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Testing, vaccines, sequencing: experts call for multi-pronged approach to Omicron

·5-min read
<span>Photograph: REX/Shutterstock</span>
Photograph: REX/Shutterstock

‘Best hope’ for containing the new variant is worldwide vaccine campaign where rates are low, public health experts say


As new cases of the Omicron coronavirus variant are uncovered across the globe and threaten to spread in America, US officials are reacting by urging vaccinations and boosters instead of imposing restrictions which have increasingly provoked political fights.

But the US should quickly invest in other tools as well, experts said, including testing, genomic sequencing and surveillance, better communication, and a strong focus on global vaccine equity to prevent the emergence of new variants.

All of that would prepare America better to deal with a variant that many experts suspect is probably already inside the country, even if undetected so far.

Joe Biden sought to reassure Americans that his administration is taking steps to slow the spread of the new, potentially serious coronavirus variant in a press conference on Monday. “This variant is a cause for concern, not a cause for panic,” the US president said.

Biden focused on the importance of vaccinations, including booster doses for adults. But national shutdowns or restrictions, like business closures or masks and vaccine requirements in public places, are off the table because “people are vaccinated and they’re masked,” Biden said.

A large number of mutations in Omicron may make this variant more transmissible than others and better at evading immune responses. Early evidence suggests the variant more easily reinfects those who have survived Covid previously.

If the new variant is more transmissible or able to evade the vaccines, vaccinations and booster doses will be important to strengthen immune responses.

Boosters not only elicit more antibodies, but they also seem to produce a wider array of antibodies, which may be important in responding to a variant that can evade some immune responses. And vaccinating those who aren’t yet vaccinated takes on a new urgency amid early reports that those who have recovered from Covid previously may be reinfected with Omicron.

Another tool Biden has sought to use is travel bans for certain countries. The US banned flights from eight southern African countries, only two of which – Botswana and South Africa – have detected cases of the new variant.

But vaccines and travel bans aren’t the only tools the US should employ, experts said.

“Testing is the number-one thing that we really need to be on top of right now,” Katelyn Jetelina, assistant professor of epidemiology with the University of Texas Health Science Center at Houston, told the Guardian.

PCR tests are very effective at identifying a key feature of this variant, known as an S-gene dropout, before full genomic sequencing takes place. And making all types of testing, including rapid tests at home, easy and accessible would help curtail the spread of Omicron and other variants, including the current Delta wave.

“​​We’re ignoring what we were seeing in the UK and northern Europe and Germany, and ignoring what we saw in Michigan and Minnesota,” Larry Brilliant, CEO of Pandefense Advisory and senior counselor to the Skoll Foundation, told the Guardian. “That was a mistake. It was obvious that surge would come to the whole country.”

Sequencing positive tests is also important to understand which variants are circulating. The US lags behind many countries in genomic sequencing, and there are vast differences between states.

“We’re not doing nearly enough genomic sequencing in this country still,” Céline Gounder, an infectious disease specialist and epidemiologist at New York University and Bellevue Hospital, told the Guardian. “I’m sure we have Omicron here in the US; we just haven’t detected it yet.”

Another under-used tool for monitoring the spread and prevalence of the virus is wastewater surveillance, which can often be a “canary in the coal mine” to warn of local surges even before they’re detected by testing for the virus, Gounder said.

New antiviral treatments from Merck and Pfizer could make a difference, but they need to be free and widely available, Gounder said. “You definitely want to make it broadly available, and it needs to be where you literally have one-stop shopping” – where antivirals are offered immediately after a positive test, she said.

And one of the most important ways to prevent the spread of the Omicron variant – and the emergence of others like it – is to vaccinate the world, Brilliant said.

“We should be flooding the zone,” he said, with both vaccines and PCR tests that can detect the variant.

Quickly deploying vaccines to countries where Omicron is detected but vaccination rates remain low would be a major step toward halting transmission of the variant, and access to the vaccines and vaccine hesitancy must also be addressed, he said. “It’s our best hope right now.”

Although there are more questions than answers about Omicron, other precautions that have helped with previous variants will still help here: masking, ventilating indoor spaces, distancing, avoiding large gatherings.

”I know everyone’s sick of us saying that, but stick to what we know right now,” Jetelina said. “If we get everyone wearing a mask, that will certainly help calm the fire in the United States right now.”

The US was already enduring a new wave in cases driven by the Delta variant, and officials were opposed to national public restrictions, even though most Americans support mask and vaccine mandates for public places, according to two polls from August.

Local health measures have become markedly more difficult to implement in many places. More than half of US states have seen their public health powers sharply curtailed during the pandemic, making it harder to respond to new variants than when Covid first emerged.

Many of the questions about Omicron will only be answered in coming weeks, as countries monitor cases of the new variant and as scientists conduct experiments to test the mutated virus’s ability to break through immunity responses.

If updated vaccines and boosters are needed to combat this variant, their development will be speeded up, Biden said. Leading vaccine makers, including Moderna and Pfizer/BioNTech, are already working to reformulate vaccines to be more effective against this variant, with new vaccines potentially available early next year – to countries that can access them.

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