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Omicron may be spreading fast, but there are signs it's not actually worse than Delta

Hilary Brueck   

Omicron may be spreading fast, but there are signs it's not actually worse than Delta
Science6 min read
  • Early evidence suggests Omicron may be easier to catch than Delta, even for people who are vaccinated and boosted.
  • But that doesn't mean it's a more dangerous variant.

With roughly 50 mutations, public health experts say Omicron's genetics look like a jumbled alphabet soup compared to the coronavirus they first sequenced two years ago.

Some of the mutations look similar to ones we've seen before, in variants including Delta and Alpha. But dozens of new ones have sparked concern: they were found on the all-important spike protein, which our vaccines are designed to recognize.

Still, a picture is starting to emerge of a virus that could be easier to catch, yet less serious.

In fact, some very early research has suggested Omicron may have picked up some seasonal coronavirus genetics, meaning it may have just become more related to some of the other coronaviruses that cause common colds.

And one of the first people to spot this new variant says the world is "overreacting" to Omicron.

"We are suspicious that it might cause a few challenges," Sikhulile Moyo, a virologist at the Botswana Harvard AIDS Institute Partnership, recently told the Associated Press. "But, we also predict that there is going to be protection from the vaccines."

Dr. Anthony Fauci, the US's top infectious disease expert, agrees.

"It almost certainly is not more severe than Delta," Fauci told the AFP on Tuesday. "It might even be less severe, because when you look at some of the cohorts that are being followed in South Africa, the ratio between the number of infections and the number of hospitalizations seems to be less than with Delta."

Vaccinated people are experiencing fatigue and scratchy throats with Omicron

Moyo's lab is believed to be the first to find the new variant in early November — around the same time that scientists in South Africa and Hong Kong were also beginning to discover Omicron.

Now, the variant has been tracked in more than 18 European countries, as well as across various locations within the US, Canada, Australia, Brazil, India, and Japan. The list of infected countries continues to grow, and as scientists' search for the variant intensifies, they're increasingly finding cases with no history of international travel.

In the US, the first documented Omicron case, a vaccinated Californian, experienced mild symptoms. The second, a 30-year-old vaccinated and boosted man who attended Anime NYC, suffered a scratchy throat and some fatigue, the Washington Post reported.

The same types of stories are being shared out of South Africa, where patients are showing fatigue, and flu-like or cold-like symptoms.

"Everyone is looking for the Delta symptoms, and these symptoms are definitely not the same," Dr. Angelique Coetzee, chair of South African Medical Association, and one of the first physicians to discover Omicron cases in that country, told CGTN on December 1.

So, even as the percentage of positive COVID-19 tests in South Africa is shooting up (from 2% two weeks ago to roughly 25% today), virus watchers are cautiously hopeful that its impact will be less severe than Delta's.

Why Omicron seems to be so infectious

There is some evidence, from early case reports, that Omicron may be easier to catch than previous variants.

Two Pfizer-vaccinated travelers, one from South Africa and the other from Canada, may have passed the virus around a Hong Kong quarantine hotel in mid-November, even as they were under strict orders to remain inside their rooms. (Scientists think the virus might've floated from one traveler to the other across the hallway.)

That kind of hyper-infectiousness may be due to Omicron's mutations, which are so unusual that the US quickly designated Omicron as a "variant of concern" — the only variant aside from Delta to receive that designation.

It's true that its diverse set of mutations could allow Omicron to:

  • More easily skirt around the protections people get from vaccines and prior COVID-19 infections, spurring more cases.

and

  • Be more infectious than other versions of the virus we've seen before, by (potentially) making it easier for this virus to get into our bodies.

But just because Omicron has transformed into a potentially more wily virus doesn't necessarily mean it's more damaging than Delta is.

If Omicron is spreading fast without causing severe disease, that's reason for optimism

Generally speaking, viruses should prefer to become more transmissible and less deadly over time — that allows them to keep spreading and surviving.

"Pathogens are pretty predictable — we know what they do: they mutate and they spread," Charity Dean, a former top-tier official at the California Department of Public Health, recently told Insider.

"Ideally, the pathogen mutates to become less virulent but more transmissible, and over time becomes less and less of a threat," she added.

It's starting to look like that could be the case for Omicron, according to early evidence from South Africa. Omicron cases, though they seem less severe, are on a sharp uptick in that country. One preprint suggests a roughly 3-fold greater reinfection risk for those who've already had the virus.

This means reinfection and mild breakthroughs may become far more common with Omicron than they were for Alpha, Beta, Mu, Delta, or any other variant yet.

Take the case of that 30-year-old NYC Anime convention attendee from Minnesota. He'd boosted his J&J vaccine with Moderna in November, according to the Washington Post, and was only mildly inconvenienced by Omicron. The same has largely held true in California so far. Both the very first Omicron case there, and many others since identified have been people under 50, fully vaccinated, who contracted mild illnesses.

Unanswered questions remain for unvaccinated, vulnerable people — including children

Other unknowns complicate the equation.

For example: How will Omicron act in the US, where the vaccination rate, demographics, and even history of people's immune systems is different than in South Africa? How will the unvaccinated be affected? And what about kids?

Fears that Delta would be more deadly for children never really materialized, as infectious disease expert Müge Çevik recently pointed out to Nature. But, the fact that Delta was more transmissible did mean that more kids got sick, and a small number of those children died — more so than in earlier waves of the pandemic.

"Even if it is a mild disease, it's important that we still act fast now to take measures to control its spread, because even if we have a large number of cases that are mild, some of those individuals will need hospitalizations," the World Health Organization's COVID-19 technical lead Maria Van Kerkhove said Sunday on CBS. "More cases can mean more hospitalizations, more hospitalizations could mean more deaths, and we don't want to see that happen on top of an already difficult situation with Delta."

Good news: We are more ready than ever for Omicron

Dean is optimistic that whatever happens, we are more ready for Omicron now than we've ever been.

"Even if we see a worst case scenario from Omicron where it's more transmissible, it's more virulent, and there is a component of vaccine escape," she said, describing her "worst case" bet, "we know how to respond to that, and the medical community, the pharmaceutical companies, the government, the stakeholders are already preparing for that."

Dr. Anthony Fauci, the president's chief medical advisor, said during a briefing Tuesday that early answers on Omicron's threat to our vaccines may be ready by the middle of next week, once more laboratory samples have been analyzed.

The last thing we'll get a "handle on," he says, is how severe the new variant is, even if the "inklings" being gleaned from South Africa now suggest "we are not seeing a very severe profile of disease."

Still, when asked if the coronavirus will, eventually, become a less "lethal" threat during a briefing last week, the doctor didn't hesitate to lay out final terms for the pandemic.

"Absolutely," Fauci said. "I mean, there's no doubt that this will end. I promise you that: This will end."

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