The Omicron Variant

A new variant is sweeping the globe.  Today, the WHO designated the b.1.1.529 variant a Variant of Concern and assigned it the name Omicron, humorlessly passing on the opportunity call the new variant Nu.  The Omicron variant, first identified earlier this month in South Africa, has already spread to Israel, Hong Kong, and Belgium, prompting travel restrictions by many countries.

There’s much more to learn about this variant, but reports so far suggest this is a highly mutated form with cluster mutations in the receptor binding domain, the portion of the spike protein where vaccine immunity is aimed.  It’s reasonable to infer that these mutations may lead to increased vaccine escape.  More breakthrough infections can be expected.

According to an article published in Nature yesterday, there are already anecdotal reports of reinfections and cases in vaccinated individuals.  If the infectivity of Omicron is as least as high as Delta, expect Omicron to soon replace Delta as the dominant form in the U.S.    

As the virus continues to evolve, the vaccines remain static.  The vaccines available today were designed to provide immunity against the spike protein of the wild type strain identified in Wuhan in January 2020, but that viral strain has practically vanished.  As the virus continues to move, individuals who are only protected by vaccination will be increasingly exposed to virus attacks.

Those who have been previously exposed to the virus can be expected to have broad immunity.  Think of castle walls deflecting missiles launched from many directions and angles.  Those protected by vaccine alone have neutralizing antibodies against the wild-type spike protein.  Think of the protection provided by a slender pole.  An attacker needs only move over a few feet to obtain a direct line of sight to the target.  That’s why breakthrough infections are common, why vaccinated individuals can transmit the virus, why vaccinated individuals require hospitalization, and why vaccinated individuals die from COVID-19.

One more point about variants.  The CDC now has four variant classes, listed from least to most significant: Variant Being Monitored (VBM), Variant of Interest (VOI), Variant of Concern (VOC), and Variant of High Consequence (VOHC).  In April 2020 there were many variants on the VOI and VOC lists.  However, as vaccination rates increased, all but one of these variants disappeared from the United States and were moved to the VBM list, including the Alpha variant responsible for the COVID-19 spike last winter.  The Delta variant and its rare sublineages are the only remaining Variants of Concern. 

As the virus continues to evolve, a variety of variants should be expected, but instead we find a monotypic variant population.  This suggests unnatural manipulation, and this observation is coincidental with the continued push for vaccination by a first-generation vaccine.  Could there be a causal relationship?  Could the Omicron variant be a result of the vaccination policy advocated by national and international health organizations?  We don’t know for sure, but it is plausible.  What we do know is that this virus will be with us for some time.  Universal vaccination will not eradicate SARS-CoV-2.  We must look elsewhere if we are going to live with the virus.  

Early treatment shows the most promise.