What You Need to Know: Omicron (B.1.1.529) South African Variant
Clear Health Pass Covid Pandemic Update: December 06, 2022
The B.1.1.529 variant was first reported to the World Health Organization (WHO) from South Africa on November 24, 2021. The epidemiological situation in South Africa has been characterized by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant. In recent weeks, infections have increased steeply, coinciding with the detection of the B.1.1.529 variant. The first known confirmed B.1.1.529 infection was from a specimen collected on November 09, 2021. The variant as of December 05, 2021, has now been found in 16 states as hospitals prepare for a potentially massive spike in hospitalizations.
Omicron has 50 mutations, 30 of which are in the spike protein. Specifically changes to amino Acids 333 to 527, which contain ACE2. One study in March 2020, demonstrated that ACE2 was the dominant area for receptor binding of antibodies. These changes represent one of the most dramatic variant mutations to date whereas approximately, representing a greater than 15% change in the surface area of the spike protein. Ten of those mutations are within that amino acid range (438-506). Given that monoclinic antibodies bind in a 3-dimensional space (aka lock and key), there is a high probability that the overall surface change will inhibit viral neutralization, due to lack of binding receptor availability via the body’s immune system, monoclonal antibody therapeutics, and potentially greatly reduced efficacy of current vaccines. In addition, there may be an increase in T-cell response once an infection is onset, which may also cause inflammation that may trigger complications, like long-haulers, even post-infection.
Omicron is now designated by the WHO and the European Center for Disease Prevention and Control classification as a Variant of Concern (VOC) based on epidemiological data indicating an increase in infections in South Africa in recent weeks and the virus ability immune escape and potentially increased transmissibility compared to the Delta variant and have raised its classification status as a Variant of Concern (VOC).
Breakthrough Variants Still Cause Spread, Illness, Hospitalization, and Death in the Vaccinated
On June 25th, Dr. Chevy Levy Israel’s Director General of Health Ministry stated during a radio interview that 40-45% breakthrough rates reported SARS-Co-2, from those previously vaccinated. According to Reuters, as of December 04, 2022, Israel is one of the global leaders in vaccinations and early variant detection with approximately 89.6% of Israeli adults being vaccinated, with 57% being fully vaccinated, which is on par with the United States. In August, the Israeli Minister of Health Nitzan announced that it became the first nation to offer a third dose of vaccine to people as young as age 50. Since then, the breakthrough rate has continued to climb according to their health ministry. Though the unvaccinated will have an overall higher infection, hospitalization, and mortality rate, the rate of breakthrough infection data strongly suggests that Sar-Cov-2 variants will inevitably outpace the deployment of new vaccines and boosters. What is clear is that “breakthrough” cases are not the rare events the term implies. According to Israel’s Health Ministry, in an article on August 15, 2021, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology and an advisor for the county’s Covid task force.
Asymptomatic SARS-CoV-2 Super Spreaders: What you Don’t See My Harm
In an August 2021, a PNAS research article, Asymptomatic SARS-CoV-2 infection, researchers cross-referenced data sets of PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020, and April 2, 2021, to identify studies that reported silent infections at the time of testing, whether pre-symptomatic or asymptomatic. At the time of testing, 42.8% of cases exhibited no symptoms, a group comprising both asymptomatic and pre-symptomatic infections. Epidemiologists, those that study and analyze the distribution (who, when, and where), patterns, and determinants of health and disease conditions usually observe a “20/80 rule” or the “1:4 ratio” in the way that infectious diseases are transmitted within a population. For clarity, 1 infected person will infect 4 healthy persons. This “1:4 ratio” applies to many transmissions of infectious pathogens among different species. A COVID-19 epidemic model with a latency period follows the same 1:4 ratio, but new variants have also created an asymptomatic carrier, which can spread the virus, but themselves show little to no sign of infection. This dramatically changes the current Covid-19 epidemic modeling of a typical 1:4 ratio to that of a “Super-spreader”. Super-spreaders can transmit pathogens disproportionately to more than an average number of secondary cases and are likely to promote the speed and scale of outbreaks. Usually, super-spreaders transmit at least ten individuals, sometimes even up to 100 secondary cases, and exponentially increase infections by a factor of 10+ every 24-48 hours, without testing or quarantine in effect. Thus, asymptomatic super-spreaders of COVID-19 can be extremely dangerous and must be handled time-efficiently. Prior pandemic data suggests that “Symptomatic” Super Spreaders (E.g., EBOLI & SARS) transmit from 10-100x secondary cases. In a JAMA study released as of January 11, 2021, 59% of all transmission came from the asymptomatic transmission, comprising 35% from pre-symptomatic individuals and 24% from individuals who never develop symptoms. Under a broad range of values for each of these assumptions, at least 50% of new SARS-CoV-2 infections were estimated to have originated from exposure to individuals with infection but without symptoms.
The US is 38 of 130 countries in Genetic Variant Testing
According to the Global Influenza Surveillance System (“GISAID”), which collaborates, supplies, and syndicates, genomic data sets concerning SARS-CoV-2 variants to the CDC, the World Health Organization (“WHO”), the U.S. Department of Health (“DOH”), the European Union, other world governments and tens of thousands of researchers worldwide reports that the United States gnomically identifies less than 1.6% or 0.29% as a global genomics contributor of its positive COVID-19 cases a month. This ranks the U.S. as 38th out of 130 countries in terms of sequencing Positive COVID-19 cases, which is the only current defense against identifying potentially variant strains. According to the WHO, the United States is doing so little of the genetic sequencing needed to detect new variants of the coronavirus—like the ones first identified in Great Britain and South Africa—that such mutations are probably proliferating quickly, undetected. At one time, BUT NOT DEEMED as VOC, the coronavirus variant known as B.1.1.7, which studies show is both more deadly and transmissible than the original version of SARS-CoV-2, first identified in December 2020, now serves as one of the most common strains circulating in the United States, and its growing prevalence alarms prominent epidemiologists.
Relaxed Travel Bans in Allowing the Vaccinated and potentially the Infected into the United States
On October 25, President Biden announced a Presidential Proclamation titled “A Proclamation on Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic.” This proclamation, which took effect at 12:01 am Eastern Standard Time on November 8, 2021, ended the travel restrictions under Presidential Proclamations (P.P.) 9984, 9992, 10143, and 10199 as they relate to the suspension of entry into the United States of persons physically present in Brazil, China, India, Iran, Ireland, the Schengen Area, South Africa, and the United Kingdom. In place of these restrictions, the President announced a global vaccination requirement for all adult foreign national travelers. Unfortunately, the South American variant has already made entry into the US in much larger numbers, given the estimated breakthrough rates of over 50%+ of vaccinated, which may potentially lead to the vaccinated, asymptomatic super spreader.
Key Take Always:
If the variant is sufficient to cause regional to national outbreaks, vaccine breakthrough is likely.
Thus, vaccines and antiviral treatments will be reduced in the overall effectiveness.
Vaccines may still help reduce long-term hospitalization and mortality.
Changes in the virus may also cause systemic complications due to inflammation caused by overactive T-cells.
Avoid large gatherings especially during the holiday season
Get vaccinated or a booster is available
About Clear Health Pass™ (CHP):
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