Uncertainty, uncertainty, uncertainty — that’s the message infectious disease specialists are spreading about the new variant named omicron that was recently identified in South Africa.
The World Health Organization designated omicron as a variant of concern on Friday and followed up Monday with a risk assessment stating that a high number of mutations located within the spike protein may make the variant more transmissible and immune-evading.
But the key word there is “may.” The WHO also emphasized that there are many uncertainties about omicron and we don’t yet know if or how the variant could impact the course of the pandemic.
Though a large number of mutations could certainly make the variant more problematic — hence the reason for all the hype — it’s also plausible that they won’t have a meaningful impact on our vaccines or therapeutics.
This is a time of tremendous uncertainty, but we will know more in the days and weeks ahead.
“We don’t know to what extent, if any, this will evade some protection from the immunity via vaccination or recovery from infection. We still don’t know, if at all or to what extent, this might have different clinical symptoms or different clinical spectrum. And we still don’t know, if at all, if this is more transmissible. We just don’t know — but best to approach with caution,” Isaac Bogoch, an infectious disease physician and scientist with the University of Toronto, told HuffPost.
What we know about the COVID omicron variant so far
South African scientists announced their discovery of the omicron variant last Thursday after the region experienced a rapid uptick in cases.
Since then, the variant has been detected in several other regions — including the United States, United Kingdom, Israel, Belgium, the Netherlands, Canada, Australia and Hong Kong. The first case of omicron in the U.S. was identified in California on Wednesday.
“Efficiently spreading respiratory viruses are often gone from the place they originated by the time they are recognized,” said Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security and an infectious disease expert.
The variant has more than 30 mutations in the spike protein — the part of the virus that binds to our cells. The spike protein is also what the vaccines teach the immune system to go after.
Some of the mutations identified in omicron have been seen in other variants — including beta, gamma and alpha — and have been associated with increased transmissibility and some ability to evade protection from vaccines and monoclonal antibody treatments.
But it’s hard to know exactly how this variant, with these mutations, will actually behave in a real-world setting, Bogoch said.
Viruses mutate and a large number of mutations does not automatically mean the variant will be more dangerous — though it is surely something to look into. Most mutations have no meaningful impact on the behavior of a virus.
The recent spike in cases in South Africa, for example, could have been triggered by superspreader events or the region’s low vaccination rate, rather than the variant itself.
“What we need to do before we panic is find out whether the mutations translate into three worrisome potential problems — one, increased transmissibility, two, increased severity of disease, and three, loss of effectiveness in the vaccines — but the mere number of mutations doesn’t necessarily translate into a doomsday situation,” said Lucy McBride, a practicing internal medicine physician in Washington, D.C.
Early anecdotal reports also suggest the bulk of hospitalizations are happening in unvaccinated people and that vaccinated people infected with omicron — who tend to be younger — appear to have milder symptoms, if any at all.
“This suggests, to me, that the vaccine does protect against serious illness, hospitalization and death,” Adalja said, noting that we need more data to know this for certain.
November 2021 is very different, even with omicron, than January of 2020.Amesh Adalja
What experts predict could happen with the omicron variant
It’s too early to guess what kind of impact omicron will have on the pandemic — we don’t know for certain yet whether it’s more transmissible and whether it has some immune-evading traits.
“The best-case scenario, assuming it’s more transmissible, is that it’s less severe and omicron is a mild respiratory illness that the coronavirus may ultimately become. The worst-case scenario is that it’s more severe and evades immune protection from the vaccines — but we’re definitely not back to where we were in 2020,” McBride said, adding that we really need more time and data to make these types of predictions.
We’ve learned so much about the coronavirus since the start of the pandemic and now have the tools — vaccines, masks, ventilation, testing, monoclonal antibodies and soon antivirals — to manage variants.
In addition, even if the vaccines trained our bodies to fight the original strain, our immune systems are complex and will make fresh antibodies that can help neutralize whatever new variants we’re exposed to, McBride said.
Bogoch would be surprised to see a variant that completely evades protection from our vaccinations; it might erode the efficacy of our shots, but it wouldn’t erase their benefits.
“I think the vaccines will still have some reasonable protection against this particular variant — total speculation, let’s get the data — but I think that you see heavily vaccinated regions, they’ll fare much better,” Bogoch said.
If omicron diminishes the power of the shots to some degree, there might be a stronger push for boosters (as studies have shown a booster not only restores but exceeds neutralizing antibodies after the first two doses). Though, as Adalja points out, it wasn’t a lack of boosters that led to the emergence of omicron — it was a lack of first and second doses.
Ultimately, even if the vaccines don’t prevent every single omicron infection, experts suspect they’ll likely continue to do a great job at protecting people against severe illness, hospitalization and death.
“November 2021 is very different, even with omicron, than January of 2020,” Adalja said.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.
This article originally appeared on HuffPost and has been updated.