B.1.1.529 (Omicron): Likely first concerning Covid variant since Delta, though still many unknowns. The emergence of this variant is a shot across the bow and underscores why it’s so urgent we address vaccine inequity. Here’s what we know and don’t know about Omicron. 1/thread
A coalition including @NCDCgov, @gavi, @WHO and @ResolveTSL worked to improve the time it takes to confirm tests for yellow fever in Nigeria from over 30 days to just 24 hours. Wonderful success in strengthening lab capacity.
Lots more we need to find out. Major q's:
Able to evade vaccine and/or infection-induced immunity?
More severe illness?
Getting science right can take time. Epidemiologists get this; many in media don’t. The more we learn, the better we can fight Covid. 7/
One piece of good news: we can easily track spread because B.1.1.529 causes something called S-gene target failure which creates a specific pattern in PCR test results. This can make it easier to spot than Delta. 6/
Data suggests Omicron may be even more easily spread than Delta (which was already 2X more transmissible than the original strain.) We don’t have data yet on whether or not Omicron causes more severe or less severe illness or can escape existing immunity. 5/
The Omicron variant has >30 mutations in the spike protein. That’s a lot. Some are associated with increased transmission and possible immune escape, though not possible to predict reliably how the variant will act in the real world. 4/
You can see the striking accumulation of mutations in the S1 domain of the spike protein just by plotting S1 mutations against time and coloring by clade (). Omicron viruses bear many more S1 mutations than previously circulating variants. 7/16
The rapidity with which the Omicron variant has become predominant in Gauteng Province is concerning. Evidence from other provinces suggests the variant has already spread across South Africa. B.1.1.529 has now been detected in samples from patients in multiple countries. 3/
The South Africa Health Ministry did the right thing and its actions will save lives: quickly identified Omicron through sequencing where there is evidence of increased transmission and immediately shared this information with the world. @WHO labeled it a Variant of Concern. 2/
The virus that causes Covid adapts – faster than many thought possible. We need to adapt, learning more, doing more of what works, collaborating more. That's the best route to a safer world. In fact, that's the only route to a safer world.
We underestimate the coronavirus at our peril. New variants anywhere in the world are a shot across the bow. Stopping the emergence and spread of them—including by addressing vaccine inequity—will save lives everywhere.
As many of us celebrate today with family, friends, and food, a pandemic still rages. People still get sick. So a big debt of gratitude to all our healthcare workers. Today and everyday. I know many of you are hard at work even as we speak. We see you and honor you.
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