New York- Travel bans and other snap defenses that countries threw up against omicron, the new Covid-19 variant, are buying time for scientists to answer key questions that could prevent another wave of deaths.
Labs in Europe, the U.S. and Africa are preparing for tests to see how the new variant is likely to behave in people who’ve been vaccinated or previously infected. Real-world research will be important too, as health authorities monitor the outbreak in South Africa closely to find out how much more transmissible the new variant will be as it spreads and whether it’s more dangerous or deadly.
The questions will take weeks to answer, scientists and policy makers said Friday. The search for understanding starts in the variant’s dramatic pattern of 50 mutations, more than 30 of which are on the virus’s spike protein, which is the weapon Covid-19 uses to invade victims’ cells. It will continue via lab work and finally in observations of illness and transmission patterns in real life.
What’s clear so far is that a constellation of mutations has come together that may make omicron spread more quickly, said Wendy Barclay, head of the department of infectious disease at Imperial College London.
“Taken together on paper, it’s very biologically plausible that this virus has increased transmissibility,” Barclay said in a briefing Friday. Researchers must apply the knowledge they’ve gained in more than a year of intense study of the virus, she said. “That’s where you start, and then you try and back up that sort of approach by looking at the epidemiology and the laboratory-based studies.”
Wily Virus
The first job of a virus is survival in its hosts, and nature has programmed them to shift shapes. SARS-CoV-2 has been mutating and changing since it was first identified, with the first variant of concern — alpha — designated in December 2020. Omicron, previously known as B.1.1.529, is the fifth variant of concern the World Health Organization has named.
Omicron may have a growth advantage over the others, however, because it’s been found at faster rates than in previous surges, the WHO said on Friday. It may also pose a greater risk of reinfection than other variants of concern, the WHO said.
There are hints in omicron’s spread in South Africa that it may be more transmissible, said Sharon Peacock, a professor of public health and microbiology at the University of Cambridge who also heads the Covid-19 Genomics U.K. consortium. “When the Ministry of Health saw the numbers were doubling every day, the question that they asked was, ‘Well, where are these cases coming from?'”
Those questions and the quick surveillance by South Africa and its neighbors may have put the rest of the world in a position to buy more time than was possible when the delta variant was emerging in India, said Jeffrey Barrett, director of the Covid-19 Genomics Initiative at the Wellcome Sanger Institute in the U.K.
“They found this, understood that it was a problem and told the world extremely fast,” Barrett said. “It took many, many weeks into India’s extremely terrible wave before it became clear what was going on, and by that point delta had already seeded itself in many parts of the world.”
Knowledge Sprint
The impact the new variant will have on vaccines could become clear relatively soon. BioNTech SE, which works with Pfizer Inc. on the world’s best-selling Covid vaccine, said it’s beginning lab studies on the variant and should have the first data on how it interacts with the vaccine within two weeks.
BioNTech and Pfizer have long promised that they’ll be able to roll out a new version of their vaccine within 100 days if necessary.
Moderna Inc. is also studying how well its current vaccine booster dose neutralizes omicron, with data likely in the coming weeks. The company said on Friday that it is also working on a high-dose version of the booster, new multivalent boosters and a new booster specific to omicron. Moderna said it is typically able to get new experimental vaccines into testing in 60 to 90 days.
Mutations may also help omicron elude the antibody treatments, such as Roche Holding AG and Regeneron Pharmaceuticals Inc.’s Ronapreve, that have become a mainstay of therapy for people who can’t muster an adequate immune response on their own, ICL’s Barclay and other scientists said.
Roche’s researchers are studying the new variant, said spokesman Karsten Kleine, and it’s too early to say how it will interact with the antibody cocktail.
GlaxoSmithKline Plc, which markets a Covid antibody with Vir Biotechnology Inc., said it believes its antibody will probably work against the variant because it targets part of the spike protein that’s shared among many different, distantly related coronaviruses. The company is working urgently to confirm that in the lab, it said in a statement.
Antiviral Arsenal
Even if the new variant resists vaccines and monoclonal antibodies, doctors won’t be out of weapons.
Antivirals such as the experimental pill being developed by Pfizer Inc. will probably still work, Barclay said.
That’s because of the way those pills act in the body. Instead of targeting the virus’s spike protein, as vaccines and other treatments do, they attack in different way to prevent the virus from multiplying. That makes the new variant’s spike-protein mutations less likely to resist the pills.
“There are no mutations that would signal a change in susceptibility,” Barclay said.
The antivirals aren’t approved for use yet. Pfizer on Nov. 16 filed for an emergency-use authorization for the medicine in the U.S.; a similar review began in the European Union three days later.
A second pill, from Merck & Co., ran into a hurdle after trial results showed it was less effective than had been thought. The U.S. Food and Drug Administration staff raised questions about whether it could cause birth defects, bone and cartilage toxicity and genetic mutations. A panel of FDA advisers will meet Tuesday to review the pill. (Bloomberg)
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