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.
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.
