‘Pharma cos must adapt existing vaccines as fast as possible’

The new Covid-19 variant, B.1.1.529 NU, has now officially been renamed Omicron (the 15th letter of Greek alphabet) by the WHO late Friday night. It's the first new ‘variant of concern' since Delta, which means the world needs to be on alert and healthcare service providers vigilant, as possible risk of reinfection is higher, according to health experts.

Expressing deep concern over the emergence of the new variant, Dr Wiqar Shaikh, Professor of Medicine at Grant Medical College and Sir JJ Group of Hospitals, said that the new variant was first isolated through genome sequencing in Botswana, Africa, on November 11 this year and has now spread to other countries, including South Africa, Israel, Belgium and Hong Kong. Belgium has, in fact, become the first European country to be affected by the new variant. Several dozen cases have been reported so far. The potential of the variant, he added, has been backed by the Africa Centre for Disease Control (Africa CDC) which states that because of the widespread mutations, Omicron could be the most infectious and transmissible variant of Covid-19, hinting that vaccines could be less effective in fighting it.

Dr Lieve Fransen

"It is estimated that Omicron is 500 times more infectious than the Delta variant [of Covid-19], which is currently the predominant strain worldwide," shared Dr Shaikh, adding that Omicron has been found to have 59 mutations, of which 32 are spike protein mutations. "It is also more adaptable to bind to the host."

Interestingly, the Omicron variant shares similarities with the Lambda and Beta variants of Covid-19. Quoting the findings of multidisciplinary science journal, Nature, from its November 25 edition, Dr Shaikh says Omicron may spread more efficiently and even dodge or paralyse parts of the immune system, particularly T-cells, which are the main cells in the body's ability to attack and eliminate a virus. "The ability of Omicron to paralyse T-cells is a phenomenon that has been detected for the first in a Covid-19 variant. Besides, it has also been found that the human body has reduced antibody recognition to Omicron, which again makes it unique," he explained.

Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle believes this mutation in the spike protein will play a key role in the virus' entry into cells in the body. "Spike protein is also what is targeted by vaccines. It still remains to be determined whether Omicron variant is more transmissible or more lethal than previous variants of concern, such as Delta," he said.

According to South African health authorities, the new variant has been confirmed largely among young people. Currently, an alarming surge in Covid-19 cases in North America and Europe and Omicron have added to the fear that we may see more deadly waves in this pandemic, says Dr Shaikh. A recent study by the Indian SARS-CoV-2 Genomics Consortium (INSACOG), CSIR and the National Centre for Disease Control in Delhi, have concluded that the Delta variant can also infect fully vaccinated individuals. "The world may have to develop another Covid-19 vaccine for deadly variants such as Delta, Delta Plus and the new Omicron," he said.

‘Be alert, but don't panic'

While alertness in genomic sequencing by the WHO is highly appreciated by its member states, unfortunately, its detection sent adverse waves across commercial markets across the globe, thinks Dr Hira. "This is the first time that the Omicron variant has added a new amino acid in the sequence chain, and changed essential amino acids at 32 slots. It will mean that the Omicron virus can become a ‘superbug' [bacteria that are resistant to most of the antibiotics]. This will be seen during the follow-up of 100-plus patients currently being monitored in Southern Africa. India needs to stay alert but avoid panic with every mutant."

Dr Wiqar Shaikh and Dr Subhash Hira

Dr Lieve Fransen is a well-recognised policymaker at senior management level in the European Union and based in Brussels, Belgium. Omicron, she says, is very different from the original Wuhan strain. "The WHO is closely monitoring the situation and will have regular discussion on the significance for tests and vaccines. But, it will take a few weeks to know the real impact in terms of transmissibility and lethality." Given that the information about the new strain is still at a preliminary stage, she fears it could spiral into a worrying situation that is mainly created by the prevalence of a high number of viruses and the low level of vaccinations worldwide. But more information is needed to ascertain its nature. "If this variant is proven to be even more transmissible and/or lethal it will, of course, spread to the rest of the world, including India. At present, the best way forward is to keep a physical distance, use masks, wash hands, get fully vaccinated and start with boosters for those that were vaccinated more than six months ago." She believes the large manufacturing capacities in India should also play a major role in battling the variant. "Pharmaceutical companies must step up and adapt the existing vaccines as fast as possible." Dr Shaikh agrees. "Variants of Covid-19 mutants will keep bringing wave after wave. The only way to control a surge is to ensure Covid-appropriate behaviour, and ramp up health services, including in rural areas," Dr Shaikh said, adding that the world may have to develop another Covid-19 vaccine for deadly variants if needed.

Meanwhile, the WHO has warned against countries hastily imposing travel restrictions, saying they should look to a "risk-based and scientific approach". Banning travel from countries reporting on new variants, while not providing large scale access to the vaccines for those countries does not seem fair, thinks Dr Fransen. "We should not punish and isolate people from Southern Africa, but be happy that South African scientists were able to identify the variant quickly and report it immediately to the rest of the world," says Dr Fransen, adding that the same was true when Indian scientists identified the Delta variant. The ban, fear experts, will have a serious impact on businesses and livelihoods of people in the region. "This new variant being reported by scientists from South Africa should be an urgent appeal to get the people in LMIC (Low and Middle Income Countries) rapidly vaccinated, and for all of us to continue with the public health measures and protect each other," she says.

Vaccinate children first: Bharat Biotech

Reacting to the new strain, an official from Bharat Biotech, which produced Covaxin, said that India should first announce vaccines for children, as they are the most vulnerable. "Most adults have either been immunised with one or two doses or have been naturally infected. Hence, boosters can be second priority after children." The official added that the company is working on the Delta variant-specific vaccines. "Covaxin was developed against the original Wuhan variant; it has also shown that it can fight against other variants, including the Delta variant. We are continuing to research newer variants."