government could consider booster doses for those 40 years of age and over “first targeting the most high-risk/high-exposure”.
On the heels of the INSACOG bulletin came the announcement by Puducherry that vaccination was compulsory for all eligible people in the Union Territory. Amid a call by the Centre for states and UTs to quickly expand vaccination coverage to include non-vaccinated people amid the rise of Omicron, reports said that Himachal Pradesh is on the verge of achieving 100 per cent vaccination coverage.
It has been pointed out that the same measures that served to keep infection at bay during the earliest outbreaks — mask-wearing, frequent hand-washing, avoiding crowded spaces — would continue to prove effective as well in thwarting Omicron.
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