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What is the truth about Omicron?  What does Omicron mean for our world?

For over two decades before COVID-19 hit the world I warned of risks from new viral pandemics. 

And since COVID-19 emerged, I warned repeatedly that we should continue to expect significant new variants to emerge, at a rate of maybe around one significant variant per 100 million new infections.  So Omicron is no surprise.

And many of my COVID forecasts have turned out to be correct - see elsewhere on this site.

Firstly, we need to see Omicron as part of a wider picture....

(Article written 1st December 2021 - World AIDS Day. AIDS is caused by HIV, just another virus that jumped unexpectedly from animals to humans, but in the case of HIV, we still have no vaccine after 35 years of trying to develop one, nor any curative treatments, and 35 million have died.  My own medical practice as a cancer doctor working in palliative care was overwhelmed by HIV / AIDS in 1987 which is why I have been so sensitised to risks of more pandemics.)

Omicron has 50 mutations - 10 times more than Delta

On 26th November 2021, WHO designated B.1.1.529 or Omicron a variant of concern, less than a week after identifying the first cases in South Africa, where it appeared to be spreading fast in Gauteng province that includes Johannesborg, where Omicron was already causing most new cases.

By 1st December, cases of COVID-19 caused by the variant Omicron had been detected in many other nations.

The great concern about Omicron was 50 mutations, of which 30 are on the so-called spike protein on the outside of the virus, that latches onto human cells.

Omicron has deviated so far from any previous variant that questions have raised about how it happened. The most likely explanation is that Omicron evolved inside the body of someone whose immune system was damaged, for example, someone living with HIV, as is the case for a large number of people in the Southern African region.

15 Omicron mutations are in the receptor-binding domain.  Others mutations affect the outer coating of the virus in ways that may make immune attack more difficult, or may mean evasion of existing vaccines is easier.

Omicron may be better optimised to infect and spread

These Omicron mutations looked likely to make the virus even more efficient in latching and infecting human cells, and better at evading attack by the immune system.

Fortunately, there is a limit to how well optimised the spike protein can become, and previous COVID-19 variants such as Delta already had spike proteins that were a superb fit to human cells.  So there is also a limit to how far the spike protein can be reshaped before it fails to infect.  

And therefore it is likely that existing vaccines which produce antibodies to spike proteins will continue to some extent to recognise COVID-19 Omicron virus variants.

Omicron mutations have changed other properties of the virus

The other concern is Omicron variants in the genetic package itself of RNA which is injected into human cells, turning them into COVID-19 Omicron virus factories, killing the cells in the process, and also triggering all kinds of other health issues.

Omicron is so different from Delta variant of COVID-19 virus that it can be detected on PCR tests very rapidly.

Tests of waste water (sewage) in South African cities such as Pretoria suggest that Omicron variant has been spreading for some time and had already reached the same levels as Delta variant in the past, within a much shorter space of time than the case with Delta.  

Yet numbers in hospitals have been relatively stable, which could indicate that Omicron variant is less likely to make people ill. 

So what do we make of all this?

1. More variants like Omicron will emerge

At least 2 billion people have yet to encounter COVID-19 infection, or to receive even a single dose of vaccine. And people with even two vaccine doses are becoming re-infected after a few months as immunity wears off. Therefore we will continue to see major spread.  

And we will continue to see differences in infection rates affected by many factors including genetics, for example some genes widely found in Africa offer a degree of protection, while others found commonly in parts of Asia seem to increase risk of becoming unwell.

2. Some variants will be more or less infectious than Omicron

As in many past viral pandemics, most COVID-19 variants will turn out to be failures - too damaged to be infectious or dangerous

3. Current types of COVID-19 vaccines are likely to need repeating each year - unless other solutions found

A third booster dose of vaccine seems to provide far more robust immune responses than just one or two doses, and the greatest single action that government leaders and individuals can take is to work together across the world to ensure rapid universal vaccination.

4.  Universal global vaccination is vital to overcoming COVID-19 / Omicron and other variants

There is little point in some nations endlessly pumping their citizens full of vaccines while most of the world lacks a single dose.

The fastest way to prevent new and potentially much more dangerous variants is for developed nations to commit to providing vaccines etc to 85% of the world who live in emerging nations.

5.  In past pandemics, eventually a variant emerged which was mild in impact and very infectious

We hope that a mild variant which is highly infectious will emerge soon, which will ensure natural exposure in a relatively safe way, of the entire world, on a regular basis. So new variants can be good.

6.  COVID-19 continues to highlight massive gap in antiviral therapies 

We have not yet managed to find a way to stimulate the immune system with permanent protection against coronaviruses such as COVID-19- as we do for example with polio vaccine etc.  

A major reason we are in this crisis is one I have pointed out many times now, which is complete failure over the last 80 years to discover a single drug that has the same impact against viruses as penicillin had back in the 1940s.  

We don't have effectively antivirals to match the huge success of antibiotics.

7.  We will rapidly identify a wide range of effective therapies against variants like Omicron

Thousands of existing drugs have already been tested in labs against cells infected with COVID-19, and several are already being used to treat people with COVID-19.  

In addition, many other drugs are being designed specifically to target different aspects of the virus ranging from attachment to cells, to RNA multiplication and so on.

8. Our world will continue on a war-like basis to fight COVID-19

Despite street protests and campaigns, governments will seek to enforce laws to keep their populations safe.  

That may include measures such as compulsory vaccination for people in certain jobs - or even across entire nations.

This will continue to raise major issues about liberty and human rights.

Governments will also continue to pump vast amounts into their economies to provide resilience during the COVID storm.

9.  A key defence strategy is to enable normal economic activity as far as possible

In wartime, governments insist that industry, offices, government agencies and non-profits continue to operate normally as far as possible, without exposing people to undue risk.

Therefore expect a continuous balancing act between restrictions and freedoms.

10.  Seize the Day - Carpe Diem - meet when you can (but stay safe)

Our consistent advice to boards of multinationals has been to Seize the Day.

When opportunities emerge that enable face to face client meetings, or physical team meetings, take them (paying full regard to safety), as COVID may take those opportunities away again for longer than you may expect.

Physical meetings remain Number 1 priority in winning major new contracts, integrating new team, innovation and rapid change management.


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