The Truth about Omicron

A new variant of Covid has emerged, it’s more infectious, with under 40s more likely to develop symptoms but much milder than previous variants – cold, headache, maybe a cough for just 4 days. There’s no need for panic.

1. Why is it called Omicron? We are going through the Greek alphabet to name each variant as it appears – alpha, beta, gamma, delta. When you get to O, the vast majority of people would use Omega. Rarely, the name Omicron is used and this sounds far scarier. The WHO chose the name.
2. So what is Omicron? It’s another SARS-Cov-2 variant. It may have even existed in several forms months ago, each with slight changes. It appears to have up to 30 mutations in the spike protein coat. Dr. Soumya Swaminathan, the chief scientist of the WHO, believes that Omicron could become the dominant variant of COVID-19 and we are all likely to catch it at some stage.
3. What are the characteristics of Omicron? First, it appears highly infectious. It is much easier to catch than previous variants. However, South African Doctor, Angelique Coetzee, who has more experience of this variant than anyone else in the world, told the BBC that the symptoms are ‘extremely mild’, fatigue, a scratchy throat, cold-like, aches and pains, possibly with a headache, sometimes a weak cough and last approximately 4 days. Coetzee is chair of the South African Medical Association. There have been zero hospitalisations and deaths from Omicron in South Africa to date. The WHO reports no deaths from Omicron anywhere in the world, as of December 9.
4. If I am fully vaccinated, can I catch it? To date, mRNA vaccines have proven poor at preventing transmissions – either in catching Covid-19 or passing it on. Omicron would likely prove to be no exception. All the people in Botswana who have so far caught Omicron have been fully vaccinated. So, the answer to the question is ‘Yes’. This is because mRNA vaccines make antibodies to the particular variant – imagine a piece of jigsaw puzzle; the next piece must fit it exactly. If the piece of puzzle changes, the same piece may not fit.
5. What does research say about the existing vaccines and Omicron?   A new study from Columbia University (1) has shown that no mRNA vaccines or boosters work against Omicron. The Study was entitled “Striking Antibody evasion Manifested by the Omicron variant”. However, the good news is that this may well not be the case for the AstraZeneca Oxford University vaccine which works a completely different way by boosting attacker T-cells. These have widespread abilities. While the antibodies to mRNA vaccines decline rapidly, the AZ T-cell boost does not seem to do this. Professor Dame Sarah Gilbert, a vaccinologist and expert in T-cells at Oxford University, is even saying booster shots may well not be needed with the AZ vaccine.
6. Did Omicron originate in South Africa? No. In conversations with an expert South African virologist who does not wish to be named, he stated that it may even have been around for 6-8 months. The virologists in South Africa merely identified it when numbers of cases suddenly jumped in one township. This view is confirmed by the South African Government. It is likely already present in most countries.    As of midnight GMT at the start of 8th December. Omicron had been identified in 9 African countries, but also in countries from India to Denmark and from Holland to the UK, most patients having no connection with travel from Africa. The WHO is saying it is already in 38 countries. In the USA, it has already been identified in 19 States. Dr Fauci meanwhile is saying that ‘It is inevitable this will arrive in the USA’.
7. Is this new variant really milder? To date, this Omicron variant seems more infectious but much milder with no deaths reported. However, it is linked to greater levels of infection in the under 40s than was the case with previous variants.
8. How did Omicron arise? According to Sharon Peacock who has led the UK Genetic Sequencing of Covid at Cambridge University, the variant “may have evolved in someone who contracted an earlier Covid variant but could not clear the virus”. It’s how experts think the alpha variant emerged. This makes the imperfect performance of mRNA vaccines a real danger. Mutation happens in people already vaccinated.
9. Are the unvaccinated more likely to be infected by Omicron? Since mRNA vaccines don’t work against Omicron, the answer in No. And anyway, the major Harvard study (2) which reviewed data from 68 countries and over 1,000 counties in the USA concluded there was, in October 2021, no increased infection rate in the non-vaccinated population over the vaccinated population. If anything, populations with higher vaccination rates were recording more Covid cases. Despite this, and despite the finding that vaccinated people have little defence against Omicron, Governments such as those of the USA, France, the UK and Australia are urging vaccination. There is no point with current mRNA options, but you should expect new modified vaccines.
10. Will future variants be worse? According to Dr Paul Elias Alexander, an expert epidemiologist, former Associate Professor at McMaster University and former advisor to the WHO and on Pandemic Policy to the US Government, the answer is ‘No’. Typically viruses get more infectious but weaker as they mutate. Exactly what we are seeing with omicron. 
11. Can you catch Omicron if you have previously had Covid? Research from the National Institute of Communicable Diseases in South Africa  shows ‘Yes’, you can, but that the reduced risk of contracting Omicron is 84% if you have previously had Covid. So Natural Immunity seems best. There was also no increased risk of catching Omicron if you previously had beta or delta, but after you have had Omicron, you can catch it again. What we are actually seeing is the sort of data that happens with the common cold.
12. How long is the period between infection and symptoms? It looks like the gestation period for Omicron may be just 36-48 hours not 5-6 days as with Delta. Indeed Professor Salim Abdool Karim, a clinical epidemiologist and infectious disease expert at Columbia University and vice-chancellor of KwaZuluNatal in SA, is saying that virus infections from Omicron are doubling every one and a half days, a much higher rate than other variants.
13. Can a PCR test detect Omicron?  Another concern is that the PCR tests seem to miss about 40% of omicron infections. And Lateral Flow tests seem not much better. So you could take the test and seem clear when boarding the aeroplane. And again when taking the test at your destination, but 24 hours later you might develop the cold-like symptoms of omicron. This makes foreign travel hazardous, for both the traveller and the recipient country.
14.  The latest comment from the WHO (as of 7 days ago) is the ‘Omicron could change the face of the pandemic’. It also states that there have been zero deaths so far.
15. Outbreak in the USA. In the USA, several newspapers and WebMD’s Medscape reported that ‘One of the largest outbreaks of the Omicron variant to date is believed to have occurred at Cornell University in Ithaca, New York, where almost 930 cases of Covid have occurred in the past week including cases of Omicron’. Yet, masks are mandated at the University and 97% of the students and staff are doubly vaccinated with a high percentage having already had the booster. Reports don’t actually say how many of the cases were Omicron (3).
16. UK Covid case levels are running at an average of 87,958 per day for the 7 days to December 21st. Although the UK Government is saying this is ‘most likely’ driven by London where it is ‘most likely’ that 70% of cases are Omicron. The UK Government website states that “Scientists have warned that two doses of a Covid vaccine are not enough to stop people catching the Omicron variant, but a booster dose prevents around 75% of people getting any symptoms”. The research (1) from Columbia University contradicts this last claim, which anyway has little or no data we can find to support it.

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References

1. Striking antibody evasion, Columbia University – https://www.cuimc.columbia.edu/news/new-study-adds-more-evidence-omicron-immune-evasion 
2. Subramanian, S.V., Kumar, A. Increases in COVID-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States. Eur J Epidemiol (2021). https://doi.org/10.1007/s10654-021-00808-7
3. WebMD, Cornell University – https://themedicalprogress.com/2021/12/15/cornell-university-reports-930-covid-cases-omicron-included/