Omicron, 'variant of concern' says WHO
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Dec. 1—PLATTSBURGH — Omicron, the 15th letter of the Greek alphabet, is the latest Covid variant newly identified in South Africa.
Last Friday, the World Health Organization designated the variant B.1.1.529 a variant of concern, named Omicron, on the advice of WHO's Technical Advisory Group on Virus Evolution (TAG-VE), according to WHO's website.
VARIANT PIVOT
Omicron is on the radar of Infectious Disease Specialist, Keith Collins, MD, at the University of Vermont Health Network, Champlain Valley Physicians Hospital in Plattsburgh.
"To try to summarize my understanding of things so far, it appears, at least primarily, this virus is more contagious than Delta based on what we've seen coming out of southern Africa," Collins said.
"That's always a concern if something becomes more contagious. That's clearly a concern for everyone.
"The good news so far, I think is that first of all, the PCR (polymerase chain reaction) tests that we've been using do pick this variant up. It appears that that's the case. Some of the antigen tests, it's still unclear whether they will or not. They may, but we just don't know yet."
Antigen tests are immunoassays that detect the presence of a specific viral antigen, according to the federal Centers for Disease Control and Prevention.
"We do seem to have a good idea that the tests we normally use to detect COVID also detects this variant," Collins said.
"Secondly, it appears that the medicines that we normally would use to treat COVID should still be the same medicines to treat this variant."
Collins has not seen any reports if Omicron makes people feel sicker than Delta.
"I think that's really an important question because the natural thing that viruses do is they tend to mutate, but they tend to mutate in a way that increases the likelihood that the host survives," he said.
"Because if you think about it when a virus kills its host, it's killing its food supply. Viruses and bacteria tend to become what we call less virulent. They make people less sick as they mutate usually.
"There are obviously exceptions, but that's the natural history that most viruses and bacteria do is they tend to make you less sick when they mutate because it lets the host survive, and then they can infect other hosts."
Collins also hasn't found proof if Omicron is increasing hospitalizations in South Africa.
"It could all still be Delta," he said.
"That's what I'm still waiting to hear myself is are we looking at more hospitalizations or less? Could would be lucky and this just cause a mild, cold-like illness in which case it could be a blessing in disguise?
"If that's the case because if it's more contagious and it doesn't make you very sick, well then, it's a great way to get immunity if you haven't been vaccinated."
With a population of 60.3 million in South Africa, just under one-quarter of the population has been fully vaccinated, according to a New York Times report.
"That's the one point that I really wanted to stress with this is that I'm waiting with bated breath on whether or not it actually makes you equally as sick or more sick or, hopefully, only a mild illness," Collins said.
"I think the question in addition to how contagious it is, is equally as important. I have heard very little about that part yet."
GENOME SEQUENCING
Specialized tests have to be conducted to differentiate one variant from another.
"What countries do, and in our case states do, is they sequence the whole genome of the virus," he said.
"They can compare the genome of what they sequenced to known variants, and that's how it's done. It's specialized testing to actually detect a specific variant."
When a person tests positive for COVID, it doesn't tell which variant the person has.
"It only tells you, you have COVID," Collins said.
"You have to do more specialized testing to detect what variant of COVID you have. That involves sequencing the whole genome, and then comparing it to known variants.
"That's essentially what they did in southern Africa to find this variant. Some countries do a lot more sequencing routinely than others."
Experts caution that Omicron could have originated elsewhere other than South Africa, according to a Washington Post report.
"Quite honestly, that's one thing I think that has been lacking on a consistent basis in the United States is I think in some respects we are not as good at detecting variants because we don't have the resources and place to routinely look for variants as well as we should be," Collins said.
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OMICRON SUMMARY
Current knowledge about Omicron
Researchers in South Africa and around the world are conducting studies to better understand many aspects of Omicron and will continue to share the findings of these studies as they become available.
Transmissibility: It is not yet clear whether Omicron is more transmissible (e.g., more easily spread from person to person) compared to other variants, including Delta. The number of people testing positive has risen in areas of South Africa affected by this variant, but epidemiologic studies are underway to understand if it is because of Omicron or other factors.
Severity of disease: It is not yet clear whether infection with Omicron causes more severe disease compared to infections with other variants, including Delta. Preliminary data suggests that there are increasing rates of hospitalization in South Africa, but this may be due to increasing overall numbers of people becoming infected, rather than a result of specific infection with Omicron. There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants. Initial reported infections were among university students—younger individuals who tend to have more mild disease—but understanding the level of severity of the Omicron variant will take days to 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, and thus prevention is always key.
Effectiveness of prior SARS-CoV-2 infection
Preliminary evidence suggests there may be an increased risk of reinfection with Omicron (ie, people who have previously had COVID-19 could become reinfected more easily with Omicron), as compared to other variants of concern, but information is limited. More information on this will become available in the coming days and weeks.
Effectiveness of vaccines: WHO is working with technical partners to understand the potential impact of this variant on our existing countermeasures, including vaccines. Vaccines remain critical to reducing severe disease and death, including against the dominant circulating variant, Delta. Current vaccines remain effective against severe disease and death.
Effectiveness of current tests: The widely used PCR tests continue to detect infection, including infection with Omicron, as we 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 detection tests.
Effectiveness of current treatments: Corticosteroids and IL6 Receptor Blockers will still be effective for managing patients with severe COVID-19. Other treatments will be assessed to see if they are still as effective given the changes to parts of the virus in the Omicron variant.
Studies underway
At the present time, WHO is coordinating with a large number of researchers around the world to better understand Omicron. Studies currently underway or underway shortly include assessments of transmissibility, severity of infection (including symptoms), performance of vaccines and diagnostic tests, and effectiveness of treatments.
WHO encourages countries to contribute the collection and sharing of hospitalized patient data through the WHO COVID-19 Clinical Data Platform to rapidly describe clinical characteristics and patient outcomes.
More information will emerge in the coming days and weeks. WHO's TAG-VE will continue to monitor and evaluate the data as it becomes available and assess how mutations in Omicron alter the behaviour of the virus.
Recommended actions for countries
As Omicron has been designated a Variant of Concern, there are several actions WHO recommends countries to undertake, including enhancing surveillance and sequencing of cases; sharing genome sequences on publicly available databases, such as GISAID; reporting initial cases or clusters to WHO; performing field investigations and laboratory assessments to better understand if Omicron has different transmission or disease characteristics, or impacts effectiveness of vaccines, therapeutics, diagnostics or public health and social measures. More detail in the announcement from 26 November.
Countries should continue to implement the effective public health measures to reduce COVID-19 circulation overall, using a risk analysis and science-based approach. They should increase some public health and medical capacities to manage an increase in cases. WHO is providing countries with support and guidance for both readiness and response.
In addition, it is vitally important that inequities in access to COVID-19 vaccines are urgently addressed to ensure that vulnerable groups everywhere, including health workers and older persons, receive their first and second doses, alongside equitable access to treatment and diagnostics.
Recommended actions for people
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 1 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 when it's their turn.
WHO will continue to provide updates as more information becomes available, including following meetings of the TAG-VE. In addition, information will be available on WHO's digital and social media platforms.
Reference material:
Classification of Omicron (B.1.1.529): SARS-CoV-2 Variant of Concern
Further information on TAG-VE
SOURCE: www.who.int
