The pandemic-weary world faces weeks of confused uncertainty as countries restrict travel and take other steps to stop the newest potentially dangerous mutant of the coronavirus before anyone knows just how dangerous the omicron really is.
Will it spread even faster than the already highly infectious Delta variant? Does it make people worse? Is it eluding vaccine protection or re-infects survivors? There are many speculations, but little hard evidence, as scientists rush to find answers amid scrutiny from a concerned public.
“A fairly correct level of nervousness,” was how Trevor Bedford, who studies the evolution of coronavirus at the Fred Hutchinson Cancer Research Center, described the reaction of health experts.
“Omicron may not be as bad as we might imagine, but I think it’s appropriate to see him as such at the moment,” he said.
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So far, the world has been slow to respond to every curve of the coronavirus. This time, an early warning from South Africa and Botswana could give an important head start.
“It’s hard to say: have we just caught up with reality, and now the world reacts with the appropriate speed when options appear?” asked Dr. Jacob Lemieux, who oversees options in a research collaboration led by Harvard Medical School.
WHY IS THIS Worry?
Omicron raised the alarm because of the huge number of mutations, more than in previous versions. Perhaps 30 of these are in a key location, the spike protein, which allows the virus to attach to human cells.
Scientists recognize several mutations from earlier variants that were more infectious or slightly resistant to vaccination. But they have never seen this particular constellation of changes.
Most are “really unique to this virus,” said Dr. William Moss of the Bloomberg Johns Hopkins School of Public Health. “It’s a combination of potential increased transmissibility and the ability – the potential ability – to escape our immune system, which is of concern to everyone.”
“It’s a balance,” Moss said. “We want to take this seriously because of the combination of mutations, but we don’t want to panic and we don’t want to overreact until we really know more about this virus.”
Scientists still have little data on whether omicron causes more severe disease than other options. And although it has already been diagnosed in many countries just days after its discovery was announced, it is still too early to tell how contagious it is.
The alpha variant, which emerged about a year ago, was more contagious than the virus that caused the pandemic. Then there was a delta strike, much more infectious than an alpha.
It’s unclear how omicron will compete in a place like the United States, where this strong delta variant is causing over 99% of current COVID-19 cases, said Louis Manski, director of the Institute for Molecular Virology at the University of Minnesota.
Even in parts of South Africa, the reported spike in omicron-related cases cannot indicate that the mutant is more infectious than delta, Lemieux said.
“We really don’t know if omicron really outperforms delta in the competition, or if it just became the dominant strain in some places by accident,” he said.
To better understand the omicron, scientists are trying to figure out how it came about. It is not a descendant of the delta. One of the popular theories is that a person with a severely weakened immune system contracted a coronavirus infection, which he could not get rid of for so long that mutations accumulated.
“This is totally weird,” said Bedford, whose summer 2020 versions appear to be close relatives of the omicron.
Viruses mutate every time they spread, and it’s possible that omicron was boiling unnoticed somewhere with poor COVID-19 testing. But Bedford said its sudden onset is more likely as a result of fights between cats and mice, as the immunocompromised body fights the virus, which repeatedly changes its spike protein to avoid detection. (Bedford receives funding from the Howard Hughes Medical Institute, which is also supported by the Associated Press’s Department of Health and Science.)
WHAT TO WATCH
Scientists say it can take two to four weeks to get important answers.
One of the biggest concerns is how much omicron can escape immunity. So far, the beta has been the biggest challenge for vaccine protection, but fortunately this mutant has not been widely adopted.
“It is highly unlikely that this new variant escaped all of the antibodies generated after vaccination,” said immunologist E. John Werry of the University of Pennsylvania.
Vaccine manufacturers and other scientists conduct laboratory tests to determine how well antibodies produced by vaccines or prior infection can fight the omicron compared to earlier versions. This takes time because they must first grow samples of so-called “pseudoviruses” that contain worrying new mutations.
But that’s “not the whole story,” Moss said.
The immune system has several layers of defense beyond antibodies, including T cells, which should help avoid serious illness, even if someone survives a breakthrough infection.
The experts will also closely monitor the prevalence and severity of omicron infections.
In terms of treatment, Regeneron says its cocktail of COVID-19 antibodies may be less effective against the omicron, although more research is needed. But there are several antiviral pills in development – a long-needed new option that should not be affected by omicron mutations.
WHAT TO DO NOW?
Scientists are urging people to take simple precautions while awaiting answers – camouflaging indoors, avoiding crowds, injecting, if you’re one of the 45 million adults in the U.S. who have not yet been vaccinated – no matter which option is circulating.
One thing is clear: vaccination remains critical. Today’s imagery does indeed protect against delta and other versions of the virus that are already raging, whether the omicron is spreading or not. The US and other countries are urging people eligible for booster vaccinations not to wait because the extra dose triggers a huge release of antiviral antibodies.
“People who are hesitant about getting vaccinated should see a good reason to get vaccinated. People who have not yet received boosters and are eligible should receive them. And then I think we need to let scientists and public health practitioners do their job, ”Lemieux said.