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Omicron Variant – The Good, Bad, and Ugly 

By  Dr. Mike Hansen

We know very little about the Omicron variant, B.1.1.529.
But we’re starting to learn some things, and by this article, you know the good, the bad, and the ugly when it comes to this virus.

With Omicron variant, there is a fine line between overreacting and being too carefree because it’s still so known.

How we react depends on these 3 things MAINLY.

  1. The severity of COVID it causes.
  2. How easily it spreads.
  3. If it’s resistant to our vaccines.

Omicron Variant

It’s unlikely to have total resistance to vaccines, but there is a good chance of making them less effective.

The answers are starting to trickle in but will take time to know for sure in the next few days and weeks. Omicron variant could be really nasty, or it could be a false alarm. Or somewhere in between. But the most important thing we need to do is learn about Omicron and answer these 3 questions.

What we know for sure is the entire genetic sequence of Omicron variant. It has over 30 concerning mutations in its spike protein. Omicron variant shares several key mutations with two previous variants, Beta and Gamma, that made them less vulnerable to vaccines. The antibodies that are generated from the vaccines. They target three regions on the spike protein, and Omicron variant has mutations in all three of those regions.

Also, the mutations make it more prone to spread faster by binding more tightly to the ACE2 receptor and getting into cells more efficiently by tweaking the furin cleavage site.
Because of all of these specific mutations, many of which are already known to be marks of badness in other variants that promote viral proliferation, spread, and antibody resistance – this is the bad news.

So even though we know the genetic sequence, the technology to predict how a virus’s behavior will change reliably, including whether it can evade our current vaccines, is based purely on genetic information that technology does not exist. That’s why the upcoming testing is crucial.

Within the next couple of weeks, we’ll have this answered, though.
Initial data will come from lab tests of blood samples from vaccinated people or lab animals, analyzing antibodies in the samples after exposure to the new variant. There will also be labs looking to make the Omicron variant and test its antibody sensitivity, which will take a couple of weeks. The first real-world studies of vaccine effectiveness in the community will likely take at 3-4 weeks.

And then there is the ugly.
By ugly, I mean those who are hitting the panic button. You want to be prepared and concerned but not overreact. Yes, this virus looks like it’s spreading quickly. Not just within South Africa, but how quickly it’s spreading across the globe. It’s in Canada. Asia. Europe. About 20 countries now. And it’s also concerning that it has already started spreading in the community in Germany.

The ugly includes the overzealous partial travel restrictions that do nothing more than to perhaps slow the spread and buy some time, mainly because the virus already had a global spread before it was identified. You don’t want countries to feel punished for reporting variant information.

The good news is that of the known cases, it does not seem to cause worse disease. But it’s still too early to come to a definitive conclusion on that. But Imagine this for a second. Let’s say hypothetically speaking that you have a new virus that is super contagious, but at its worst, causes nothing more than a common cold without any long-term effects; no one would care. You wouldn’t need masks. A vaccine. Medications. Restrictions. Nothing. So if, and this is a HUGE if, if Omicron turns out to be super contagious but extraordinarily low virulence, that would be great news.

Realistically speaking, it’s unlikely that it will have low virulence, but again, right now, we don’t know, but this question should be answered in the next couple of weeks. Of course, sitting on your thumbs and waiting for ‘definitive proof’ is not the most thoughtful way to react to a virus that has the potential to cause mass suffering. Especially if it’s nastier than previous variants. So we need to be vigilant, get the science right, and answer the most important questions as soon as possible.

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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