'consequences may be severe': escaping variants, virulence and other questions about omicron

if another major surge of covid-19 takes place, driven by the omicron variant, “consequences may be severe,” the world health organization warned monday.“omicron’s very emergence is another reminder that although many of us might think we’re done with covid-19, it’s not done with us,” director-general tedros adhanom ghebreyesus told a special session of the world health assembly.there is still a lot that is unclear about the variant, which was detected in southern africa earlier this month and was declared a variant of concern on friday. that includes whether omicron is likely to make people more severely ill compared to infections from other variants.for researchers, one of the most interesting aspects of this variant is that it is being detected at faster rates. but just because it’s fast doesn’t mean it’s more dangerous, said immunologist angela crawley, an immunologist at the ottawa hospital and the university of ottawa, and a member of canada’s coronavirus variants rapid response network.“maybe you can run really fast. but if you can’t shoot your gun, you’re useless.”
what is an escape variant and is omicron one?an escape variant is a dominant strain that evades the immunity established through vaccines. even vaccinated people will not be able to neutralize it effectively and vaccine efficacy will be lower.we don’t know if omicron is an escape variant. preliminary data suggests that there are increasing rates of hospitalization in south africa, according to the world health organization.while increased hospitalization is one piece of evidence, an escape variant can only be verified by scientists using assays of the plasma of vaccinated people, which will put numbers on neutralization. that takes time, said crawley.will current vaccines offer protection from omicron? we don’t know the effectiveness of the vaccine against the omicron variant, ontario chief medical officer of health dr. kieran moore said monday.ontario should remain focused on the present threat, which is the delta variant, he said. “we know the vaccines are very effective and two doses prevent admission to the hospital at a very protective rate.”there is no evidence to suggest that the vaccines we’re now using won’t protect us, said crawley. “while it’s important to investigate and track vaccine efficacy, maintaining vaccine efforts continues to be one of the tools we use to mitigate spread.”there is also no current evidence that we need to develop another vaccine, she said. “more likely, we will be building on the current vaccine and tweaking it annually, driven by our understanding of existing immunity and viral evolution.”are there other options for treating omicron?public health officials in ontario will be keeping an eye on whether oral antivirals are effective against this variant, as well as newer vaccines, such as the novavax vaccine, said moore.on friday, novavax said it had started working on a version of its vaccine to target the omicron variant, and would have it ready for testing and manufacturing in the next few weeks.moore also predicted the province will see an acceleration of its third-dose strategy.will omicron affect travel? ontario is pushing for enhanced testing of returning travellers, said moore. he noted that the two cases in ottawa were picked up because of random testing.“this virus has been present around the globe, for probably many, many weeks, if not months, and it has spread to multiple locations around the globe. it may be more prudent to broaden the testing of all returning travellers.”what role does international co-operation play?scientists in canada have been impressed by the openness, speed and expertise of their colleagues in south africa. “we feel confident they’re delivering fast, open and detailed information, said crawley.omicron has an unprecedented number of spike mutations, some of which are “concerning for their potential impact on the trajectory of the pandemic,” according to the world health organization.the “spike” on this variant is a little different, said crawley. once scientists have the genomic sequence and can engineer the protein in the spike, they will be able to put it in the assays to see if antibodies can bind to the spike. this will help determine the efficacy of immunity, said crawley.canada has had banks of human plasma samples collected since the beginning of the pandemic. using these samples, assays will help tell how effective various levels of vaccination have been, cross-referenced according to vaccine manufacturer, the number of doses, boosters, as well as different demographics.should people be worried about omicron?cautious, yes. freaked out, no. get vaccinated if you haven’t already been vaccinated, crawley urges.“even if the vaccine is less effective with this variant, weak is better than nothing.”crawley also urges vigilance about covid-19 symptoms and getting tested if there are symptoms. covid fatigue means people are ignoring their symptoms and have been more lax about protection, she said.“this is something we have cause to be cautious about. but there is no need to panic.”