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With Covid vaccination & booster shots, should we worry about omicron? What is known and still unknown – Economic Times

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What is the omicron variant?

First identified in Botswana and South Africa, this new iteration of the coronavirus has prompted concern among scientists and public health officials because of an unusually high number of mutations that have the potential to make the virus more transmissible and less susceptible to existing vaccines.

The World Health Organization has called omicron a “variant of concern” and Monday warned that the global risks posed by it were “very high,” despite what officials described as a multitude of uncertainties. Cases have been identified in 20 countries so far, including Britain, Italy, Belgium and the Netherlands. Although omicron has not yet been detected in the United States, experts say it is only a matter of time before the variant shows up.

Should we be worried?
Omicron’s discovery has prompted considerable panic, with a number of countries banning flights from southern Africa, or — like Israel, Japan and Morocco — barring entry of foreign travelers altogether.

But public health experts have urged caution, noting that there is as yet no firm evidence that omicron is more dangerous than previous variants like delta, which quickly overtook its predecessors in the United States and other countries.

Although delta turned out to be much more transmissible than prior variants — and there is some data suggesting it can cause more severe illness in the unvaccinated — there is little evidence it is more lethal or capable of outsmarting vaccines.

Much remains unknown about omicron, including whether it is more transmissible and capable of causing more serious illness. There is some evidence the variant can reinfect people more readily.

There are early signs that omicron may cause only mild illness. But that observation was based mainly on South Africa’s cases among young people, who are less likely overall to become severely ill from COVID.

Dr. Angelique Coetzee, who chairs the South African Medical Association, said that the nation’s hospitals were not overwhelmed by patients infected with the new variant, and most of those hospitalized were not fully immunized. Moreover, most patients she had seen did not lose their sense of taste and smell, and had only a slight cough.

On Tuesday, Regeneron said its COVID antibody treatment might be less effective against omicron, an indication that the popular and widely beneficial monoclonal antibody drugs may need to be updated if the new variant spreads aggressively.

That said, omicron’s emergence is so recent that it may be a while before experts know whether it is more pathogenic. COVID hospitalizations lag new infections by two weeks or more.

Scientists expect to learn much more in the coming weeks. At the moment, they say there is no reason to believe omicron is impervious to existing vaccines, although they may turn out to be less protective to some unknown degree.

There’s another reason to remain calm: Vaccine makers have expressed confidence they can tweak existing formulations to make the shots more effective against new variants.

Also reassuring: Omicron’s distinctive mutations make it easy to quickly identify with a nasal swab and lab test.

Why are scientists so concerned about omicron?
As the coronavirus replicates inside people, new mutations constantly arise. Most provide the virus with no new advantage, but sometimes mutations can give the pathogen a leg up by allowing it spread more readily among its human hosts or dodge the body’s immune response.

Researchers in South Africa sounded the alarm because they found more than 30 mutations in the spike protein, a component on the surface of the variant that allows it to bind to human cells and gain entry to the body. Some of the samples from Botswana shared about 50 mutations throughout the virus not previously found in combination.

The spike protein is the chief target of antibodies that the immune system produces to fight a COVID-19 infection. Having so many mutations raises concerns that omicron’s spike might be able to somewhat evade antibodies produced by either previous infection or vaccination.

Those mutations also raise the prospect that the variant will reduce the efficacy of monoclonal antibody treatments — a fear partly confirmed Tuesday with Regeneron’s announcement.

Still, it is worth remembering the fate of earlier variants that stirred concern: Beta and mu, for example, evolved the ability to partially evade the body’s immune defenses, but they never became a serious threat to the world because they proved to be poor at transmitting.

What about vaccines?
Vaccines are expected to provide some protection against omicron because they stimulate not only antibodies but also other immune cells that attack virus-infected cells. Mutations to the spike protein do not blunt that response, which most experts believe is instrumental in preventing serious illness and death.

Citing the potential for waning immunity six months or more after vaccination, some health experts are promoting booster shots to increase antibody levels.

The nation’s top infectious disease expert, Dr. Anthony Fauci, has urged people to get a booster shot, which he said would most likely provide additional protection against severe disease. “We’ve said it over and over again and it deserves repeating. If you’re not vaccinated, get vaccinated, get boosted if you are vaccinated, continue to use the mitigation methods, namely masks, avoiding crowds and poorly ventilated spaces,” he said Tuesday.

Moderna, Pfizer-BioNTech and Johnson & Johnson, makers of vaccines approved for use in the United States, and AstraZeneca, which is widely used in Europe, have all said they were studying omicron and expressed confidence in their ability to tailor their formulations to target the variant.

Why is it called omicron?
When the WHO began to name emerging variants of the coronavirus, they turned to the Greek alphabet — alpha, beta, gamma, delta and so on — to make them easier to describe. The first “variant of concern,” alpha, was identified in Britain in late 2020, soon followed by beta in South Africa.

