When Jeremy Kamil got his first look at B.1.1.529, the coronavirus variant that would soon be named omicron, it didn’t take long to see the differences.
More than 30 mutations made the variant’s spike proteins, which cover the outside of the virus and are the main targets of vaccines and the body’s immune responses, different from those of the virus that first emerged in late 2019.
“The number of changes blew people’s minds,” said Kamil, an associate professor of microbiology and immunology at Louisiana State University Health Shreveport.
The World Health Organization has identified and tracked more than 20 variants. Yet unlike with others that popped up around the world before they mostly fizzled out (including the lambda variant, which was first documented in December in Peru, or the mu variant, which was detected a month later in Colombia), there were early signs that the omicron variant’s cocktail of mutations made it different and worthy of swift action — even overreaction — experts say.
While it’s too soon to know what the mutations mean for the effectiveness of vaccines or how sick people could become from the variant, the emergence of the omicron strain also highlights the frustrating reality of the Covid pandemic: Variants will continue to pose serious threats until countries around the world have more equal and ready access to vaccines, experts say.
“It’s definitely sobering,” Kamil said. “It’s an exaggeration to say we’re back at square one, but this is not a good development.”
Within hours of the WHO’s designating omicron a “variant of concern” Friday, dozens of countries imposed new travel bans, places that had loosened restrictions reintroduced mask mandates, and anxieties ran high.
It was the kind of quick and intense development reminiscent of early stages of the pandemic, prompting some concern that governments were overreacting before enough about the omicron variant was known.
“It’s partly why people started facetiously calling these things ‘scariants,’” said Dr. Amesh Adalja, an infectious disease doctor and a senior scholar at the Johns Hopkins Center for Health Security.
But even before it was given the “omicron” designation, the variant quickly gained attention among Covid researchers.
South Africa was the first to report clusters of cases involving the omicron variant last week. Days before, data about the newly identified variant had also been uploaded to GISAID, an online database for disease variants, by a research team in Hong Kong, followed by more early sequences from scientists in Botswana.
The number of mutations observed with the omicron variant hasn’t previously been seen with other strains, Adalja said. There are concerns that specific mutations to the spike protein could make the omicron variant less vulnerable to the so-called neutralizing antibodies generated by vaccines or natural immunity from previous Covid-19 infections.
“There’s a very good chance this variant will be very resistant to neutralizing antibodies, but we can’t yet say with any degree of certainty how resistant,” said Theodora Hatziioannou, a virologist at Rockefeller University in New York City.
Researchers have been preparing for this possibility.
In lab experiments with a virus that was genetically altered so it didn’t pose a threat to humans, Hatziioannou and her colleagues produced myriad combinations of spike protein mutations and tested how well they were able to evade Covid-19 antibodies.
One of their more worrisome outcomes was observed in a lab-produced spike protein that carried 20 mutations — more than had been observed in any other known variant at the time but fewer than in the omicron variant. It was largely resistant to neutralizing antibodies from both vaccines and natural immunity.
“Nature essentially reproduced our experiment, only at a much larger scale,” she said.
Scientists around the world are racing to characterize the omicron variant, focusing in particular on whether it is more contagious, causes more severe disease or can evade the protection of vaccines. Those open questions may awaken anxieties from early in the pandemic, but Carl Bergstrom, a professor of biology at the University of Washington, said drug therapies and the vaccines still offer crucial advantages.
“We have a whole bunch of tools now that we didn’t have before,” he said. “But it’s disappointing, for sure. There was kind of this general feeling that we’re coming off this delta wave, we’re triple-boosted, and it could almost be like 2019 again.”
Adalja said the emergence of the omicron variant should spur people to get vaccinated or to get booster shots. Countries should also increase testing for Covid-19 to track where — and how quickly — the variant is spreading.
Since omicron was designated a “variant of concern,” more than 40 countries have banned travel from southern Africa.
Hatziioannou said such sweeping measures, which may have been a “knee jerk reaction” to the most recent devastating wave of delta infections, are largely ineffective.
“The variant is likely already here,” she said. “Closing the barn door after the horses have bolted is useless.”
“The variant is a cause for concern, not a cause for panic,” he said.
Kamil similarly said it’s too early to know what impact the omicron variant may have in the U.S. and around the world. He added, however, that it underscores the importance of vaccine equity and the need for wealthy countries to help provide that access.
“A booster shot in America has a far smaller effect of preventing variants than the first dose that someone gets in Chad or Benin or Togo,” he said. “If we do not protect other nations, we are all going to sink together.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
