Delta continues to play havoc where I live and work in Minnesota. COVID-19 cases continue to rise, hospitals are overwhelmed.
Yet, there seemed a sense of, not normalcy, but expectancy, that things would get worse, then start to improve. People have asked me what really worries me. My answer: a crazy new variant that changes the landscape again.
Hello, Omicron.
On November 26, 2021, the World Health Organization Technical Advisory Group on SARS-CoV-2 Virus Evolution named a new Variant of Concern as Omicron. They bypassed Nu (too confusing) and Xi (too politically touchy, a common family name in China, like Xi Jinping, their leader) and went to Omicron on their list of Greek letters used to name Variants of Interest or Concern.
Earlier in the week, scientists in South Africa, where leading edge surveillance and epidemiology is practiced, had noticed that one variant, B.1.1.529, now dubbed Omicron, had started to outcompete Delta variant in new cases. They identified many mutations on this variant, some associated with both increased transmissibility and increased ability to escape immune surveillance from previous infection or vaccination.
As SARS-CoV-2, the virus that causes COVID-19, replicates, new mutations are generated, and some of these mutations are carried forward (propagated) in new variants. (I have written about variants before, and what they are.) Previous variants that have been especially impactful have been Alpha last winter and spring, and Delta, which is currently the dominant strain causing infection. In 2021, first we saw the emergence of the Alpha variant, then the dominance of the Delta variant.
Both of these variants are notable for increased transmissibility, and, in the case of Alpha, some ability to evade monoclonal antibody therapy. However, both of those strains can be controlled by vaccination (and boosters), and the current Delta strain is treatable by the current monoclonal antibody therapy.
Now, Omicron variant has entered the mix. It is very early, as noted by the small red dot on the far right of the graph below.
We’ve been here before, right? Another new variant, maybe more transmissible. So why have many countries placed travel limits again, and the Governor of New York declared a State of Emergency? It appears that Omicron contains mutations seen on an earlier variant, Beta, that are associated with changes to the spike protein part of the virus. Some of those changes in the spike protein may permit Omicron to be able to evade the immune system like Beta. The combination of increased transmissibility with immune evasion can be especially worrisome if it comes to pass that Omicron, unlike Alpha and Delta, can evade our vaccines or immunity from prior infection.
When will we know if this is a “worst case scenario”? Likely not for several weeks or more. It will take time to review cases from South Africa and elsewhere for an indication that Omicron is causing new cases to occur in people previously recovered from infection, or who have been fully vaccinated.
Countries may wish to reimpose traveler quarantine, or at a minimum, increase surveillance of incoming travelers for signs of infection—especially in those recently returned from countries that have seen the Omicron variant.
What can WE do? First and foremost, get vaccinated. If qualified for a booster, get that as well (CDC updated their guidance that everyone should get a booster). Mask up if indoors where you may be close to strangers. Some of them may have lowered immunity due to health issues or because they are unvaccinated. We know that even vaccinated or recovered individuals can get infected or reinfected. Wearing a mask helps you protect others in our communities. Continue to get tested if you have signs of illness. Wash your hands.
In the meantime, vaccine manufacturers will be evaluating the genetic code of Omicron—and looking at updating vaccines if needed.
No need to panic—but concern is certainly warranted.
So, what's Nu? Omicron.
I’m going to share this. The first thing I’ve read that adds understanding with facts as we know them.
Thank for.this timely update. Very helpful to get the latest from someone I trust.