By Dr Edward Nazareth
Dec 11: As on now, the preliminary reports on Omicron, the new variant of Covid-19 suggest that this variant is highly infectious but causes mild illness. Though it is premature to conclude, if Omicron is truly infects many people and causes mild disease in them, it may be the beginning of the end of this deadly pandemic.
Now infamous ‘Omicron’ is the B.1.1.529 variant of Covid-19 virus which was first detected in South Africa in a specimen collected on 9th November 2021. This was reported to World Health Organization (WHO) on 24 November 2021. Two days later, the World Health Organization named it as ‘Omicron’ (the 15th letter of Greek alphabet) and classified it as the ’Variant of Concern’. According to World Health Organization, a variant of concern is a variant that has significantly rise in transmissibility, an increase in fatality and a significant decrease in effectiveness of vaccines, therapy and other health measures.
The variant has more than 30 mutations – around twice as many as the Delta variant – which make it more transmissible and can evade the protection given by prior infection or vaccination. In South Africa, several people who had infection earlier are getting infected. The breakthrough infections in vaccinated people also are high.
More infections, less admissions
Almost after two weeks of expressing this concern, the reports from South Africa suggest that Omicron appears to be a tamed variant that wants to stay with human beings without harming them significantly. The Omicron variant is reaching more countries across Africa and weekly Covid-19 cases in the continent surged by 93%. However, the hospitalizations across South Africa remain low. Africa recorded more than 107000 cases in the week ending on 5 December, up from around 55000. Five countries accounted for 86% of the cases reported over that week and all the sub-regions in the continent – up from one the previous week – reported increases in new cases. Southern Africa recorded the highest increase with a 140% hike. The number of cases of this variant appears to be increasing in almost all provinces in South Africa. However, the data from hospitals indicates that Omicron causes less severe illness. The ICU occupancy has increased only by 6.3% across South Africa between 14 November and 4 December 2021, which is very low compared with the period when the country was facing the peak of the Delta variant in July 2021. With a positivity rate of 29.8%, on 9th December 2021, a total of 22,391 new cases of Covid 19 infection were detected; the deaths due to Covid-19 reported were only 22 in South Africa.
The variant is not causing severe illness either. The hospitals and GPs across Southern Africa are increasingly reporting that the symptoms of the aggressive new strain Omicron are ‘unusual but very mild’. Around 90 per cent of all new infections in the Johannesburg region were caused by the Omicron strain but, the Covid-19 death rate and even hospital admissions appear not to be increasing significantly.
The symptoms of Omicron variant infection appear to be different from the previous virulent strains. The hundreds of infected people across Southern Africa reportedly complain of nausea, headaches, fatigue and a high pulse rate, but none seem to suffer from a loss of taste or smell, which was the most common symptom with other Covid mutations.
Dr Angelique Coetzee who reported the first case of Omicron variant has confirmed that the symptoms were so different and so mild from previous Covid patients she had treated earlier.
Out of more than 1200 admissions due to Omicron variant infections in the last week, 98 were receiving supplemental oxygen and only four were on ventilation. This initial data may not be showing the true picture of the infection because of a small sample size and most of the people admitted to the health facilities were under the age of 40. It is cautioned that as the clinical profile of patients’ changes, the impact of Omicron may change.
It may take two more weeks before we can conclusively state that the Omicron is a strong strain of infection and a weak strain of disease.
Enemy wants to compromise?
Mutation is a blessing for the viruses to survive. It is the property of a virus to undergo changes when it multiplies. The basic structure of virus is the combinations of different amino acids placed at particular places. The spike protein, the surface protein of Covid-19 virus is composed of a linear chain of 1,273 amino acids, neatly folded into a structure. They are like the bricks placed in a proper order to build a structure. As the virus multiplies, it alters some of its amino acids, change their position resulting in new strains. (Some bricks are interchanged so that the structure remains the same, but look alters). These new strains may be stronger than the original or at times weaker. During the process of mutation, some strains die out, while the more effective ones, which spread efficiently, survive.
The Covid-19 virus also has mutated several times. The virus that has spread around the world is not the same as the virus that emerged in Wuhan province of China in late 2019. This is because, like many other viruses, Covid-19 virus has changed in its genetic structure through mutation. Mutation is a blessing from Mother Nature to many of the micro-organisms like viruses so that they survive facing the ‘situations that might eliminate them otherwise’! We have invented vaccines so that the virus may not multiply in a vaccinated person. To overcome this hurdle, the virus has to change its genetic structure- that is exactly what Covid-19 virus has been doing.
But all the mutations may not help the virus to thrive. Many of the mutations are silent: they do not alter the function of the virus in any way, and they don’t result in changes in disease severity or immune responses. Of those that are not silent, many are damaging to virus functions and result in non-viable viruses, and therefore do not survive into a new generation of viruses. It is known that of the 30 plus possible mutations of Covid-19 virus so far, only about 5 have benefitted the virus.
As written earlier, Mother Nature helps the virus to survive. If the mutations make the virus more deadly, it may not give the virus an opportunity to spread efficiently. If the humans get too sick or die quickly from a particular virus, the virus has less opportunity to infect others. As it is seen with delta, more infections from a faster-spreading variant will lead to more hospitalizations and deaths. Therefore for the survival the virus has to infect more and cause less illness. It’s ‘victim’ should not die, probably should not become too sick also. It appears that Omicron variant is a compromise the virus is making with humans!
Omicron, blessing in disguise?
The WHO had warned that preliminary evidence suggests the variant has an increased risk of reinfection and may spread more rapidly than other strains, including Delta. However, some experts are cautiously optimistic that – if Omicron turns out to be less lethal but more contagious and dominant than the Delta variant – the new mutation may actually be a blessing in disguise. If the omicron variant is less pathogenic, with greater infectivity, it will replace earlier deadly Delta variant and it will be a positive change.
If, as some evidence suggests, Omicron turns out to be a fast-spreading virus with mostly mild symptoms in the majority of the people who catch it, that would be a useful step on the road to herd immunity.
The fast spreading mild infection can be like involuntary vaccination. Even if someone doesn’t want to get vaccinated, he or she may not be able to avoid infection by Omicron. It will lead for the formation of antibodies in their system which will make them immune for further infection.
As stated earlier, it is premature to come to any conclusion. Till the picture is clear, we will have to continue to live with the virus as we have lived so far. Getting the vaccination is the only proven way to avoid deadly complications even if one is infected. Wearing the mask, wearing it properly and, avoiding the crowded places are the ways to avoid infection from Covid-19 virus till it totally disappears from this world. Even a weak virus may mutate to become strong and deadly, nothing can be assured!
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