It took a month for the warning to go up about a new respiratory disease in Wuhan, and another month for the US to suspend flights from China. The coronaviruses had spread around the world. The recent identification of a new and potentially dangerous variant of covid-19 in South Africa took place within days. Travel bans were imposed within hours. The new variant of Omicron was announced before the World Health Organisation had dubbed it.
The work of South Africa's scientists and their openness, along with the rapid recognition that Omicron poses a genuine threat, show that the world has learned a lot about dealing with Pandemics in the past two years. The fact that Omicron was spotted early, using sparse data, means that its true nature will not be known without further research. The real test of how prepared the world is will be how it uses the time it has.
Answering some questions is one task. The Delta variant is causing 2.5 million cases a week in Europe alone, and whether Omicron will replace it is the most important. It seems to be spreading very fast in South Africa. There is a chance that it was already dispersed, which may explain why there are so many sporadic cases around the world.
There are some complicating factors. South Africa has a low level of immunisation and until recently there were only 1% of cases that peaked in July. Maybe that gave Omicron a head start. The other variant, including Gamma and Lambda, looked dangerous for a while. It could take two to four weeks to work out transmissibility, according to professor of immunology and infectious diseases at Harvard, Yonatan Grad.
Is Omicron responsible for severe disease? There are early reports of mild cases in South Africa. They may have said that young people are less vulnerable to covid-19.
Scientists need to observe enough cases across a range of ages and in people with secondary conditions, such as chronic kidney disease and diabetes, that are known to make catching covid more dangerous. If Omicron is less infectious than Delta, it could still lead to a rise in hospital admissions and deaths. Dr Grad thinks it will take one to two months to assess Omicron's severity.
How much protection do vaccines, prior infections and medicines give against Omicron? There are mostly theoretical grounds for concern. Some of the Omicron's 30 mutations on the spike protein are thought to help viruses enter human cells and other things that frustrate attacks from the immune system. Some of the 20 more genes in the viral genome may be dangerous.
There is anecdotal evidence that people who have been fully vaccined are catching the disease. What matters is how common such cases are, how easy they are to pass on the disease, and what share of them end up in intensive care and an early grave. Data on vaccines will be available in a couple of weeks, according to Dr Grad.
Maybe Omicron will never amount to much. Governments can use the time they have to prepare. The spread of the disease will be slowed by early travel bans and bicyle restrictions in South Africa. That helps track-and-trace systems keep up.
Track-and-trace is swamped if Omicron proves so infectious. If that is the case, transmission from within communities will become more important than cases spread by international travellers. South Africa is currently being punished for its good citizenship, so travel bans should be lifted immediately.
pharma companies have to be able to make new vaccines Omicron's is heavily mutated and these target it. The vaccines can be edited with the new variant's genome in a matter of minutes. It will take 100 days or so. The other vaccines could take longer. The work has begun.
It's not clear whether administering these new vaccines makes sense. The ideal jab is designed to guard against a range of existing versions, according to Jeremy Farrar, head of the Wellcome Trust. Specialising in Omicron may not be the best strategy.
Governments can accelerate booster programmes on the assumption that today's vaccines give some protection against the new threat. It makes sense if Omicron comes to dominate or not. Delta is currently sweeping through Europe and threatens the United States again.
Governments will have to use non-pharmaceutical interventions if Omicron starts to spread. The two-metre rule is the least disruptive, as long as you wear a mask and work from home. If Omicron is more infectious than Delta, the efforts to stop it will have to be more strenuous. When cases look as if they are about to overwhelm the health system, locks of increasing scope are a last resort.
Governments need to know when to act. Understanding how the new variant is spreading is important. A common test fails to detect one of its target genes when analyzing Omicron because of the virus's genome having a flaw. The cost of a full sequence of the virus is more expensive than a full test. They can be used as a rough guide to Omicron's status.
Governments have made mistakes at every stage of the Pandemic. When cases are already out of control, their most consistent mistake is to act too late. South Africa bought them time with Omicron. How will they deal with it?
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