Omicron and the threat of mutation

The patient’s death has come at a time when reports pertaining to the new variant of concern have said that Omicron causes mild disease as compared to the dominant strain Delta.

As far as governments and stakeholders in healthcare are concerned, this might signal the beginning of yet another conversation on restrictive protocols, and that too, right before the holiday season.

Even as a clearer picture emerges about the newest coronavirus variant, we still don’t know enough to assess the full threat that is posed by it and map the ways it is evading the immune system. But there is some data that has thrown light, even if a faint one, on this latest variant.

It has already displayed, for instance, a worrying capacity to spread quickly; preliminary studies suggest it is four times as transmissible as the Delta variant. In South Africa, where it was first detected, the numbers have grown by well over 100 percent week by week, and the country’s president has also contracted the virus now. Neighboring countries such as Namibia and Zimbabwe have not fared much better.

These countries have a low rate of vaccination, which could have helped in its spread. But Omicron is now present in about 63 countries, many of which have high vaccination rates. In these countries, Omicron has displayed another worrying characteristic – a capacity to infect people who are already fully vaccinated.

In India, of the 32 confirmed cases reported last week, 14 or more of them were breakthrough infections. This has led the Centre to ask States to closely monitor clusters and hotspots, which is absolutely necessary given the worrying rate of transmissibility.

Researchers from the London School of Hygiene & Tropical Medicine went on to present a model this week that projected 74,800 deaths in the UK by April 2022, due to the variant, in the absence of additional control measures. Omicron will most likely strengthen the case for booster shots, which are already recommended and available in a few countries including the UK and the US.

The UK’s NHS expanded the booster program after it found that an additional dose significantly restored protection against mild disease caused by Omicron. India is still debating the issue, but Omicron’s myriad mutations and its ability to cause breakthrough infections could tilt the balance in favor of recommending boosters. In India, this is a difficult decision, given that there is a lot of ground to be covered for regular vaccinations.

Although it is commendable that as many as 81 crore people have received one dose, only around 50 crores have received both doses – a gap that needs to be bridged urgently.

The WHO had said on Sunday that the Omicron variant reduces vaccine efficacy, but causes less severe symptoms, a moot point considering the UK fatality. India’s Health Ministry has also stated that the symptoms of all those infected by Omicron in India so far were mild. Even so, it will take a while before we can conclusively say that this variant, with its 30 mutations, does not cause severe illness.

The Omicron variant and its capacity to get past the current clutch of vaccines is a reminder that the battle against coronavirus is far from over. It is not clear whether we will need to update or modify our vaccines to deal with it.

Dr. Anthony Fauci, Chief Medical Adviser to the US President has said that an Omicron-specific vaccine may not be necessary, bolstering the hope that the existing vaccines and booster shots will be sufficient to meet this new challenge. However, if Omicron mutates further, then the long-term battle against coronavirus will become so much harder.