Why a transmissible Omicron variant needn’t be bad news

The World Health Organization (WHO) has warned that the Omicron variant of the Sars-CoV2 virus is likely to spread internationally and poses a "very high" global risk of infection surges. However, eminent virologist Dr Shahid Jameel says there’s too little data to worry about this variant just yet. Dr Jameel, who was head of the advisory group to the Indian Sars-CoV-2 Genomics Consortia (Insacog), said the emergence of a possibly more transmissible variant should motivate India to vaccinate people faster. Speaking to TOI’s Rema Nagarajan in an episode of The Times of India podcast, he said India doesn’t need to worry about shutting down again but does need to keep its guard up against the virus.Edited excerpts: How worried should we be about the Omicron variant and what do we know about it so far?Let's say that we should be cautious about it, but we shouldn’t worry ourselves sick over it. What we know at this point is very little and much of what you see is speculation. What we do know is that it is spreading quickly. For any variant of the virus, we should ask three things: One, is it more transmissible? The answer is at this point, it does appear that it is quite transmissible, at least as transmissible as the Delta variant. I don't subscribe to the view that it is six times more transmissible than Delta as there is no evidence for that. medium nocaption88009334 medium nocaption88009352The second thing you should ask is, does it cause more severe disease? There is no evidence. In fact, it's too early to say. And the third thing one should ask is, will it cause infection, and more importantly, severe disease in people who have pre-existing immunity? This means those who have been vaccinated or have had prior infections. It's too early to say anything about that as well. My hunch is that the effectiveness of vaccines will go down a bit, but they will not become useless.In India, we had just started opening schools and relaxing curbs. Does this variant mean that we need to start thinking about a shutdown? No, there is no evidence at this point to suggest anything like that. After our second wave, 67% of Indians had antibodies against the virus, and at that time only around 10% of Indians had received at least one dose of the vaccine. A majority were exposed. medium nocaption88009453It's a blessing in disguise, because those people will be protected from severe disease. They may get infected again and even vaccinated people can get reinfected. But then the disease is very mild. We should exercise caution. We should continue to use masks in public transport and in closed spaces. As far as schools are concerned, it's very important that adults in school settings are fully vaccinated. Let's open schools. Let's be cautious.Do we need to be worried because India hasn't managed to vaccinate a large percentage of its population? If somebody has not been infected and this person has also not been vaccinated, then they should get vaccinated. As a public policy, what tops my list as a response to this news, would be to give vaccines to as many people as possible and as quickly as possible. medium nocaption88009364We could consider reducing the time between the two doses for Covishield from the current 16 weeks to 12 or 14 weeks. Data has shown that anything above 12 weeks gives better efficacy. And vaccine availability is no longer a problem. That way, in a limited period of time, you'll get many more people partially or fully vaccinated. Is it true that virus variants crop up in unvaccinated populations?If any virus circulates in a person before the immune system controls it, the virus will mutate. So a hypothesis for this particular variant is that it arose from somebody with a weak immune system, in whom the virus persisted for a long period of time. Normally, this virus will infect you and make you miserable for a few days. Then our immune system controls and clears it. But if our immune system is weak, then the virus continues to evolve. People who haven’t been vaccinated should be vaccinated, especially people with weak immune systems. like those on cancer treatment, those who are HIV positive and pregnant women. They have weaker immune systems and should be vaccinated on priority. medium nocaption88009385Doesn't that indict the Western nations because large parts of the world are not able to vaccinate because they haven't been able to access vaccines? The WHO has been saying for a while that unless everyone is safe, no one is safe. This is an example of that. Africa has less than 5% of people fully vaccinated. I think it's a wake-up call for all of us. I'm very pleased to see that India has resumed the export of its vaccines. Hopefully, that will help vaccinate lower and middle-income countries much better than what we have. Do vaccine variants not surface among the vaccinated? Variants can develop among the vaccinated as well if their immune system has given them weaker protection. But every variant is not necessarily bad. A variant simply means that the virus has changed but it can still be neutralised by the existing immunity. The only variants that we see are the ones that have some selective advantage. The ones that don't disappear, you never see them. There is a limited mutational space in every virus, it cannot just keep on mutating endlessly because ultimately it will affect the virus itself. If the virus is transmitting better but it's causing very mild disease, it’s telling us that the virus is changing towards becoming like a common cold virus and endemic. If something spreads better but doesn't cause much disease, you don't care about it. We see it happening with other coronaviruses. So maybe this is a blessing in disguise with the virus going towards becoming endemic. However, we don't know that yet.So there couldn't be more lethal variants that could come up? I'm not too sure. At least in India, there is enough exposure to the virus. So I’m not sure about lethal, but maybe more transmissible. We have to continue to be alert.South Africa has done a brilliant job of sequencing and alerting the world early enough.Untitled Carousel 87965580 Is there a need to do much more in terms of genome sequencing? Also, what's the incentive for any country to actually report after the way South Africa was treated? Let me say upfront that South Africa should be commended for what they did. They released results very quickly so that the world could come to grips with it. The virus may have been first reported from South Africa, but there's no evidence that it emerged there. It can emerge from anywhere and all we can do is report it to the world as quickly as we can. They have done a commendable job of this and they should be appreciated, not stigmatised. I think India is doing enough sequencing. India did pick up both the precursor to the Delta variant as well as the Delta variant in time. It's just that things moved a bit slower at that time, and we have all learned our lessons.We are not looking at a repeat of last year where things are shut down? India already has a guideline that was released by the Ministry of Health, which essentially says that everyone who arrives from anywhere in the world will be sampled. Should people shift to a different kind of mask? Are cloth masks protection enough? The fact is that you can have an N95 or N99 mask but if you're not wearing it properly, then it's of no use. If you have a cloth mask, and you're wearing it properly, it gives you protection from aerosols and that is what you want to protect yourself from. The virus being airborne doesn't mean that the virus is floating around. The virus is carried in droplets and a cloth mask is good enough for that. They are easy to make, they're cheap and everyone can use them. The thing is, you have to wear it properly. Untitled Carousel 87987771