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What to know about the omicron variant of the coronavirus

The Washington Post logo The Washington Post 11/26/2021 Meryl Kornfield, Adela Suliman, Christine Armario, María Paúl, Lindsey Bever
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A new variant of the coronavirus that causes covid-19 is raising concern around the globe.

South Africa confirmed late last week that scientists there had detected a variant with a high number of mutations that could make it more transmissible and adept at evading the body’s immune defenses. The World Health Organization has labeled it a “variant of concern” and given it a Greek letter designation: omicron.

Several countries, including the United States, have since restricted travel from southern Africa while epidemiologists race to learn more. Cases have been identified in nearly a dozen nations, most but not all tied to recent travel to Africa.

There is too little research to draw conclusions, and experts are urging caution while warning against panic. Studies are underway to examine how vaccines hold up against the new variant, with some experts expressing initial optimism that they will offer protection.

“This is the most concerning variant we’ve seen since delta,” Eric Topol, director of the Scripps Research Translational Institute, said in an interview. “It’s going to take a really high bar for something to take over for delta, and we don’t know whether this is going to do it.”

E.U. moves to ban flights from southern Africa over fears of new variant

Where has omicron been confirmed?

Omicron, pronounced aa-muh-kraan in American English, was first identified in South Africa, but where it came from is unknown. Scientists in South Africa recently made data on the variant public. Noticing the distinct sequence, a virologist at Imperial College London, Tom Peacock, raised alarms about the “really awful Spike mutation profile.”

In South Africa, where nearly 25 percent of the adult population is fully vaccinated, the variant has spread rapidly. There were 50 new daily cases of coronavirus per 100,000 people in South Africa from Nov. 20 to Saturday, a 592 percent increase from the previous week, according to The Washington Post’s virus tracker.

Cases have also been identified in Australia, Belgium, Botswana, Britain, the Czech Republic, Denmark, Germany, Hong Kong, Israel and Italy. Dutch health authorities said Saturday that testing of about 600 passengers who arrived from South Africa found 61 infected with the virus, including 13 cases attributable to the omicron variant.

The U.S. Centers for Disease Control and Prevention said that omicron has not been detected in the United States, but officials aren’t resting easy. New York Gov. Kathy Hochul (D) declared a state of emergency on Friday in response to a cold-weather surge of infections and the threat of the new variant. “It’s coming,” she said.

‘You’ve got to prepare for the worst’: World responds to new variant’s arrival

What do we know about the new variant?

Omicron’s genetic profile is unique from other circulating variants, meaning it represents a new lineage of the virus.

It is distinct from other variants in another crucial way: There are a greater number of mutations. Tulio de Oliveira, director of the Center for Epidemic Response and Innovation in South Africa, said there are more than 30 mutations in the spike protein, the part of the virus that binds to human cells, allowing it to gain entry.

Scientists are worried that those mutations could make omicron more transmissible and potentially equipped to defy immune defenses, making vaccines less effective. The WHO said last week that preliminary evidence suggests an “increased risk of reinfection” compared with other variants.

“The one good news, if there’s any good news, is that this variant, the B. 1.1.529, can be detected by one particular PCR assay,” de Oliveira said at a news conference, meaning that diagnostic labs can quickly identify the new variant.

What you need to know about the coronavirus variants

Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center, who has conducted mutational scanning experiments for the variant, noted that three mutations could make the virus a more elusive target for antibodies produced through vaccines or prior infection.

“What that’s going to mean for how likely people are to get infected, even if they’ve been vaccinated, it’s too early to say,” Bloom said, noting that more traditional experiments should provide more data. “But having a drop in the antibody neutralization is never a good thing.”

Linda Bauld, a professor of public health at the University of Edinburgh, said there were “genuine” causes for concern, given that “it does look like a more transmissible variant.” But she added: “I think it’s premature to panic. … There’s just a lot we don’t know at the moment.”

Why is it called omicron?

The WHO named B. 1.1.529 omicron following the tradition of giving variants a Greek letter name.

After using the most recently named variant, mu, officials chose to skip the next letters available for variants, nu and xi.

