The situation so far in relation to the new Omicron variant of the coronavirus that has caused widespread concern internationally, the possible scenarios for the future, as well as what we should do due to the new data, the Health Policy professor summarizes in a Facebook post, Elias Mosialos, of the London School of Economics and Political Science (LSE) and Imperial College.
The post in detail:
1. What we know and why we are worried
We know this is a variant with at least 50 changes from the original virus. 32 of them are in the protein spike, while Delta had respectively 16. One of them is a concern because probably due to location – and compared to Delta – it can make the virus more contagious. In other words, we are worried because on the whole, if these mutations prove to be functional, they can potentially lead to more mild or even serious infections.
We know the above from data from South Africa, which has an excellent network of infectious diseases and pandemic vigilance. A new element is that the transmission is observed in young people (generally in people under 40 years of age), where almost 65% are unvaccinated and the vast majority of the rest are unvaccinated. Only indirectly, then, may we be able to draw an early conclusion that vaccinated people are protected from a serious infection. But we are not sure yet.
Let me point out here that the data we have, mainly concern a younger population. And let me remind you that, in addition to the difference in vaccination levels between the two countries, the median age in South Africa is 27.6 years while in Greece it is 45.6 years.
It is possible that the Omicron variant causes more severe disease than Delta in older carriers. But we do not know that yet. We will know in the coming weeks.
2. What are the possible scenarios
The scenarios that are heard are many, but I will stay in the most important of them, based on the outcome of the infection and the burden on the health system.
– The new executive should be less contagious compared to Delta. In this case we will not have a significant problem.
– To be dealing with an equally infectious virus with the Delta variant, but to cause more mild and severe infections in unvaccinated, and at the same time more mild infections in vaccinated. But not necessarily more serious infections in vaccinated. In this case, the vaccines will be less effective in preventing mild infection, but will still be effective in preventing severe infection. This is the second best case scenario.
– Dealing with an equally contagious virus with the Delta variant, but causing more mild and severe infections in both the unvaccinated and the vaccinated compared to the Delta (again here we will obviously expect more infections per 100,000 unvaccinated people). In this case we will have a big burden on the health system.
– To be dealing with a more infectious virus than the Delta variant, but to cause more mild and severe infections in unvaccinated and vaccinated (again we will have higher numbers in unvaccinated per 100,000 people). In this case, because we will have more patients, we will have a greater influx of hospitals. This is the worst case scenario.
Of course, it is difficult to predict with the data so far which scenario will prevail. Given that we only have data on young people who are ill, it remains to be seen, of course, the impact on older people.
3. What we will know in a few weeks
In 2-3 weeks we will know how many are stuck and how many of them were hospitalized. We will also know quality characteristics for them, such as age, gender and possible comorbidities.
Given the great potential of the South African health system, we will also have data on the clinical picture of the institutions. That is, data on the severity of the disease and the outcome of the hospitalization. At the same time, we will have data from laboratory studies that will deepen the protection of vaccines in those of those who were vaccinated.
Let us say here that these two types of data are necessary and, together with the epidemiological records, will give us the real dimension of the new situation brought about by the new variant.
4. What should we do now?
Now we have to save time and enable scientists to characterize the variant. But there are things that can be done at the level of government decisions and things that citizens can do.
For example, many countries already restrict flights – and they do well – to some African countries. This will not stop the spread, but we hope to delay it until we have more secure data for the new variant.
Other countries are reviewing older samples from travelers who have entered their country to trace the possible existing dispersion. In England, rapid tests will no longer be performed, but PCR, and travelers will be isolated until the results come out. This is perhaps something that our country should also consider.
And in closing, the effort to curb the virus must be made by all of us. Those who have not been vaccinated, I hope that the uncertainty of the outcome of the new variant will help them make the decision to be vaccinated. Those who have not done the third installment, let it start. To try to save time and help not to spread the Omicron variant. Let us all follow the measures strictly.
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