Could Omicron End the Pandemic?

We are now in probably the most intense phase of this pandemic if you look at daily infection cases. Numbers in areas impacted by the Omicron variant are doubling about every 3-4 days and the trend is only accelerating. The variant is highly contagious and seems to evade the antibodies of the vaccine. Numbers have already eclipsed the surge we saw last holiday season and it’s just getting started. But based on recent reports, while Omicron is highly contagious it is not as severe as other variants, leading to the big question – will this be the variant that ends the pandemic?

There is no doubt that this once in a century pandemic has taken its toll on the world, from personal loss to economic hardship. Even more disturbing is how the fight against it has polarized so many over simple things like just asking people to wear a mask to protect others. The stance on pandemic issues taken by government leaders has driven people to one political ideology or another. So, you could probably add that to the list of things the pandemic has dealt us these past two years. But there may be light at the end of the tunnel when you look at several factors associated with Omicron.

What Is Omicron?

Let’s start with its contagious nature. Omicron has a total of 50 mutations from prior variants, 36 of them on the spike protein, the critical juncture point where the virus binds to cells it targets for infection. Based on early analysis of the Omicron variant, the mutations resembled mutations from prior variants that allowed the virus to bind more easily to ACE2 receptors on cells within the respiratory regions of our body. For a better understanding of that, the link above provides a great explanation.

Not only do those mutations allow Omicron to bind more easily to the ACE2 receptors to increase the level of infection, but those mutations also evade the ability for antibodies to bind to the virus to block it from binding to cells. In many cases, those antibodies are a result of vaccines architected to generate a pool of them based on the way the spike protein looked during the original Alpha strain. However, even with the mutations antibodies can still find points to bind to and block infection, just not as effectively as when the vaccines were developed.

Does that mean we need a new vaccine designed for Omicron? That really depends on several factors which I’ll discuss shortly. But let’s talk about the supercharged ability that Omicron has in infecting people. When Omicron was first discovered in South Africa and revealed the Friday after Thanksgiving, 7-day averages had quintupled from 1 per day to 5.47 in just a day on November 23rd. Cases kept rising steadily for the next several weeks, peaking on December 17th at 40.02. Since then, they have been falling, giving rise to a possibility that Omicron has peaked in the country.

The Spread Across the World

Since first emerging in South Africa, Omicron has spread throughout the world and its effects are being seen in astronomic rises in infection rates. For example, in the UK average cases were hovering in the 60-70 cases per day range during November and the first part of December. The variant showed up in the country at the end of November. In two weeks, cases started to rise and by the end of December, they had more than doubled.

In the US, the bellwether for surges seems to always be NYC. Up to the middle of December, average cases had risen to about 40 per day and were slowly rising. Just like the UK, the first cases were reported in the city the first of December. By the third week of December, cases were accelerating at about 70-80% a day. By the end of December, cases had risen to an average of 400 a day, a level never seen in the city during the entire pandemic.

Cases across the nation also rose, albeit a week later than NYC. For example, in AR average cases were at about 30-35 per day just after Christmas. As of the end of December, they rose to 83 a day. The same has been true in states along the East Coast. As we have seen in many surges, those waves will start to move across the nation, especially as people traveled for the holidays. By the middle of January, we will probably see the highest levels of infection in our nation in the history of this pandemic.

Omicron Is Not As Deadly

But unlike the holiday surge at the beginning of 2021, this surge has a different characteristic in that the virus seems to not be as deadly as prior variants, particularly the Delta variant. While there are a number of factors which seem to contribute to the absence of hospitalizations and deaths at the same rate as infections, early data from South Africa and the UK seems to suggest this variant doesn’t impact the body as severely.

New studies seem to suggest that Omicron is very effective at infecting upper respiratory cells, but does not have the same success at infecting cells within the lungs and beyond. After infecting several types of animals with Omicron, scientists found that the level of infection in the nasal passages was the same as other variants, but 1/10th that in lung cells. This is very important because severe cases of COVID-19 occur when infection spreads through the lungs, creating swelling and pooling of fluids. Also, the body often overreacts to those infections, creating cytokine storms of antibodies that can be as damaging as the virus itself.

What scientists are looking at is a particular protein found mostly in lung cells that often help viruses easily gain entry into the cells. However, that protein doesn’t seem to grab onto the Omicron variant as easily, resulting in fewer lung cells being infected. Even with this reduction in severe infections, with the volume of infections occurring people are still being admitted to hospitals, being put on ventilators, and dying. However, this seems to be happening mostly with the unvaccinated. Hospitalizations and deaths rarely seem to be occurring with the vaccinated, even at the rates of infection we are seeing.

The End Of the Pandemic

So, where does this leave us as we move into the fifth surge of this pandemic? Since Omicron evades the antibodies provided by the vaccines, does this mean we’re in for more years of this pandemic? I don’t believe so and I’m finding other experts believe the same. At some point, the pandemic will transition to being endemic as noted by some experts last August. We will never be rid of SARS-CoV-2 and COVID-19. Due to the nature of this virus, it will resemble the virus that sparked the Spanish flu pandemic back in 1917-18.

At some point, the world will have achieved enough immunity through either vaccinations, infections, or both to drive infections and more importantly, hospitalizations and deaths down to reasonable levels. Here are the reasons why I believe this:

  1. Infections will continue to grow and infect most of the population with the Omicron variant. Based on the fact it evades antibodies from vaccinations and prior infections, the population vulnerable to infection has grown significantly. Some experts speculate most of the population will eventually contract the Omicron variant.
  2. The variant is not as severe as prior variants, meaning the public response will be focused more on management rather than containment. As long as hospitals are able to maintain some degree of capacity to deal with severe cases, the nation will focus on managing infections as much as reasonably possible.
  3. Antibodies achieved from the Omicron variant will convey even more immunity to the population, reducing the ability for the virus to spread rapidly. Most likely, this current surge will begin to wane sometime in January. Experts differ on when that will be, but based on prior surges we should see the improving case numbers within weeks. Evidence of that has already been seen in South Africa.
  4. Vaccinations will continue to be the key to management and public acceptance will grow as more people see the results of how those vaccinated are less likely to be impacted by the variant than those not. At some point this coming year, yet another booster will be formulated, most likely designed to combat omicron.

So, a milder virus further contained by vaccinations that spreads rapidly through the nation will build the herd immunity needed to transition to the endemic stage. It will not come without some pain as loved ones will be lost to the disease. Hopefully new therapeutics will provide some level of protection should someone contract the disease.

A lot to think about, but I truly believe the beginning of the end is near.

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