Medically reviewed by Susan Kerrigan, MD and Marianne Madsen
Omicron is very much the new kid on the Covid-19 block. A few weeks ago, when omicron raised its head for the first time, the world panicked. Everyone’s first reaction was to swiftly proclaim that this variant was going to be as punishing as the delta variant–dominant, deadly, and difficult to control. With new information emerging daily, it is unclear exactly where omicron is taking us, but some reviews shed light on the journey.
Omicron in South Africa
South Africa’s huge wave of omicron cases appears to be subsiding just as quickly as it grew in the weeks after the country first announced to the world that a new coronavirus variant had been identified.The SARS-CoV-2 omicron variant of concern (VOC), consisting of over 30 mutations within the spike protein, almost completely replaced other variants in South Africa during November 2021. It was associated with an alarmingly rapid increase in COVID-19 cases.
An early assessment of the variant carried out in South Africa found that the omicron variant seems to have seen a significant decline in hospitalizations and a reduced risk of severe disease when compared to earlier delta-infected individuals. Some of this reduction is likely a result of high population immunity.
Do the vaccines work against omicron?
According to a Cambridge study, the omicron variant of SARS-CoV-2 may be significantly better than previous variants at evading vaccine-induced antibodies. But preliminary evidence also suggests that it is less likely to cause severe COVID-19 illness in the lungs. On average, omicron required around a ten-fold increase in the concentration of serum antibodies to neutralize the virus when compared to delta. Of particular concern, antibodies from the majority of individuals who had received two doses of the AstraZeneca vaccine were unable to neutralize the virus. The data were confirmed in live virus experiments. Reassuringly, however, following a third dose of the Pfizer vaccine, both groups saw a significant increase in neutralization.
According to Professor Ravi Gupta, who was involved in this study, “While further work is needed to corroborate these findings, overall, it suggests that omicron’s mutations present the virus with a double-edged sword: it’s got better at evading the immune system, but it might have lost some of its ability to cause severe disease.”
Dr. Gupta very much advocates for an upsurge in vaccination, and he emphasizes that “omicron still represents a major public health challenge.” He cautions that individuals who have only received two doses of the vaccine–or worse–none at all, are still at significant risk of COVID-19, and some will develop severe disease.
Could omicron signal the end of the COVID-19 pandemic?
Nobody really knows how COVID-19 will end. However, history often plays a role in guiding us toward predicting patterns for the future. COVID-19 has been likened to the Spanish flu pandemic that swept through the world from 1918 to 1920. Perhaps understanding how the Spanish flu ended can shed some light and spark some hope toward the end of the current COVID-19 pandemic.
Reports at the time suggest the virus became less lethal as the pandemic carried on in waves. It is interesting to note that this strain of the flu didn’t just disappear. The influenza virus continuously mutated, passing through humans, pigs, and other mammals. The pandemic-level virus morphed into just another seasonal flu. Descendants of the 1918 H1N1 virus make up the influenza viruses that we are fighting today.
Are influenza and COVID-19 even comparable?
According to the CDC, influenza viruses and coronaviruses are not the same–at all. There’s very little that one can draw from influenza to provide treatment and guidance for the infectious disease named COVID-19.
Influenza is consistent and relatively quick when compared with COVID-19. If a person gets exposed to the flu, they will start to show symptoms within one to four days after becoming infected. According to the Centers for Disease Control and Prevention, it tends to take five days for those infected with SARS-CoV-2 to start showing symptoms of COVID-19, but the timing can fluctuate from two days to two weeks.
However, influenza is a useful comparison when trying to understand the COVID-19 pandemic. As the Spanish flu remained in place, it became less and less lethal. Omicron seems to be displaying the same pattern. Is the world beginning to see a light signaling the end of the worst of the pandemic? Indications are that COVID-19 will not go away completely but will mutate into a more manageable, but still concerning, form of the virus, much like the annual flu.
References
- Early assessment of the clinical severity of the SARS-CoV-2 Omicron variant in South Africa
- mRNA-1273 and BNT162b2 mRNA vaccines have reduced neutralizing activity against the SARS-CoV-2 Omicron variant
- Omicron may be significantly better at evading vaccine-induced immunity, but less likely to cause severe disease
- ‘The 1918 flu is still with us’: The deadliest pandemic ever is still causing problems today
- Similarities and Differences between Flu and COVID-19