World’s still stuck with a ‘Delta wave’ hangover. For Omicron, we need to stick to basics

Booster shots are like trying to stop a fire by pouring a mug of water repeatedly at one spot. Ensuring everyone is vaccinated is better in the long run.

People paint an awareness poster about getting vaccinated as well using sanitiser and mask in view of the Covid-19 pandemic, in Bikaner, Rajasthan in April 2021 | ANI

Over the last few weeks, social media was flooded with news of people getting married or going on long-awaited vacations. The Indian festive season saw markets with huge crowds, but luckily, the dreaded ‘third wave’ did not come to India. Before Covid cases mushroomed in India, the Union health ministry was limited to quarantining passengers arriving from certain countries and advising people to not travel to China. A travel advisory on 19 March 2020, shortly after India crossed 50 cases of Covid, banned international flights from India. Now after a full-blown pandemic with two deadly waves, just as the world was gearing up for a brighter 2022, SAR-CoV-2 reared a new head — Omicron and its 50 mutations.

In the initial days of the pandemic, the health ministry was sharing more details about each traveller who tested positive for Covid. But with Omicron, the ministry is keen on “protecting the privacy” of the travellers. The travel guidelines issued this November, in light of the Omicron variant are more elaborate: “Passengers originating or transiting from at-risk countries shall be informed by the airlines that they will undergo post-arrival testing, quarantine if tested negative, stringent isolation protocols if tested positive.”

Small changes in the coronavirus have given rise to the Omicron. But these tweaks completely changed the mood of the world, which now had vaccines and yet was blindsided. Foreign vacations, homecomings and wedding plan once again hanging by a thread — and it feels like we are back to the uncertainty of December 2019. Except for this time, we are already burdened with the knowledge of what we stand to lose, and what we have to fight. This is why Covid-19’s Omicron variant is ThePrint Newsmaker of the week.

What we know about Omicron

The B.1.1.529, or the Omicron variant — first detected in Botswana and later linked to a surge in cases in South Africa — is not altogether an unexpected development for those who have been closely following the science behind coronavirus.

Like all organisms that run on genetic codes, viruses mutate constantly. Mutations can be understood as small errors or typos in the genetic code that occur when the virus makes copies of itself. Most of the time, these changes do not affect the virus, but sometimes these can lead to changes in the proteins of the virus that enhance some of its functions — including infectivity or severity. Omnicron, for instance, reportedly has about 50 mutations, with about 32 mutations in the protein spike alone. Over time, changes that make the virus more ‘fit’ persist — causing such variants to spread more than others.

The data on Omicron is still scarce. What we do know is that on 1 December, South Africa recorded 8,561 cases — a sharp increase from 3,402 reported on 26 November and several hundred per day in mid-November. Much of this spread occurred in the Gauteng province.

Some of these mutations have been previously identified in other variants and are associated with immune escape properties and increased transmissibility.

However, Angelique Coetzee, a private practitioner and chair of the South African Medical Association, who first drew attention to the new variant also noted that the variant caused “very mild” disease.

In an article written in the Daily Mail, Coetzee said that the global reaction after the announcement of the variant from South Africa was unwarranted — almost as if Western countries were punishing good science. “No one here in South Africa is known to have been hospitalised with the Omicron variant, nor is anyone here believed to have fallen seriously ill with it,” she wrote. “Yet Britain and other European nations have reacted with heavy travel restrictions on flights from across southern Africa, as well as imposing tighter rules at home on mask-wearing, fines and extended quarantines.”

“The simple truth is: we don’t know yet anywhere near enough about Omicron to make such judgments or to impose such policies,” she added.

Currently, as much as 70 per cent of the new Covid cases in the world are being reported from Europe — while less than 2 per cent are from South Africa. Yet, news of the variant has caused nations to close doors to travellers from South Africa.

The ‘Delta Wave’ hangover

The reactions are understandable in the aftermath of what the “Delta wave” did to India and other countries. As a result, countries don’t want to take a chance and political leaders want to be seen as taking steps to stop the next wave. But if banning flights would stop the virus, we would not have faced a two-year-long global pandemic, to begin with.

What made the Delta variant deadly was not the virus in itself. It was the lack of Covid protocols along with low vaccination rates that caused the disease to spread to more people than the hospitals could handle.

At its peak, people lost lives from the lack of treatment — with hospital beds and oxygen cylinders running scarce. India was not prepared to deal with a surge of cases, having become complacent as Covid numbers went down by the end of 2020. The virus demands constant vigilance. This means aggressive testing even when cases are low, and more importantly thorough genome sequencing efforts. Less than one per cent of the samples of people who have been infected in these two years have been sequenced in India. If genome sequencing was done sufficiently, researchers would immediately be aware if a ‘variant of concern’ flagged elsewhere was already circulating in the Indian population.

Moreover, health authorities need to be particularly vigilant of cases in immunocompromised people who suffer from prolonged Covid, as research has shown that such cases give rise to new variants.

For now, what we do know is that vaccines work in preventing severe Covid for several of the emerging variants. Whether this remains true for Omicron needs further study. For example, a study by ICMR showed people who suffer from breakthrough infections after two doses of the vaccine are actually better equipped to fight off new variants than those who have never been infected.

Booster shots

The emergence of the variant has once again sparked the debate of booster shots. But World Health Organization (WHO) experts have been reiterating something for a long time — no amount of booster shots will protect populations unless all countries can get the majority of their population vaccinated.

Vaccine inequity — which means that richer countries have access to more doses than their underdeveloped counterparts — means that certain populations remain vulnerable and thus serve as ‘nurseries’ for new mutants. Instead of repeatedly vaccinating those who already have received two doses, the focus should now be towards ending the pandemic in countries that have so far had limited access to the vaccines. Booster shots are like trying to stop a raging fire by pouring a mug of water repeatedly at one spot. Ensuring all populations are vaccinated will in the long run prove to be a better weapon in the fight against the pandemic.

As the WHO put it: “None of us will be safe until everyone is safe”. With the two Omicron cases already detected in India, and several Covid positive travellers still waiting to get the results of genome sequences, Omicron is likely to continue to make headlines over the next few weeks.

Implementing lessons from the past two years — including the effectiveness of masks, ventilation in closed spaces, vaccinations, testing and tracing — can perhaps help ensure that Omicron, or any other variant, does not usher in another wave.

Views are personal.

(Edited by Srinjoy Dey)