“Nu is too easily confounded with ‘new,’ and Xi was not used because it is a common surname,” the WHO said in a statement to The Post. The agency’s “best practices for naming new diseases suggest avoiding ‘causing offense to any cultural, social, national, regional, professional or ethnic groups,’ ” the WHO noted.

What’s being done to halt the spread of omicron?

Within days of the discovery of the variant, several countries began imposing restrictions on flights to and from South Africa and its neighbors.

Israel closed its borders to “foreigners from all countries.” Australia, Britain, Japan, Thailand and the United States are among nations curbing travel from southern Africa or imposing new quarantine rules for those arriving from the region. The United Kingdom said Saturday that it would require all international travelers to take a PCR test within two days of arrival and quarantine until their test returns a negative result.

The U.S. restrictions will apply to travelers from Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, South Africa and Zimbabwe. They do not apply to American citizens and lawful permanent residents. President Biden said in a statement that the move is “a precautionary measure.” He urged Americans to get vaccinated and get booster shots.

Officials in South Africa expressed concern about the travel bans, while some experts cast doubt on the efficacy of the restrictions, noting that they may be too late. The nation’s health minister, Joe Phaahla, characterized them as a “draconian reaction.”

“It really doesn’t look scientific in any way,” he said. “That kind of reaction is quite a knee-jerk and panicked and almost wants to put a blame on other countries rather than work together.”


Video: Omicron Variant: What We Know So Far (CBS Minnesota)

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Before the novel coronavirus spread through the world, a study published in February 2020 in the Journal of Emergency Management found that a travel ban could delay the arrival of an infectious-disease in a country by days or weeks. However, little evidence suggested it eliminated the risk of the virus jumping borders in the long term.

Amesh Adalja, an infectious-disease physician and professor at Johns Hopkins University, said the measure would do little or nothing to curb the spread of a variant that may have been “spreading for probably several days or weeks before it was noticed.”

Faheem Younus, an infectious-disease specialist at the University of Maryland, said that by the time travel bans are imposed, “the new variant has already traveled out of the country.” He noted that the O.R. Tambo International Airport near Johannesburg serves more than 1 million travelers a month.

“These bans also come at a cost and will disincentive other countries in the future,” he said. “ ‘Why alert the world promptly if that means your people will be punished and your economy crushed?’ they might wonder.”

Do we know whether vaccines are effective against omicron?

Even if the variant limits the effectiveness of vaccines, it probably will not completely subvert the protections that vaccines provide, experts say.

“My expectation would be that the mutations in this variant are not going to ablate or completely escape that type of antibody neutralization” from vaccines or prior infection, Bloom said.

“Regardless of whether or not this new variant ends up spreading, I would suggest that people do what they can to minimize their chances of getting infected with SARS-CoV-2,” Bloom added, referring to the virus by its technical name. “There are certain obvious things you can do: Get vaccinated, get a booster vaccination, wear a mask.”

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Though the sample size is small, Ian Sanne, an infectious-disease specialist and member of South Africa’s Ministerial Advisory Council on covid-19, said physicians have seen a higher rate of breakthrough infections among those previously vaccinated in South Africa. But he added that initial data indicates the vaccines are still proving effective, with the majority of hospitalizations being among those who hadn’t been immunized.

“We have every indication that the vaccines are still effective in preventing severe disease and/or complications,” he said last week during a news conference. “The data, however, is small and early.”

Meanwhile, vaccine makers, including Pfizer and its German partner BioNTech, Moderna and Johnson & Johnson, said they are working to understand how well their vaccines can counter omicron.

In addition, Pfizer and BioNTech “expect to be able to develop and produce a tailor-made vaccine against that variant” within about 100 days, pending regulatory approval, a Pfizer spokesperson said in a statement.

And Moderna CEO Stéphane Bancel said in a news release that the company has been “moving as fast as possible to execute our strategy to address this variant,” also testing a booster to target this specific variant.

Given the spread of omicron in South Africa, several experts have pointed to the crucial need to vaccinate underserved countries to bolster the world’s protection from future, more-evasive variants.

