Omicron likely to be more widespread than just South Africa, says Ho Ching

Omicron likely to be more widespread than just South Africa, says Ho Ching

The new variant of concern (VOC) named is likely to be more widespread than just South Africa, said Ms Ho Ching in a Facebook post. One Belgian case, for instance, visited Egypt and Turkey, and was not anywhere near southern Africa. This suggests more widespread transmission than just in southern Africa.

The Omicron, said Ms Ho Ching, is not a descendant of the Delta family which has been dominant in the world.

Its closest evolutionary relative, based on the types of mutation, goes all the way back to the middle of last year in 2020. This adds to the speculation that the Omicron (and/or its ancestral variants) may be more widespread, she said.

The carries mutations that are associated with higher infectiousness as well as higher escape capability.

Higher infectiousness from several mutations have been seen in the N501Y, and the E484Q, a brother of the E484K, that we saw last year but these are now presented together in the Omicron, said Ms Ho.

These others have more or less dies off, outrun by the more infectious Delta. However, looks like it can outrun the Delta, the reason being that it reportedly also have many mutations which made it slippery against the antibodies from past infections or vaccinations.

“This combination of being more infectious and more slippery could enable to quickly become globally dominant,” said Ms Ho. Therefore, we should expect to meet it sooner or later.

Scientists in South Africa have been quick in sequencing the virus, understanding its potential risk, raising the alarm to both their government and WHO, and uploading the sequence to GISAID, a platform, to share with scientists and researchers around the world.

The variant was first identified in Botswana earlier this month.

Scientists are trying to understand the variant’s properties, such as whether it can evade immune responses triggered by vaccines and whether it causes more or less severe disease than other variants do.

“We’re flying at warp speed,” says Penny Moore, a virologist at the University of the Witwatersrand in Johannesburg, South Africa, whose lab is gauging the variant’s potential to dodge immunity from vaccines and previous infections. There are anecdotal reports of reinfections and of cases in vaccinated individuals, but “at this stage it’s too early to tell anything”, Moore adds.

“There’s a lot we don’t understand about this variant,” Richard Lessells, an infectious-diseases physician at the University of KwaZulu-Natal in Durban, South Africa, said at a press briefing organized by South Africa’s health department on 25 November. “The mutation profile gives us concern, but now we need to do the work to understand the significance of this variant and what it means for the response to the pandemic.”

Meanwhile, Israel has become the first country to shut its border to all international travellers at news of the Omicron. The ban would last 14 days. They hope that within the 14 days, more will be known of the variant including information on how effective COVID-19 vaccines are against Omicron.

“Our working hypotheses are that the variant is already in nearly every country and that the is effective, although we don’t yet know to what degree,” Interior Minister Ayelet Shaked told N12 News.

Israel has so far confirmed one case of Omicron, with seven suspected cases.

How much of a threat it is, is still unknown.

Professor Wang Linfa, an expert on emerging infectious diseases at Duke-NUS Medical School, said there are three important key variables in play – its transmissibility, -escaping ability and virulence.

Transmissibility is not a threat if the variant does not carry with it the potential for serious illness, he said.

There is a limit to the number of ways a virus can mutate though.

“The virus cannot mutate in just any part of the spike protein. Some parts are highly conserved and mutations in this part could destroy the architecture and hence the viability of the virus,” Professor Ooi Eng Eong, researcher and Deputy Director, Programme in Emerging Infectious Diseases, Duke-NUS Medical School said.

And because some parts of the spike protein are immutable (highly conserved), our immune responses would still be able to elicit protective effects against the virus by targeting these parts of the spike protein.

Our immune system is quite sophisticated. “It can kill viruses in many different ways, and some of these killing mechanisms are difficult to measure in the laboratory,” Prof Ooi said.
People who have been infected would also have antibodies and T cells that target other parts of the virus beyond the spike protein.

What can we do?

Don’t panic. Vaccinate. may not stop infection, but it will still protect against serious illness or fatal infection. With more therapeutics to come, we have more tools in our toolkit. Just do our part so that we do not put pressure on our workers. That’s Ms Ho Ching’s advice. Couldn’t agree more.


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