SEOUL – Fears of the Omicron variant are tearing across the world, hammering markets, upending forecasts and compelling countries to halt incoming travel – but there may be an upside.
Amid shock reports about Omicron’s extreme transmissibility, one expert says that the geographic origin of the latest Covid-19 mutation points to a less severe form of the disease.
And a combination of high transmissibility and low morbidity, if proven, could provide a pandemic-weary humanity with the silver bullet it has been waiting for.
“This could be the vehicle by which Covid becomes a less lethal disease,” Ogan Gurel, a doctor and neurosurgeon who has been monitoring the pandemic from South Korea and Canada said. “Time will tell.”
Mutating to lesser severity?
An overlooked factor in analyses of Omicron so far is the geographical origin of the variant, Gurel, chief science officer of Flite Material Sciences Corp in Montreal, told Asia Times.
“If we take the premise that this highly transmissible variant arose in an immune-compromised population, by definition, it is not that severe,” Gurel, who has taught courses on medicine in Asia, Europe and North America, said.
The variant, identified last week, appears to have originated in Southern Africa, a hotspot of the immune compromised. Citing 2019 data, Gurel noted that HIV/AIDS is present among 17.3% of adults in South Africa; in Botswana the figure is 22.20%; and in Lesotho, it is 23.10%.
If the disease is not killing off hosts whose immune systems are already weakened, it strongly suggests lower morbidity than other strains.
Another indication that the mutation lacks virulence is that Southern Africa is one of the least-vaccinated parts of the globe, but is not seeing soaring death rates – at least, not yet – even as infections take flight.
And early findings from South African doctors who have been seeing patients presenting with Omicron since November 18, are that the variant is producing “extremely mild” symptoms so far.
Still, reports on the variant’s lack of severity have won less attention than a preliminary finding by a US epidemiologist that Omicron is massively more transmissible than prior variants.
Eric Feigl-Ding, a senior fellow at the Federation of American Scientists tweeted on Friday that Omicron could be “500% more competitively infectious” calling the data “staggering.”
Counter-intuitively, such extreme transmissibility could – assuming Omicron has lower morbidity than previous strains – be a massive plus.
“If this is highly transmissible, it should outcompete the other strains,” said Gurel.
That has been the case with Covid-19 thus far, with the original Wuhan variant being replaced by subsequent mutations, such as Alpha and Delta.
This would fit into a broad biological-evolutionary-historical pattern: If pathogens evolve to kill all their hosts, they, too, die out.
“Basic evolutionary biology will eventually lead to less fatalities, more transmissibility as the perfect pathogen does not want to kill all the hosts,” Gurel said. “Generally speaking, pathogens have reduced virulence over time.”
Indeed, some evolve to become part of us. Again, returning to basic biology, Gurel noted, “Some bacteria in our guts and skin have evolved to be required,” he said. “They are symbiotic.”
Don’t jump to conclusions
Still, it is extremely early to jump to conclusions about the variant, given the sparse amount of data collected.
“There could be populations in Southern Africa that are already immune thanks to previous infections,” suggested Jerome Kim, who heads the International Vaccine Institute.
Covid-19 is not a particularly deadly disease. Among 262 million infections, 5.21 million have died, a mortality rate of 1.9%. Moreover, a considerable population of those infected are asymptomatic. And much of Africa lacks the health infrastructure to effectively test for the disease.
“The gap in diagnosis means we are fighting blind,” Kim said.
As an example of the lack of data produced in the region, he noted that while Southern Africa has sent 200 Covid-19 genomic sequences to the global sequencing database, North America has send 50,000 and Europe has sent 161,000.
And experts speaking to other media have questioned early findings about mild symptoms in South Africans, suggesting that the reported mildness may simply be connected to the youthfulness of patients cited.
“Initial reported infections were among university students – younger individuals who tend to have more mild disease – but understanding the level of severity of the Omicron variant will take days to several weeks,” the World Health Organization warned on its updated Omicron page.
Yet another possible issue is the latency period. Omicron has been identified so recently, that its severity could only become apparent in the weeks ahead.
Still, Kim admits that there is “the possibility that Covid could become something less serious.”
But relying on hope, or waiting for nature to take its course, cannot be a strategy. And there is another risk. Both Kim and Gurel separately told Asia Times of their concerns that Omicron could mutate into something deadlier.
Kim stressed that the world has to continue vaccinating, social distancing and mask wearing, while waiting for effective medications and antibodies to pass through testing regimens and hit the market.
Gurel stressed that assumptions about Omicron, and the overall biological trend that pathogens decline in lethality, should not be grounds for action by governments or health authorities.
“That is not something we should hang policy on,” he said. “Millions could die because we think it will get less lethal.”
But he said there is one lesson the world should take from events in southern Africa. As people with immune-compromised systems provide a rich “soup” for viruses to mutate in, they should have been prioritized in vaccine distribution.
“Sure there are limited vaccines in the Third World, but vaccines should have been distributed in relation to immune-compromised populations,” he said. “We should have triaged this: Southern Africa should have been fully vaccinated.”