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The WHO is warning the new Omicron COVID-19 variant poses a ‘very high’ global risk. Anthony Okolie speaks with Tarik Aeta, Healthcare Analyst, TD Asset Management, about what that means for the global fight against the pandemic.
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Tarik, there are a lot of questions surrounding this new COVID variant, Omicron, but data is still pretty scarce at the moment. What do we know so far about this variant?
Yes, Omicron, this new variant, first identified in Botswana a few weeks back and has been identified in greater numbers in South Africa, clustered around Johannesburg over the past week. What do we know about it? We don't know all that much to be honest at the moment, but we know a couple of things. So this variant has over 50 mutations, 30 of which impact the spike protein and 10 impacting the receptor binding domain, which is a part of the virus that latches on to our cells. And it is speculated that this heavy level of mutation is due to the virus mutating over a period of time, potentially in an immunocompromised patient. But as time goes on, we'll get more information on the virus.
What makes this variant more concerning?
Yes, so the variant was flagged as more concerning by scientists for two reasons. So first, the variant contains many more mutations, the spike protein, and this increases the risk that previously vaccinated or previously infected individuals don't recognize the virus as quickly. And second, the variant contains certain mutations, which drove success in other variants. So, for example, as the N501 mutation, which you found in the UK strain, earlier in the year. E-484, which you saw in the previous South African strain. T-478, which you saw in the Delta strain. So it has these mutations that concern scientists because these mutations were successful in other variants.
I think another question that people are asking is, is this new variant more transmissible and or dangerous?
Yeah. So the data from South Africa suggests that the variant is dominating new infections and really for the first time since May, there's something in South Africa with this new variant that is able to displace Delta. So it does suggest that it is more transmissible. And that would make sense, given the cases in South Africa have increased from 273 back on November 16 to over 2,800 cases today. That said, though, there's nothing from the anecdotal data so far that the variant is more lethal. In fact, the anecdotal data from South Africa suggests so far that it is a touch milder than Delta. Patients are experiencing tiredness, fatigue, body aches, headaches. And all that to say is that the virus is unlikely to be more dangerous than Delta. All in, it probably will be similar to Delta or may potentially a touch milder, but I would expect to be largely the same in terms of how dangerous it is versus other variants of COVID 19.
How likely is it that Omicron replaces Delta as a leading variant globally?
Yeah. The answer is that it's too early to tell. That said, though, based on the early data from South Africa, this variant definitely has better odds of breaking out and becoming a global variant. So this is something I will be watching for closely in the weeks ahead.
Again, I know that data is sparce, but will we need vaccines or antivirals to combat this variant and how soon can those vaccines get to market?
Yeah. So on the antiviral side, we'll start with that. There's nothing suggest that the Pfizer, the new antiviral that they have won't be effective. Just because it's a protease inhibitor, it inhibits the viral replication. So small changes in the spike protein are going to get a little bit more bigger changes and shouldn't impact the effectiveness of that. And that's important given the clinical trials for that antiviral had 89% effectiveness against hospitalizations and severe COVID, including deaths. So it's good news there that that won't be impacted. In terms of the vaccine front, it's a bit more of a complicated answer. Given the spike protein is still largely the same, the consensus view from the scientific community is the vaccines should continue to work, but directionally that effectiveness will be somewhat weaker. It's hard to know whether effectiveness goes from 90% to 80% or 70%, or even a bit lower. But that's something we'll only know with time. In the meantime, scientists are doing in vitro studies and looking to see how the virus behaves. And as we as we understand that, we'll have better insights there. But either way, the vaccine manufacturers have already begun the process of creating updated vaccines just in case one is required with the RNA vaccine. The good news is we can create vaccines very quickly. Both Pfizer and Moderna have talked about creating new vaccines under 100 days and from a logistical perspective, also the other area of good news is that we don't need large 40,000 plus individual clinical trials. Like the flu shot every year, given the manufacturing process is the same, given the vaccine is largely the same, the FDA will only require probably a small trial of us and then 500 people to test for immunogenicity. And with that, you probably can get approval of an updated vaccine.
And what about the need for booster shots? What are your thoughts there?
Yeah. So even before this new variant, it was pretty clear that we would need boosters due to waning efficacy after six months. With the emergence of the variant, I expect some of those plans in a lot of geographies to get fast tracked in the months to come. We even had Ontario today talk about potentially fast tracking boosters across the broader population. So ultimately, I think, yeah, boosters will probably be a requirement. And even before this new variant, and with this new variant, I think it just increases the urgency there.
So given what we know today, what's the one key message that you want listeners to take away?
So while we still don't know about this new variant, this situation we are in today is far from where we were in last March and March 2020, where we had no vaccines, we had no antivirals, we didn't even have COVID testing. So, while this variant could potentially lead to additional waves, especially in countries and geographies where you have low vaccination rates or people were vaccinated a long time ago, so that efficacy is waning on the vaccines, by no means are we going back to step one. So I think when you look forward, society is well-positioned today given we have those vaccines, those antivirals, we have boosters will be likely rolling out in the upcoming year. And I expect we won't have the same pressures that we saw back in 2020 and early 2021.
