Omicron: Can it be a game changer?

08 Dec 2021

Omicron: Can it be a game changer?

08 Dec 2021

By Dr. Charuni Kohombange Following the advice of its Technical Advisory Group on Virus Evolution (TAG-VE), the World Health Organisation (WHO) on 26 November designated the variant B.1.1.529 as a variant of concern and named it as “Omicron”. This decision was based on the evidence presented to the TAG-VE that Omicron has several mutations that may have an impact on how it behaves – for example, on how easily it spreads or the severity of illness it causes. Omicron is now found in nearly 40 countries across the globe. On 3 December, Sri Lanka detected its first case of Omicron. Amidst the public enthusiasm for the upcoming festive season, there is major doubt: Can this Omicron change our lives? In this light, University of Colombo (UoC) Professor in Medical Education and Asia Pacific Academic Consortium for Public Health (APACPH) Secretary General Prof. Indika Karunathilake shared his views based on the current scientific evidence. Following are excerpts of the interview. What is Omicron? Omicron is a variant of SARS-CoV-2, the virus that causes Covid-19. This variant has an unusually large number of mutations, several of which are new, and a significant number of these mutations affect the spike proteins. This B.1.1.529 variant was first reported to WHO from South Africa on 24 November 2021. The epidemiological situation in South Africa has been characterised by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant. In recent weeks, infections have increased steeply, coinciding with the detection of this B.1.1.529 variant or, according to WHO nomenclature based on the Greek alphabet, the Omicron. The first known confirmed B.1.1.529 infection was from a specimen collected on 9 November 2021. How virulent it can be in terms of transmissibility and the severity of the disease? Researchers in South Africa and around the world are conducting studies to have better understanding on Omicron, and the world is awaiting the new findings. In terms of transmissibility, still there isn’t adequate data to conclude that Omicron is more transmissible or that it spreads more easily from person to person, compared to other variants such as Delta. However, South Africa has reported that the number of people testing positive is increasing in the areas affected by this variant. However, epidemiological studies are underway to understand whether it is because of the Omicron variant itself or due to other factors. Still it is not very clear whether infection with Omicron causes more severe disease compared to infections with other variants, including the Delta variant. Preliminary data suggests that there are slight increases in the rate of hospitalisation in South Africa. However, it has to be further assessed to see whether this is due to the new variant or due to the increase in the overall number of people becoming infected. There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants. Initial reported infections were among younger university students who invariably tend to have more mild disease and better understanding on the level of severity of the Omicron variant may take several weeks. All variants of Covid-19, including the Delta variant that is dominant worldwide, can cause severe disease or death, in particular for the most vulnerable people. Higher the rate of spread, the chances of those who are vulnerable getting infected too increases. What can be the effects on the effectiveness of currently available testing and the effectiveness of current treatment options? Based on current evidence, the widely used PCR tests are continuing to detect the infection, including infection with Omicron, as scientists have seen with other variants as well. Studies are ongoing to determine whether there is any impact on other types of tests, including rapid antigen tests (RATs). According to the clinicians, current management strategies that are being used for hospitalised patients affected with Covid-19 should still be effective for managing patients affected with this variant. Other treatments are also being assessed to see their effectiveness on the Omicron variant. According to current available data, can you comment on the effectiveness of vaccines against this variant? The WHO is working with their technical partners to understand the potential impact of this variant on all the existing countermeasures, including vaccines. According to present understanding, vaccines remain critical to curtail severe disease and deaths, including against the currently dominant Delta variant. According to evidence, presently available vaccines remain effective against severe disease and death. Hence, it is important to obtain both vaccine doses and get the booster dose to ensure proper immunity. What is your advice to the public, especially during this festive season? According to current findings, prevention of the disease is the key. The most effective steps individuals can take to reduce the spread of the Covid-19 virus is to keep a physical distance of at least one metre from others, wear a well-fitting mask, open windows to improve ventilation, avoid poorly ventilated or crowded spaces, keep hands clean, cough or sneeze into a bent elbow or tissue, and get vaccinated as earliest possible and take the booster when you get the chance. People are more enthusiastic about celebrating Christmas and New Year, as they have been under mobility restrictions for a long period. It is highly advisable to avoid overcrowding when shopping and finish your shopping early where there are less crowds. Take care of the elderly and patients with long-term illnesses. Make sure to keep them safe at home and fulfil their needs for the festive season. Most importantly, look after their nutrition, hydration, etc. and get them the vaccine booster dose immediately. Finally, do you think Omicron can be a game changer? Still very early days, and no conclusive data to comment either way. However, there is some data emerging from South Africa that suggests the Omicron variant might be a milder variant and is rapidly replacing the much more deadly Delta variant, which is accounting for almost 99% of the cases globally at present. According to this emerging evidence, Omicron shows some features of high transmissibility. Hence, there is a possibility for Omicron to be the dominant variant in near future. According to literature, the coronavirus that has led to pandemics in the past, too, has descended into such milder forms, facilitating the culmination of those pandemics. However, we should bear in mind that the Covid-19 pandemic is still far from over and we should prepare, be cautious, and not panic but follow all the precautions until the confirmed scientific evidence is available.

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Omicron: Can it be a game changer?

Omicron: Can it be a game changer?

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