EXCLUSIVE | World Not Too Late in Detecting Omicron, May Take 2 Weeks for Clarity on Immune Evasion: Johns Hopkins Epidemiologist

The emergence of the Omicron variant is a call to continue with the progress in vaccination and expand access to the Covid-19 shots, Dr Brian Wahl, Assistant Scientist with the Department of International Health at the Johns Hopkins Bloomberg School of Public Health has told News18.com.

Many experts, he said, believe that vaccines will remain highly effective against severe Covid-19 outcomes, including hospitalisation and death. Contending that the world hasn’t been “too late” in detecting the Omicron variant, the epidemiologist said there should be a better sense about immune evasion of the virus in the next 10-14 days.

Edited excerpts:

What is your understanding of the new variant?

There is still a lot we do not know about the Omicron variant. The three key questions are: (1) is the Omicron variant more transmissible, (2) is it able to somewhat evade the immune system, and (3) does the variant cause more severe disease. It could take time to have answers to these questions.

What we do know is that the Omicron variant has more than 30 mutations on the spike protein that are concerning for a number of reasons. We have seen that it has rapidly outcompeted the Delta variant in South Africa in a relatively short period of time. However, the mechanism by which this has occurred is still not clear. It could be because this variant is more transmissible, better able to evade the immune system, or some combination of both.

Will vaccines work against it? Which vaccines do you think stand a better chance to work against it?

Some of the mutations associated with this variant have been associated with immune evasion. Scientists are now working to better understand how immunity — derived both through immunization and through natural infection — will hold up against the variant. Many experts believe that the vaccines will remain highly effective against severe Covid outcomes, including hospitalisation and death. India has made tremendous progress in increasing Covid-19 vaccine coverage. The emergence of the Omicron variant is a call to continue with this progress and expand access to vaccination.

The WHO says over 28 countries have already reported the variant. Are we already late in detecting the variant?

No, we are not too late in detecting the Omicron variant. Travel-related cases have been reported in India. In other countries, community transmission has also been documented. So, now is the time that we need to bolster testing and contact-tracing efforts to identify cases and continue with genomic surveillance to understand new potential variants that arise.

What is expected now as per your understanding of the incoming data and by when is the scenario is likely to get clearer in terms of Omicron’s behaviour?

There is still a lot we don’t know. The data is coming in mostly from South Africa, where the Omicron variant was first reported. There are reports that many of the cases are mild. In addition, cases in South Africa have also been reported in individuals who have already been infected. These initial reports, however, need to be interpreted cautiously. Laboratory studies are ongoing to get a clearer sense of the ability of the Omicron variant to evade the immune system.

We should have a better sense about immune evasion in the next 10-14 days. Preparing and conducting the neutralising antibody assays will take time. During this time, and in the weeks and months that follow, we will have real world data that will tell us much more about the Omicron variant.

What should be the governments’ strategy, especially for India?

For the time being, we need to continue with the interventions we know work —face masks, social distancing, indoor ventilation, and immunisation. Completing both doses is also especially important. Together with PGIMER, Chandigarh, we have developed a campaign called ‘Teeka Lagwaya Na?’ (You’ve been vaccinated, right?) to strengthen vaccine confidence in the country. We developed three films that can be viewed at teekalagwayana.org and which can be downloaded and shared with friends and family. We can all play an important role in further increasing vaccination coverage in the country.

India has already vaccinated more than 90% of the adult population with the first dose of Covid-19 vaccine, AstraZeneca’s vaccine mostly. We also had a terrible second wave. How vulnerable is the Indian population to Omicron?

This is the critical question. It all depends on how transmissible the Omicron variant is and the degree to which it can evade the immune system. Given the uncertainties, we should take all necessary precautions, including vaccination.

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