Opinion – Pedro Hallal: The omicron is booming: is it good or bad?

Since it was discovered, about a month ago, the omicron variant was immediately on the agenda. Preliminary reports suggested that the variant was much more transmissible than previous versions of the coronavirus, which was bad news. However, the same preliminary reports suggested that the variant was far less aggressive than previous versions of the virus, which was great news. The question remained: do the existing vaccines protect or not against the new variant?

The first preliminary report was confirmed very quickly. The omicron is booming all over the world, due to its incredible transmission capacity. The world has broken records for daily cases in the past week and virtually all countries report numbers comparable to the worst moments in the pandemic.

Here it is necessary to open parentheses. Brazil is an exception. In Brazil, statistics still do not show a daily record of cases. But that doesn’t mean that omicron isn’t booming in the country. This is just a reflection of the Ministry of Health’s data blackout, which seems to have given up on protecting the population from the virus for good. Furthermore, the ridiculously low Brazilian test hides the reality of the pandemic, not only now, but since its inception.

Anyway, the omicron is booming, all over the world (visible to everyone) and in Brazil (hidden by the lack of data). It remains to be seen: is this good or bad?

There is no definitive answer to this question, but it is necessary to assess the various possibilities. Let’s start with the downside of the wide spread of the omicron.

1) The fact that a variant is less aggressive does not mean that it is irrelevant to the health service. Imagine that, with the original virus, there was one death for every 100 infected. Imagine that, with omicron, there is one death for every 400 infected. Now, if we have 100,000 infected at the same time with the original virus, we will have 1,000 deaths. If the new variant transmits more, and manages to infect 400,000 people at the same time, the estimated death toll will also be 1,000. That is, if less aggressiveness is offset by greater contagion in the same proportion, the number of deaths may remain high.

2) The fact that a variant is less aggressive does not mean that it will not have long-term consequences for those infected. While there’s good news that omicrons affect the lungs less, the truth is, we don’t know about its long-term effects. We can never forget the large number of Brazilians who still live today with persistent symptoms after infection by Covid-19.

3) The fact that the omicron is out and about reflects that vaccines have not been able to stop its expansion, suggesting that vaccines do have reduced efficacy for this new variant. Note that reduced effectiveness is seen for infections but not for hospitalizations and deaths. In other words: vaccinated people have a much lower risk of a severe case and death, either with omicron or with previous versions of the virus.

4) The more the omicron circular, the greater the chance of mutations and emergence of new variants. And we’ve already learned how much these new variants can delay the end of the pandemic.

But we cannot turn a blind eye to the potential positive scenarios either.

1) The risk of severe cases with omicron, which is already lower overall, is much lower among vaccinated people. In a country like Brazil where most of the population is vaccinated, there is a good chance that omicron will not be able to increase hospitalizations and deaths as much.

2) Creating public policies based on “collective immunity” was criminal at the beginning of the pandemic and is still criminal today. Deliberately exposing people to the virus is a crime for which our managers are being properly investigated. However, the “collective immunity” that was unattainable with previous versions of the coronavirus may not be unattainable with the wide and rapid spread of the omicron.

Anyway, the scenario still brings many uncertainties, especially in a country where data are missing and, more than ever, the federal government is on the side of the virus and against the population.

We, from science, will continue “looking up” and trying to help our population, despite the boycott and persecution of those who only “look at their navels”.