With 30 new Omicron cases being recorded on Saturday, the overall tally for the new variant reached 143 in India. This is the highest single-day rise for the Omicron variant in the country.
With this there’s growing concern vis-à-vis Omicron. Genomic scientists in South Africa have said that Omicron has an unusually high number of mutations with more than 30 in the key spike protein to alter its structure to get into the cells.
Most viruses, including SAR-Cov-2, naturally mutated over time. Since the virus SAR-CoV-2 was first identified, thousands of mutations have arisen. A vast majority of them are just like passengers; they have little impact; they do not change the behaviour of the virus, they just carry it along. But a few manage to mutate in a way that helps the virus survive, reproduce and infect the immune system of the host.
Will Omicron unleash a wave that would be worse than the second wave of Covid-19? It is difficult to comment. The World Health Organization (WHIO), in collaboration with partners, has been monitoring and assessing the evolution of SAR-CoV-2 from January 2020.
The emergence of variants that posed an increased risk to global public health prompted the characterisation of specific variants — Omicron is characterised as the Variants of Concern (VOCs).
It is difficult to comment about the severity of Omicron, its response, and severity on the people who are already vaccinated twice. As per the primary experience of the practitioners of the South African Medical Association, this virus has started with the generation of 40 years or less and most predominant clinical symptoms are fatigue (1-2 days), headache, body ache, etc. Some of them have symptoms of throat infection, cough, dry cough, etc, but it comes and goes with little symptoms. Some patients also had high temperatures, but most of them had mild symptoms and recovered well.
Regarding the mutation, it has been noted that the more the viruses go through more and more un-vaccinated populations, the chances of mutation is more — as has already happened in South Africa. As per for the data, till 10 October 2021, 6 percent of Africans had been fully vaccinated against Covid-19. Many African countries have weak surveillance systems. Of the 1·3 billion Indians, only 6 million are older than 80 years. There is not a huge burden of diabetes or obesity. WHO reckons that 65-85 percent of SARS-CoV-2 infections in Africa do not produce any symptoms. So this has probably helped the virus to mutate further to form the Omicron variant.
Will people who are fully vaccinated be able to save them from Omicron? It is difficult to comment at this juncture because most of the mutations are clustered at ACE 2 receptor antibody binding sites which are also size targeted by Covid-19 vaccines and antibodies. But the most intriguing mutations introduced three new amino acids corresponding to nine nucleotides to the virus genetic profile. But this doesn’t necessarily mean that the insertion is more dangerous as per Venkyi Sounderajan.
So till date whatever data we have we can only comment that the transmission of this virus is definitely higher than the other strain but severity is yet to be reported. And as scientists have already expected that this pandemic will convert to endemic just like flu may be one of the silver linings. But during this season where people are not following Covid-appropriate behaviour and with the faddy immune system people will suffer with more symptoms and severity from this virus.
What should be done?
As per the WHO, we have to follow the methodology of infection prevention and control — hand washing, wearing masks and maintaining social distance. Avoidance of interaction with the animal population and control group is a crucial strategy to stop the occurrence of mutation. Need to strengthen surveillance and sequencing capacities and apply a systematic approach to provide a representative indication of the extent of transmission of SARS-CoV-2 variants based on the local context, and to detect unusual epidemiological events.
Although a few experts have suggested booster doses, which is not only difficult but not so scientific too. And if booster dose should be given after studying the antibody titer for the vulnerable people like who are more than 70 years of age, having multi-morbidity, have geriatric syndrome like fall, frailty, dementia, etc, who are staying in long-term care facility and who has other lung diseases or immunocompromised state. So justification for booster dose needs consideration and further study.
The writer, Dr Prasun Chatterjee, is with AIIMS, Delhi. Views expressed are personal.
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