Heavily Mutated Fast-Moving New COVID Variant Omicron – What We Know So Far
Saturday, November 27, 2021
In the past week, a new COVID variant has been characterized. Friday the World Health Organization (WHO) called a special meeting to discuss the problem. WHO has named the variant Omicron (also known as B.1.1.529), and designated it a Variant of Concern, the highest level of risk threat.
Omicron is the most heavily mutated COVID variant identified to date and is spreading fast in South Africa. Two weeks ago there were about 200 new cases per day in South Africa, compared with over 3,500 yesterday. It is estimated that 90% of new cases in Gauteng province in South Africa, which contains the major cities Johannesburg and Pretoria, may already be by Omicron.
News and developments concerning Omicron are evolving very quickly. This is what is known so far.
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What is it?
Omicron was first found in Botswana on November 11, and in South Africa on November 23. The number of cases in South Africa is growing very fast.
Omicron is a concern because it has new and more mutations than have ever been seen before in a COVID variant. It has over 50 total mutations, including 32 mutations in the critical ‘spike’ region the virus uses to infect our cells, and that is the target of antibodies generated by vaccines.
What are the risks?
Omicron is of great concern because the constellation of mutations it contains has been seen in other COVID variants and is associated with increased contagiousness, increased disease severity, and resistance to vaccines. Omicron is the first variant that has mutations for all of these traits.
The three major questions with any new COVID variant are:
Transmissibility – how contagious is it? Specifically, is it more contagious than the Delta variant?
Infectivity – does it cause more severe disease than other variants?
Resistance – how susceptible is the variant to being neutralized by antibodies from vaccines or antibody drugs?
Omicron is worrying because it has mutations that may give it all three of these characteristics. Omicron also has a number of mutations that have never been seen before in a COVID variant, the impact of which is unknown.
One of the most important questions is whether or not Omicron is more contagious than Delta. Other variants have emerged that are more resistant to vaccines than Delta, such as Mu and Lambda. Because they were not as transmissible as Delta, they have not replaced Delta and have petered out.
Preliminary analysis of the rate of spread of Omicron suggests that it is much more contagious than Delta. Modeling by James Weiland suggests that Omicron is 500% more transmissible than the original Wuhan COVID strain.
In comparison, the Delta variant was about 70% more contagious than the original strain.
Additionally, modeling by John Burn-Murdoch of the Financial Times shows that Omicron is much more transmissible and spreads much faster than Delta.
Will the current vaccines protect against Omicron?
It is not yet known how effective the currently available vaccines from Pfizer, Moderna, and Johnson & Johnson will be against Omicron. The concern is that Omicron has the same and multiple mutations that have been shown to be less susceptible to neutralization by antibodies from vaccines and antibody drugs. It seems likely that these mutations will decrease the susceptibility of Omicron to being neutralized by antibodies, though the extent is not yet known.
The four Omicron cases identified in Botswana were all in vaccinated individuals.
Will Omicron cause more severe disease?
It’s not yet known how severe illness will be with Omicron. The risk is that Omicron has the same mutations as other variants that have been associated with more severe disease.
For example, in Omicron the region of the spike protein called the ‘receptor binding domain’, which the virus uses to make the first contact with our body’s cells, has 10 mutations compared with 2 on the Delta variant. This suggests it might attack our cells more efficiently and get inside more easily and quickly than Delta.
Where has it been found?
Most Omicron cases so far have been found in South Africa. It has also been reported in Botswana, Belgium, Israel, Hong Kong. No cases have been reported as of yet in the U.S.
When will we know more?
Given the high level of threat of Omicron, news is developing very quickly and many studies are already underway to learn as much as possible. The first tests to determine how well vaccine-elicited antibodies work against Omicron should be known within two weeks.
What is the risk in Rhode Island?
COVID cases in Rhode Island are already increasing rapidly, 35% over the past week and about 400 confirmed new cases daily. Rhode Island remains at a High level of risk according to Centers for Disease Control definitions, the highest level of threat, and a Very High level of risk according to covidactnow.org.
Breakthrough infections in vaccinated people continue to increase in Rhode Island. Last week there were 1,413 new COVID cases in vaccinated individuals, 42% of all new cases.
Last week 61% of COVID hospitalizations, and 100% of COVID deaths, were in vaccinated people. Protection from the vaccines seems to be waning faster than people are getting booster shots. This, combined with Rhode Island taking very few public health precautionary measures, suggests we are at great risk from Omicron.
“All these things are what give us some concern that this variant might have not just enhanced transmissibility, so spread more efficiently, but might also be able to get around parts of the immune system and the protection we have in our immune system,” said Dr. Richard Lessells, an infectious diseases specialist at the KwaZulu-Natal Research and Innovation Sequencing Platform.
Developments are coming very fast concerning Omicron. Stay tuned for more news to come.
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