Why the Answers on Omicron Are Still Weeks Away

Why the Answers on Omicron Are Still Weeks Away
A covid-19 testing facility is advertised at Newark Liberty International Airport on November 30, 2021 in New Jersey. (Photo: Spencer Platt, Getty Images)

Over the Thanksgiving holiday, the coronavirus threw us yet another spiky curve ball. Scientists in South Africa identified a new, worrying variant of the virus, since dubbed Omicron. This variant’s wide range of mutations may help it evade existing immunity, though that’s not yet clear. There are many other unknowns, too, but it will likely take weeks at the soonest to get a grasp on the unique dangers it could pose. Even with our limited knowledge, though, there are many practical steps we can take to stay safe from any version of the coronavirus.

Omicron was discovered by scientists in South Africa earlier this month and was first widely reported last week (it’s important to note that South Africa is not necessarily where the variant originated). Now that other labs have learned how to track Omicron, the list of countries with confirmed cases has been growing fast. And at least some of these cases have had no clear travel history to South Africa, strongly suggesting that the variant has been spreading locally in these regions for some time.

What makes Omicron so worrying are the many mutations it has compared to the original SARS-CoV-2 coronavirus, particularly on its spike protein, the main key used by the virus to infect our cells. These mutations, as many as 32 involving the spike protein alone, may make the virus noticeably different in its behaviour and appearance when interacting with our body. Some might make the virus more inherently transmissible, similar to how Delta has been more contagious than previously dominant strains. Perhaps more worrying, some might also allow the virus to better evade the defences created by our immune system in response to past vaccination or infection, particularly our antibodies. There are signs that these mutations are enabling its spread in the real world: Daily cases in South Africa, following a lull since the summer, have rapidly increased in recent weeks, conspicuously coinciding with the emergence of Omicron.

Omicron’s genetic repertoire, along with South Africa’s surge, led the World Health Organisation to quickly categorise it as a “variant of concern,” the fifth to be labelled as such. But right now, there are still many things we simply do not know about Omicron, and it will take time and patience to solve the puzzle of this possible new threat.

“I know it’s certainly frustrating. But my old mentor had this great phrase where he said, ‘It’s better to be correct than to be first,’” Ryan McNamara, a virologist and immunologist at the University of North Carolina at Chapel Hill who has studied SARS-CoV-2, told Gizmodo by phone. “So when we’re talking about things like: How well are the vaccines protective against novel variants like Omicron? What is the transmissibility relative to other circulating variants? What are the clinical outcome changes? These are very broad questions that require time.”

McNamara said it will probably take about two weeks to a month for the first useful data on Omicron to come in. This data will include experimental studies in the lab, such as those that test antibodies collected from vaccinated and/or previously infected people against samples of Omicron or pseudoviruses made to closely resemble it. Other aspects of our covid-specific immunity, like T cells, will be tested against Omicron as well, though not as many labs can perform these tests.

That timeline will depend on some good luck, according to Lisa Gralinski, a virologist at the University of North Carolina Gillings School of Global Public Health who specialises in coronaviruses. In South Africa and other places where cases have been found, scientists are scrambling to isolate the virus itself, so that it can be grown en masse and sent elsewhere. Until then, many researchers like Gralinski are on standby waiting for virus samples, along with the other supplies needed to conduct their experiments. Some labs can opt for reconstructing the virus from the genetic sequence of Omicron we already have handy, or even just its spike protein, but that takes time and resources as well. Conducting these tests isn’t instantaneous, either, and the holidays next month may delay the timing further, especially for university labs that get closed early.

“Just yesterday morning, I spent 90 minutes on a call with 450 other global scientists, and basically everyone was saying: ‘We’re ready to go as soon as we get the virus — does anyone have the virus?’” she said.

Countries’ genetic surveillance systems will be able to track the progress of Omicron among the population, which will give us a better sense of its competitiveness. If, as appears to be happening in South Africa, cases of Omicron start to overtake cases involving Delta or other variants throughout different countries, that would provide compelling evidence that it has a true advantage in its ability to spread.

But there are many complicated questions that will take more time to unravel, including what makes Omicron tick. A virus can evolve to become better at spreading in a few different ways, often depending on the characteristics of its hosts. Delta, for instance, has picked up mutations that just make it more transmissible in general, particularly among the unvaccinated and unexposed. But experts are worried that Omicron could spread more easily even among people who have had a past infection or vaccination. That’s far from certain, though. A virus having a lot of mutations that theoretically make it more immune-evading is one thing, but these mutations may not all get along with each other, and some could impede its fitness or ability to cause illness in other important ways.

Variants in the past haven’t significantly changed how likely the virus is to make us sick, so that’s not a given either. Again, there’s just too little information to be sure either way at this point, and it could take months before there’s enough real-world data on Omicron that can be compared to the predictions we get from the lab.

Patience during these pandemic times doesn’t mean inaction, McNamara said, nor does Omicron realistically represent a threat of us losing every advantage we’ve fought hard to gain against the virus. For instance, immunity to a germ isn’t only about our existing antibodies, he noted. There are memory cells that can quickly marshal up a new supply of antibodies, faster than the body created them the first time, and T cells are another key line of defence that can keep the coronavirus from growing out of control and causing severe illness or death.

“And we have these non-pharmaceutical interventions which have worked for every variant — things like physical distance, masks, moving activities to ventilated areas. There’s no reason to believe that those won’t be very effective,” he said.

Researchers and public health organisations have long been asking for wealthy nations to ramp up vaccine distribution to areas like Africa, where access remains abysmally low (many have also called for abandoning possibly counterproductive measures like travel bans, which may only buy some time at best). Even the U.S. now ranks below dozens of other nations in vaccination rate, though certainly not due to a lack of supply. Some cities have now reinstated some of their past measures, such as requiring or advising masks indoors. Other interventions, like rapid tests that can be taken at home, still appear to be perfectly suitable for Omicron as well, though they remain more expensive in the U.S. than elsewhere. It’s also not Omicron that’s killing thousands of Americans a week right this moment, but the same Delta variant we’ve been dealing with for months now.

“The things that you should do to protect yourself from Omicron are the same things that hopefully people were already doing. But if you indeed have eased up, then maybe become more forceful about masking all the time when you’re indoors with people you’re not living with, for example,” Gralinski said. “Hopefully, people are vaccinated, but a lot of people really need to be looking at a booster shot right now.”

McNamara supports boosters as well, especially for the elderly and immunocompromised, though he’s more reassured by the protection the original shots are likely to provide for the general public. “My perspective has always been that it’s more important to get a first dose,” he said. But whatever trouble Omicron may bring, the key takeaway should be that we’re not helpless against it.

“We have a lot of tools in our toolbox right now,” he said. “And so I think that any doomsday-sayer saying that this is going to take us back to square one — I think that is just wholly unnecessary and bordering on misinformation.”