When in doubt, it’s better to ‘go hard, go early and go fast’ against omicron, says scientist

When in doubt about the seriousness of the new omicron variant, “it’s better to ‘go hard, go early and go fast’ and apologize if you’re wrong,” said leading experts in gene sequencing and public health, Sharon Peacock, director of the consortium of British genomics COG-UK and professor of public health and microbiology at Cambridge University.

The assessment was shared by several British scientists who analyzed the risks of the new strain of concern for the Science Media Center platform.

Sharon noted that there are many open questions, but scientific answers will take weeks and “there are enough warning signs to assume the worst rather than hope for the best, and take a precautionary approach.”

Since last Wednesday (24), South African and British laboratories have been working to answer five questions about omicron: 1) is it more transmissible than known varieties?; 2) is it capable of causing more serious illnesses?; 3) is it able to escape the protection offered by the vaccines already available?; 4) does it have more potential to reinfect a recovered patient and 5) are current diagnostic methods adequate to detect it?

Regarding the first question, the numbers from the evolution of Covid in southern Africa suggest that the omicron is more transmissible, “and several mutations are consistent with increased transmissibility”, says the expert.

She says that mutations are also present in this variant that, in others already known, were associated with immune evasion — that is, with a lower efficiency of immunizers or of the human defense system.

Studies already started to examine in the laboratory how antibodies and T cells (used by the human body to defend itself) interact with the micron “will take several weeks to complete”, Sharon points out. After that, it will still be necessary to obtain real-world data on whether immunity is reduced to vaccines and previous infections.

Regarding the severity of the disease, one concern is that the types of mutation found could indicate that the omicron appeared “in someone who was infected but failed to eliminate the virus, giving it a chance to genetically evolve.”

“But the meaning of many of the detected mutations and the effect of the combination of these mutations are not yet known,” says Sharon. Meanwhile, she considers it wise to limit the movement of people and says it is necessary to increase surveillance, testing and sequencing.

In the end, it may be concluded that omicron is not as serious as alpha or delta, “but the potential consequences of not taking action and then finding it to do more damage are serious,” agrees Ewan Birney, managing director. Assistant at the European Molecular Biology Laboratory.

Travel restriction is also advocated by the University of Edinburgh professor of infectious disease epidemiology, Mark Woolhouse, but should not be seen as a definitive solution.

“If a new mutant acquired advantages over the previous ones, such as being more contagious, it will arrive anyway,” he says. He says that if restrictions help buy time in the fight against coronaviruses, their value depends on what we do with that time.

“The priority must be to establish whether omicron really poses a significant threat to public health. If so, we have a set of tools available to lessen its impact,” says the scientist.

Woolhouse says the world will have to “live with the virus”, which means adopting measures in a proportionate and sustainable way, trying to avoid wholesale restrictions, which are less efficient. “It’s better to make travel safer with better testing and screening than to ban it outright.”

At the same time, developed countries should intensify efforts to vaccinate the rest of the world, among other things to prevent the emergence of new variants, says senior researcher in global health at the University of Southampton (UK), Michael Head.

“Only about 11% of the African population has received at least one dose of covid vaccine. Much of sub-Saharan Africa has been very successful in keeping outbreaks under control despite their limited resources, but the risk of a collapse is always very big,” he said.

Lawrence Young, virologist and professor at the University of Warwick School of Medicine, agrees: “Variants will continue to be generated as long as the virus can spread, especially in countries where vaccination rates are low. “.

In addition to expanding vaccination campaigns, efforts must be made to improve current immunizations, says Richard Hatchett, CEO of Cepi, https://cepi.net/, a global network created in 2017 to anticipate pathogens capable of causing pandemics.

The coalition coordinates the development of a new generation of vaccines that can overcome limitations of those currently available, such as a nasal version that can interrupt transmission, or drugs that target parts of the coronavirus other than protein S (structure used by SARS= Cov-2 to penetrate the human cell.

The fact that the omicron has a large number of mutations in this protein S is what leads scientists to fear that the variant could escape the protection offered by vaccines, created to recognize a structure that may have been greatly altered.

According to Hatchett, the innovation centers are “a step ahead of the virus”, developing vaccines against known strains of concern and others “variant proof”, capable of protecting against a wide range of mutations.

Cepi also funds studies on which are the most effective vaccination strategies, such as the combination of different drugs, which can lead to stronger and longer-lasting immunity.

As immunization agents are still scarce and insufficient for demand, the objective must be “to optimize the distribution of vaccines, so that each dose provides the maximum benefit”, says Hatchett.

In an interview this Saturday morning with the BBC, the British scientist who led the research on the Oxford/AstraZeneca vaccine against the coronavirus said that it is possible to create a new one against the omicron variant “very fast”.

Professor Andrew Pollard, director of the Oxford Vaccine Group, said it is “highly unlikely” that this new variant will spread with force among the already vaccinated population.

Manufacturers of other vaccines such as Pfizer/BioNTech, Moderna and Novavax also expressed confidence in their ability to fight the new strain.