But veterans of American sorority and fraternity life might have noticed the system has skipped the next two letters in the alphabetical order: nu and xi.

Officials thought nu would be too easily confused with “new,” but the next letter, xi, is a bit more complicated. WHO officials said it was a common last name, and therefore potentially confusing. Some noted that it is also the name of China’s top leader, Xi Jinping.

A spokesman for the WHO said organization’s policy was designed to avoid “causing offense to any cultural, social, national, regional, professional, or ethnic groups.”

Next in line? Omicron.

I’m fully vaccinated — I’ve even had my booster. So why should I care about omicron?
Like delta, which was first identified in India, the rise of yet another worrisome variant in the developing world points to a more fundamental problem facing the global community more than a year and a half into the pandemic.

The hoarding of vaccines by wealthy countries while poorer nations struggle to obtain them provides more opportunities for SARS CoV-2 to replicate and mutate among the unvaccinated. More mutations mean there are more chances for the virus to become more infectious, immune-resistant or lethal.

And as the rapid spread of delta showed, a dangerous new variant is unlikely to remain in one place for very long.

The risks extend beyond public health. The resulting economic devastation from a new variant can hit affluent countries nearly as hard as those in the developing world. One academic study estimated trillions of dollars in economic loss to wealthy countries when residents of poorer countries remain largely unvaccinated.

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Omicron subvariant appears more contagious, but not more severe, Denmark says

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The BA.2 subvariant of the Omicron coronavirus variant, which is dominant in Denmark, appears more contagious than the more common BA.1 sub-lineage, Danish Health Minister Magnus Heunicke said on Wednesday in a national address.

“There is no evidence that the BA.2 variant causes more disease, but it must be more contagious,” Heunicke told a news conference.

The BA.1 lineage currently accounts for 98% of all cases globally but in Denmark has been pushed aside by BA.2, which became the dominant strain in the second week of January.

The UK Health Security Agency has designated BA.2 a variant under investigation, saying it could have a growth advantage.

Preliminary calculations suggest BA.2 could be 1.5 times more infectious than BA.1, Denmark’s top infectious disease authority, Statens Serum Institut (SSI), said in a note on Wednesday.

However, an initial analysis by the institute showed no difference in the risk of hospitalisation for BA.2 compared to BA.1.

“There is some indication that it is more contagious, especially for the unvaccinated, but that it can also infect people who have been vaccinated to a greater extent,” SSI’s technical director Tyra Grove Krause said at the briefing.

This could mean the peak of Denmark’s epidemic will extend a bit further into February than previously forecast, Krause said.

BA.2 cases have also been registered in Britain, Sweden and Norway, but to a much lesser extent than in Denmark.

Denmark on Wednesday announced plans to scrap the last of its COVID-19 restrictions by Feb 1, the latest country in Europe to do so despite record high daily infection numbers.

(Reporting by Nikolaj Skydsgaard and Stine Jacobsen;Editing by Alison Williams, Kirsten Donovan)

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Pfizer, Moderna shots safe during in vitro fertilization; healthy gut bacteria may help prevent long COVID

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The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

mRNA vaccines safe during in vitro fertilization

COVID-19 vaccines using mRNA technology do not affect fertility outcomes during in-vitro fertilization (IVF), researchers have found.

They compared rates of fertilization, pregnancy, and early miscarriage in IVF patients who had received two doses of the vaccines from Pfizer with BioNTech or ModernaO> with those in unvaccinated patients. The 222 vaccinated and 983 unvaccinated patients who underwent ovarian stimulation – medical treatment to stimulate development of eggs – had similar rates of eggs retrieved, fertilization, and embryos with normal numbers of chromosomes. The 214 vaccinated and 733 unvaccinated patients who underwent frozen-thawed embryo transfer – where their eggs were collected from the ovaries and fertilized by sperm in a laboratory, creating embryos that were frozen and later thawed and transferred to the womb – had similar rates of pregnancy and early pregnancy loss, according to a report published on Tuesday in Obstetrics & Gynecology.

“Our findings contribute to the growing body of evidence regarding the safety of COVID-19 vaccination in women who are trying to conceive,” the researchers concluded.

Healthy gut bacteria may protect during COVID

The bacteria living in your small intestine may contribute to the risk for long COVID after infection with SARS-CoV-2, new findings suggest.

Researchers analyzed the “gut microbiome” in 116 COVID-19 patients in Hong Kong in 2020, when regulations required that every infected person be hospitalized. More than 80% were mildly or moderately ill, but more than 75% had at least one persistent symptom. After six months, the most common symptoms were fatigue (reported by 31%), poor memory (28%), hair loss (22%), anxiety (21%) and sleep disturbances (21%), according to a report published on Tuesday in Gut. Analyses of stool samples obtained at hospital admission and over the succeeding months showed long COVID patients “had a less diverse and less abundant microbiome,” said Siew C. Ng of The Chinese University of Hong Kong. “Patients who didn’t develop long COVID had a gut microbiome similar to that of people without COVID-19.”

