Omicron, the newly found variant of the COVID family has brought in a number of concerns and questions. This article covers the latest updates we have about the variant.

---

Question 1. What should doctors be familiar with?

The World Health Organization (WHO) has designated a novel SARS-CoV-2 variant that is now circulating in South Africa as a 'variant of concern'. Additionally, it was given the name Omicron. The mutation was discovered on 22 November by the Network for Genomics Surveillance in South Africa (NGS-SA).

A cluster of similar SARS-CoV-2 viruses belonging to the B.1.1.529 lineage was discovered. According to early evidence, this variation may be even more transmissible than the extremely infectious Delta version, and existing vaccinations may be ineffective against it.

---

Question 2. How much do we know about Omicron at the moment?

As SARS-CoV-2 spreads, new variations arise, and the importance of each mutation grows apparent over time. However, health officials globally must constantly monitor which ones are more critical than others. The NGS-SA discovered B.1.1.529 as part of such an operation.

According to current knowledge, B.1.1.529 has several spike protein mutations and the early study indicates that it is highly contagious. Over the previous two weeks, South Africa has recorded a fourfold spike in new cases, corresponding with the appearance of B.1.1.529.

The NGS-SA reported that B.1.1.529 has swiftly spread across Gauteng province, which encompasses Johannesburg and Pretoria, and may already be present in the majority of provinces. According to the NGS-SA, the continuous rise in incidence may be a result of cluster epidemics.

---

Question 3. In what ways does this variety differ from others?

According to the NGS-SA, B.1.1.529 contains "extremely unique mutation patterns" including 30 in the area encoding the spike protein, which is important for the virus's entrance into human cells.

According to the researchers, some of the mutations are well-characterised and have a well-defined phenotypic effect, impacting transmissibility and immune evasion.

Several of these mutations have been identified in the Alpha and Delta versions. However, the NGS-SA said that many additional mutations had been "rarely found and poorly defined" until now. As a result, the entire relevance of these alterations is unknown at the moment.

The Africa Centers for Disease Control (CDC) stated,

"Additional research is being conducted to ascertain the potential impact of these mutations on the virus's ability to transmit more efficiently, to affect vaccine efficacy and dodge immune response, and/or to induce more serious or milder disease."

---

Question 4. Which of these alterations should we be concerned about?

According to the NGS-SA, a cluster of mutations identified as H655Y + N679K + P681H is related to increased cell entrance efficiency, implying increased transmissibility. Additionally, there is a deletion, nsp6, that is comparable to those seen in the Alpha, Beta, Gamma, and Lambda versions. According to the NGS-SA, this may be related to the escape of innate immunity, which might increase propagation.

Once again, the new strain has the R203K + G204R mutation, which is also found in Alpha, Gamma, and Lambda and is related to higher disease transmission.

---

Question 5. What is the WHO's opinion on the situation?

There are less than 100 accessible whole-genome sequences. We do not know a great deal about this at the moment. We do know, however, that his variation has a high number of mutations. And the fear is that having such a large number of mutations may have an effect on how the virus acts.

---

Question 6. Is there a difference in clinical manifestations?

According to South Africa's National Institute for Communicable Diseases (NICD), "no peculiar manifestations" have been documented after infection with the B.1.1.529 strain. It has shown, like other viral variations such as Delta, that some people exhibit no symptoms.

---

Question 7. How would researchers assess the efficacy of vaccines and the seriousness of illness?

The clinical and epidemiological correlations for Omicron are not completely defined. A direct relationship to any spike is impossible without that. South Africa has begun investigating B.1.1.529's immunological escape capability in a laboratory environment.

This will also provide information on the efficacy of currently available vaccines. Additionally, it has built a real-time monitoring system to track hospitalisations and outcomes connected with B.1.1.529. The data will establish if the mutation is related to illness severity or whether it has an effect on the efficacy of therapeutic medications delivered in hospitals.

---

Question 8. To what extent can RT-PCR identify the novel variant?

According to the South African NICD, B.1.1.529 has a mutation in the S gene that enables quick detection of this variation.

As per NICD:

"Although, the majority of other targets (including the N and RdRp genes) are unchanged in over 100 specimens from Gauteng testing facilities, indicating that general PCR test sensitivities is not to be compromised. Typically, these PCR assays identify at least two distinct SARS-CoV-2 targets, which provides as a backup in the event of a mutation in one."

---

Question 9. What safeguards are necessary?

All professional authorities have emphasised the need for immunisation, particularly for individuals at high risk of hospitalisation and death. High vaccination rates also greatly lessen the pressure on health systems, as shown by real-time statistics.

The introduction of the new variation demonstrates once again that the epidemic is far from finished and that COVID-appropriate behaviour is important for breaking the chain of transmission: masks, social distance, adequate ventilation in all common locations, and frequent hand washing or sanitisation.

---

---

Click here to see references

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author is a practising super specialist from New Delhi.