Yes, Omicron, this new variant, first identified in Botswana a few weeks back and has been identified in greater numbers in South Africa, clustered around Johannesburg over the past week. What do we know about it? We don't know all that much to be honest at the moment, but we know a couple of things. So this variant has over 50 mutations, 30 of which impact the spike protein and 10 impacting the receptor binding domain, which is a part of the virus that latches on to our cells. And it is speculated that this heavy level of mutation is due to the virus mutating over a period of time, potentially in an immunocompromised patient. But as time goes on, we'll get more information on the virus.
What makes this variant more concerning?
Yes, so the variant was flagged as more concerning by scientists for two reasons. So first, the variant contains many more mutations, the spike protein, and this increases the risk that previously vaccinated or previously infected individuals don't recognize the virus as quickly. And second, the variant contains certain mutations, which drove success in other variants. So, for example, as the N501 mutation, which you found in the UK strain, earlier in the year. E-484, which you saw in the previous South African strain. T-478, which you saw in the Delta strain. So it has these mutations that concern scientists because these mutations were successful in other variants.
I think another question that people are asking is, is this new variant more transmissible and or dangerous?
Yeah. So the data from South Africa suggests that the variant is dominating new infections and really for the first time since May, there's something in South Africa with this new variant that is able to displace Delta. So it does suggest that it is more transmissible. And that would make sense, given the cases in South Africa have increased from 273 back on November 16 to over 2,800 cases today. That said, though, there's nothing from the anecdotal data so far that the variant is more lethal. In fact, the anecdotal data from South Africa suggests so far that it is a touch milder than Delta. Patients are experiencing tiredness, fatigue, body aches, headaches. And all that to say is that the virus is unlikely to be more dangerous than Delta. All in, it probably will be similar to Delta or may potentially a touch milder, but I would expect to be largely the same in terms of how dangerous it is versus other variants of COVID 19.
How likely is it that Omicron replaces Delta as a leading variant globally?
Yeah. The answer is that it's too early to tell. That said, though, based on the early data from South Africa, this variant definitely has better odds of breaking out and becoming a global variant. So this is something I will be watching for closely in the weeks ahead.
Again, I know that data is sparce, but will we need vaccines or antivirals to combat this variant and how soon can those vaccines get to market?
Yeah. So on the antiviral side, we'll start with that. There's nothing suggest that the Pfizer, the new antiviral that they have won't be effective. Just because it's a protease inhibitor, it inhibits the viral replication. So small changes in the spike protein are going to get a little bit more bigger changes and shouldn't impact the effectiveness of that. And that's important given the clinical trials for that antiviral had 89% effectiveness against hospitalizations and severe COVID, including deaths. So it's good news there that that won't be impacted. In terms of the vaccine front, it's a bit more of a complicated answer. Given the spike protein is still largely the same, the consensus view from the scientific community is the vaccines should continue to work, but directionally that effectiveness will be somewhat weaker. It's hard to know whether effectiveness goes from 90% to 80% or 70%, or even a bit lower. But that's something we'll only know with time. In the meantime, scientists are doing in vitro studies and looking to see how the virus behaves. And as we as we understand that, we'll have better insights there. But either way, the vaccine manufacturers have already begun the process of creating updated vaccines just in case one is required with the RNA vaccine. The good news is we can create vaccines very quickly. Both Pfizer and Moderna have talked about creating new vaccines under 100 days and from a logistical perspective, also the other area of good news is that we don't need large 40,000 plus individual clinical trials. Like the flu shot every year, given the manufacturing process is the same, given the vaccine is largely the same, the FDA will only require probably a small trial of us and then 500 people to test for immunogenicity. And with that, you probably can get approval of an updated vaccine.
And what about the need for booster shots? What are your thoughts there?
Yeah. So even before this new variant, it was pretty clear that we would need boosters due to waning efficacy after six months. With the emergence of the variant, I expect some of those plans in a lot of geographies to get fast tracked in the months to come. We even had Ontario today talk about potentially fast tracking boosters across the broader population. So ultimately, I think, yeah, boosters will probably be a requirement. And even before this new variant, and with this new variant, I think it just increases the urgency there.
So given what we know today, what's the one key message that you want listeners to take away?
So while we still don't know about this new variant, this situation we are in today is far from where we were in last March and March 2020, where we had no vaccines, we had no antivirals, we didn't even have COVID testing. So, while this variant could potentially lead to additional waves, especially in countries and geographies where you have low vaccination rates or people were vaccinated a long time ago, so that efficacy is waning on the vaccines, by no means are we going back to step one. So I think when you look forward, society is well-positioned today given we have those vaccines, those antivirals, we have boosters will be likely rolling out in the upcoming year. And I expect we won't have the same pressures that we saw back in 2020 and early 2021.