Lack of “friendly” immunity-boosting Bifidobacteria species was strongly associated with persistent respiratory symptoms, Ng noted. While the study cannot prove that healthy gut organisms prevent long COVID, the findings suggest “maintaining a healthy and balanced gut microbiota via diet, avoidance of antibiotics if possible, exercise and supplementing with depleted bacteria species including Bifidobacteria” might be helpful, she said.

New PCR test can identify variants

A new type of PCR test can quickly tell which variant of the coronavirus is causing infection, helping doctors choose the most effective antibody treatments, researchers said.

Most current PCR tests can check broadly for the presence of the virus but cannot identify specific variants. The new test uses special “probes” – fluorescently labeled molecules – called “sloppy molecular beacons” that glow in different colors when they attach themselves to DNA or RNA in the virus. When the sample from the patient is heated, the probes fall off their DNA or RNA targets and their color disappears. They fall off at different temperatures depending on the DNA or RNA sequence they were bound to. Because the variants each have some unique sequences, they can be identified based on the pattern of color changes at each temperature, explained Dr. David Alland of \?

.

“We have already performed a clinical study which showed that the assay was 100% sensitive and 100% specific for identifying variants of concern including Delta and Omicron,” Alland said. “We are asking the N.J. Dept of Health to clear our test” so that New Jersey labs can use it, he added. A typical hospital molecular laboratory would be able to perform it, his team reported on Friday on medRxiv ahead of peer review.

U.S. study finds slight myocarditis risk with mRNA vaccines

There is a small but increased risk for heart muscle inflammation, or myocarditis, following receipt of the mRNA COVID-19 vaccines from Pfizer/BioNTech and Moderna, researchers from the U.S. Centers for Disease Control and Prevention have found.

The 1,626 cases documented in the Vaccine Adverse Event Reporting System from December 2020 through August 2021 “exceeded the expected rates,” the researchers reported on Tuesday in JAMA. Overall, 73% of reported cases were in people under age 30, and 82% were males. The highest rates were found among adolescent and young adult males. For every million doses of Pfizer’s vaccine, there were roughly 71 cases of myocarditis in males ages 12 to 15 and 106 cases in males ages 16 or 17. In young men ages 18 to 24, the rate per million doses was roughly 52 with the Pfizer shots and 56 after Moderna shots. About 96% of patients with myocarditis were hospitalized. In 87%, symptoms were gone by the time they were discharged. Non-steroidal anti-inflammatory drugs were the most common treatment.

“This risk should be considered within the context of the significant benefits of COVID-19 vaccination in preventing COVID-19 infection and potential serious complications,” said a spokesperson for the authors, who noted that COVID-19 itself confers a 16-times higher risk for myocarditis. “The benefits of COVID-19 vaccination continue to outweigh any potential risks.”

Click for a Reuters graphic on vaccines in development.

 

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

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A third of airline pilots still not flying as pandemic drags on -survey

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More than one-third of airline pilots are still not flying as the pandemic continues to take its toll on aviation globally, according to a new survey, though the situation has improved from a year earlier when the majority were grounded.

A poll of more than 1700 pilots by UK-based GOOSE Recruitment and industry publication FlightGlobal, released on Wednesday, found 62% globally were employed and currently flying, up from 43% a year earlier.

The proportion of unemployed pilots fell from 30% to 20%, while 6% were on furlough, compared with 17% previously as air traffic began to bounce back from 2020 lows.

But in the Asia-Pacific region, the worst-hit globally by a drop in international travel due to tough border restrictions, the proportion of those unemployed rose from 23% to 25%. The region also had the lowest number that were employed flying at 53%.

“We have … seen some expatriates return home from the region due to concerns over quarantine or being stuck for long periods away from friends and family,” the report on the survey said.

Hong Kong’s Cathay Pacific Airways, a large expatriate employer in Asia, has lost hundreds of pilots through the closure of its Cathay Dragon regional arm as well as almost all of its overseas bases during the pandemic.

Pilot attrition at Cathay has also been rising amid strict layover rules that leave crew members locked https://www.reuters.com/world/asia-pacific/locked-hotels-hong-kongs-covid-19-rules-take-mental-toll-cathay-pilots-2021-11-26 in hotels when they are not flying.

Of the pilots still flying globally, 61% told the survey they were concerned about their job security.

“It appears only Northern America is back to post-COVID passenger numbers,” said an unnamed captain flying in the Middle East and Africa. “The rest of the world, especially developing nations, are still struggling to get vaccines, and are still not travelling.”

 

(Reporting by Jamie Freed in Sydney; Editing by David Gregorio)

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