“I think vaccine equity is a really important issue,” said Bauld, noting the low vaccination rates in many African countries and the fact that high prevalence of the virus means it can undergo many genetic changes each time it jumps between individuals.

However, Bauld added, transmission of the coronavirus probably will not be eliminated even with a vaccine, as seen with the delta variant, with mutations ultimately able to “occur in any country.”

Will omicron cause severe illness, and will existing treatments work?

Because there are still a relatively small number of cases, it’s hard to know. While one physician in South Africa said initial patients had mild symptoms, another warned that she was seeing younger adults with moderate to severe disease.

“Making a general conclusion would probably be a mistake at this point,” Alex Sigal, a faculty member at the Africa Health Research Institute, told The Post. “But let’s say it doesn’t look hugely different from anything we’ve seen before.”

He added: “There’s no indication right now it’s going to do something completely different.”

Other experts point out that initial outbreaks appear concentrated in younger adults, many of whom would be less vulnerable to a severe infection. Richard Lessells, an infectious-disease expert in South Africa, noted on Twitter that there is also a time lag for infections to progress to severe disease and potentially result in hospitalization.

“We would only expect to see the impact on hospitalisations in the next few weeks,” he wrote.

Similarly, we don’t yet know how omicron might stand up to therapeutics developed to treat covid-19, including antivirals and monoclonal antibodies.

Bloom, the Fred Hutchinson Cancer Research Center virologist, said that because multiple mutations could combine in a way that dulls the impact of monoclonal antibody treatments, it’s difficult to assess which would be effective. But he said his experiments show initial indications that the Regeneron-Roche cocktail could “take a hit.”

Companies that have developed monoclonal antibodies say they are monitoring the variant.

How far might omicron have already spread?

Public health experts say there is a high probability that the new variant is already spreading in a number of countries beyond those where cases have been detected, noting that the first infection in Hong Kong involves a passenger who landed Nov. 11.

“That is two weeks ago, which is forever in the pace of a pandemic,” said Eric Feigl-Ding, a senior fellow with the Federation of American Scientists.

There are several other troubling signs. One of the first cases identified in Belgium, for example, involves a young woman who did not travel to sub-Saharan Africa. Health officials there said she developed symptoms 11 days after traveling to Egypt via Turkey. She had not been vaccinated and has not developed signs of severe disease.

Feigl-Ding also expressed concern at the large number of people who tested positive for the virus on two flights from South Africa that arrived in the Netherlands — about 10 percent of all passengers: “That’s quite a statistic, even if it’s not all omicron.”

Anthony S. Fauci, the leading U.S. infectious-disease expert, told ABC News’s “This Week with George Stephanopoulos” that the variant’s arrival in the United States is essentially unavoidable.

“When you have a virus that has already gone to multiple countries, inevitably, it will be here. The question is: Will we be prepared for it?” Fauci said Sunday.

Will omicron upend plans to return to ‘normal’?

After nearly two years of a pandemic, many are nervous about what challenges the new variant might bring and whether hard-fought gains will be lost. Public health experts are urging people not to jump to conclusions.

“I have never before experienced such an absolutely anguished outpouring as I have around this,” said Bill Hanage, an associate professor of epidemiology at T.H. Chan. The response, he said, has “as much to do with humans as it does with the virus.”

Hanage said he is in a state of “weary alertness” waiting for more information. He suspects omicron’s consequences will be more serious in some places than others, particularly those with low vaccination rates.

“This is certainly a curveball,” he said. “But exactly how serious it is remains to be seen.”

Stuart Ray, an infectious-disease specialist at Johns Hopkins University, said people should follow the “new wisdom” on the virus: keeping track of local infection rates to determine how vulnerable they are while using common-sense protection including vaccination, boosters and high-quality masks such as KN95 and N95s.

“It’s still early days,” he said. “But this is probably not the last variant that we’ll see, so I think we should see this as part of the learning about this virus.”

Lateshia Beachum, Silvia Foster-Frau and Ellen Francis contributed to this report.

Read more:

Countries race to cut travel links with southern Africa, amid fears of omicron’s potential to spread

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