The next big COVID-19 variant could turn out to be a three-whale nightmare

Even as daily new COVID cases compile the all-time record and hospitals fill up, epidemiologists have come to a consensus that is perhaps surprising. Yes latest Omicron variant of the new coronavirus is bad. But it could be a lot worse.

Even as cases have increased, the number of deaths has not – at least not to the same extent. Omicrons are very contagious but in general not as severe as some older variants– “family” is the scientific term.

We got lucky. But that luck may not hold. Many epidemiologists who have breathed a sigh of relief at Omicron’s relatively low mortality rate are predicting that next lineage could be much worse.

Wondering about a possible future lineage that combines Omicron’s extreme transmissibility with the severity of the previous Delta line, experts are beginning to embrace a new public health strategy, it’s a test run early in Israeli: a four-shot regimen of messenger RNA vaccines.

“I think this is going to be the strategy going forward,” Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast.

Omicron raised alarm among health authorities around the world in late November after officials in South Africa reported the first cases. Compared to older lines, Omicron has about 50 major mutations, about 30 of which are on mutant proteins that help viruses enter our cells.

Several mutations are involved in the virus’s ability to evade antibodies and thus partially avoid it Vaccine. Others are associated with higher transmittance. The genetic makeup of the lineage indicates a spike in infections among unvaccinated individuals as well as an increase in milder “breakthrough” infections among vaccinated individuals.

“As long as we have the unvaccinated in this country – and globally – there is potential for new and possibly more related viral variants.”

That is exactly what happened. Medical staff registration over 10 million new COVID cases in the first week of January. This is almost double the previous worst week for new infections, in May. About 3 million of those infections are in the United States, where Omicron coincides with Thanksgiving, Christmas and New Year’s Eve and related travel and family gatherings.

But fortunately, the death toll has not increased as much as the cases have occurred. Worldwide, there were 43,000 deaths from COVID in the first week of January — 10,000 fewer of them in the U.S. While deaths tend to slow over several weeks from infection, Omicron has dominated for long enough that more and more conditions are being referred to by statisticians as the “separation” of cases and deaths.

Stephanie James, head of the COVID testing lab at Regis University in Colorado, told The Daily Beast: “It’s safe to say we dodged a bullet because Omicron doesn’t seem to cause a serious illness. what important. She emphasized that the data is still being collected, so we cannot be sure yet that the apparent separation is real.

Assume split To be happens, experts attribute it to two factors. First, Omicrons tend to infect the throat without necessarily going down to the lungs, where the likelihood of lasting damage or death is much higher. Second, countries have used nearly 9.3 billion doses of the vaccine to date – enough for most of the world’s population to receive at least one dose.

In the United States, 73 percent of people have at least one dose. Sixty-two percent had received two doses of the best mRNA vaccine. A third received a booster dose.

Yes, Omicron has some ability to evade antibodies, meaning the vaccine is somewhat less effective against this lineage than against Delta and other older strains. But even if the vaccine doesn’t prevent infection, it often greatly reduces its severity.

For many vaccinated people who have contracted Omicron, the resulting COVID infection is mild. “The common cold or a few sniffles in a healthy individual completely improves and enhances health,” is how Eric Bortz, a University of Alaska public health and virology expert- Anchorage, described it to The Daily Beast.

All that being said, Omicron could be a lot worse. Viruses evolve to survive. That could mean a higher chance of transmission, avoidance of antibodies, or a more serious infection. Omicron mutated for two people before. There’s a chance some future Sigma or Upsilon lineage could do all three.

When it comes to viral mutations, “extreme events can occur with negligible rate or probability and can lead to major consequences,” Michael said. Imagine a lineage as transmittable as Omicron but also attack the lungs like Delta tends to do. Now imagine that this hypothetical lineage is even more adept than Omicron at evading vaccines.

That would be the nightmare lineage. And it’s entirely possible to envision it in our future. There are enough vaccine stocks, such as about 50 million Americans who say they will never be vaccinated, that the SARS-CoV-2 pathogen will have more of a chance to mutate.

Aimee Bernard, an immunologist at the University of Colorado, told The Daily Beast: “As long as we have unvaccinated people in this country – and globally – there is a possibility that viral variants will arise. new and possibly more relevant.

Worse yet, the continued evolution of this virus is taking place against a backdrop of waning immunity. Antibodies, whether produced by a vaccine or naturally occurring from a previous infection, wear off over time. It is not without reason that health authorities in many countries recommend booster shots just three months after the initial vaccination. The US Centers for Disease Control and Prevention is an exception and recommends that everyone step up their health after five months.

A lineage much worse than Omicron could develop at the same time causing antibodies to wane in billions of people around the world. That’s why many experts believe a COVID vaccine will be given every year or even semi-annually. You will need a fourth stab, a fifth stab, a sixth stab, et cetera, forever.

“I’m waiting to get my first dose and you guys are getting the fourth?”

Israel, the world leader in global health, has turned that expectation into policy. Quote experiments that shows a huge spike in antibodies with an extra dose of mRNA and no safety concerns, the country’s health ministry this week start offering fourth dose for anyone over 60 years of age, who tend to be more susceptible to COVID than younger people.

That should be the norm everywhere, Ali Mokdad, professor of health metrology at the University of Washington Health Institute, told The Daily Beast. “Scientifically, they are right,” he said of Israeli health officials.

If there is a downside, it’s that there are still some poorer countries – mainly in Africa – where many people still struggle to access any vaccine, let alone boosters and second doses. private. If and when other wealthy nations follow Israel’s lead and start providing additional injections, there is some risk of even greater inequality in the global distribution of vaccines. bridge.

“The downside is for the rest of the world,” says Mokdad. “I’m waiting for the first dose and you guys are taking the fourth?”

The solution is not to deprive them of the doses they need to maintain their protection against future — and potentially more dangerous — descendants. The solution, for vaccine-producing countries, is to further ramp up production and redouble efforts to push vaccines to the least privileged communities.

A sense of urgency is key. For all its rapid spread, Omicron has actually been pretty easy on us. Sigma or Upsilon may not. The next big COVID-19 variant could turn out to be a three-whale nightmare


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