In the wake of the emergence of new coronavirus variant Omicron , persons with co-morbidities and the older age group need to be monitored and, in general, the vaccination of children is the next agenda and India should plan for a booster vaccine dose in the second half of 2022, although two-dose vaccination of the target population is still the priority, said Professor G. Padmanaban (IISc, Bengaluru), senior science innovation adviser, Biotechnology Industry Research Assistance Council (BIRAC), Department of Biotechnology, in an interview.
Why is this mutation being called Variant of Concern (VOC)? What does it mean in terms of treatment, hospital stay and vaccine protection?
A Variant of Interest (VOI) is one that carries specific genetic markers (mutations/deletions) that are predicted to affect transmission, diagnostics, therapeutics or immune escape. A Variant of Concern (VOC) is a VOI that, in addition, is demonstrated to be associated with one or more of public health concerns, including an increase in transmissibility or a detrimental change in COVID-19 epidemiology, increase in virulence or change in clinical disease presentation or decrease in effectiveness of public health and social measures or available diagnostics, vaccines, therapeutics.
Omicron has increased four-fold in two weeks in Gauteng province of South Africa and has spread to other countries (Botswana, Hongkong, Israel), and the expert group in World Health Organisation has termed it VOC. It also carries a large number of mutations – as many as 30 in the spike protein region. It carries mutations in the Alpha, Beta, Gamma and Lambda variants, with potential for immune escape and more transmissibility.
Also read: COVID-19 | WHO says it is not yet clear if Omicron variant causes more severe disease
How does widespread transmission enhance the potency of the mutations?
Mutations have the potential to increase transmission, for example, by increasing the binding affinity to the receptor, enhancing viral replication rate, etc. The virus will keep mutating all the time due to slippage in copying the 30,000-odd bases. Most mutations may only make the virus ineffective, but some constellations can make it a VOI and then VOC.
This will keep happening till the virus loses steam and antibodies and herd immunity can keep the virus under check. It is difficult to predict what form it will take in future – whether it will be a milder, more severe or a yearly visitor.
Also read: What the Omicron variant means for India
What does all this mean for the common man and what should the public be doing at this time?
The message to the common man is: the pandemic is not over. The virus is still around and can keep acquiring mutations that may be more or less detrimental.
It is absolutely necessary to follow the COVID-appropriate behaviour. Proper wearing of masks is critical. Both doses of available vaccine must be taken, since even with less neutralisation potential, they are protective. Even if infection takes place, there is enough evidence to indicate that severity of the disease is prevented. We need to take all precautions during international travel. Omicron is yet to be detected in India, but international arrivals would need close monitoring. Complete genome sequencing of the virus is needed in suspected cases.
What are the implications for children, since this is a totally unvaccinated population?
For children, very little is known about the clinical aspects of Omicron, since the number infected are still small. It seems to be spreading fast. A matter of concern is that Omicron carries a large number of mutations, some already seen in Alpha, Beta, Gamma and Lambda variants, in addition to new ones.
Persons with co-morbidities and the older age group need to be monitored. In general, vaccination of children is the next agenda, and I feel India should be planning for a booster vaccine dose in the second half of 2022, although two-dose vaccination of the target population is the priority.
