fear For festivus
As our holiday season began Thanksgiving dinner was marked with the arrival of a new and unwelcome guest. The omicron variant knocked the turkey right off the table and made sure you were aware of its presence. News of the omicron spread around the world overnight faster than Santa. Starting in South Africa a press conference from the Minister of Health who would announce a new variant that would present “challenges” moving forward. That evening headlines would document the fifty mutations that the omicron variant had and point out that many of these mutations could be found on the spike particle, the scariest part of the virus. International travel restrictions would follow as the world felt a collective sense of dread and Deja vu. Financial markets would tank with their biggest drop of the year and ironically within twenty-four hours of the travel restrictions the variant was discovered in the Netherlands, Germany, and England. The panic first principle was in full effect.
The WHO has several designations for variants that act as a sliding scale. The lowest is the variant being monitored (VBM) and these include alpha, beta, gamma, eta, iota, kappa, lambda and any other variant not named delta or omicron currently. Next is the variant of interest (VOI) there currently are none in that category. Climbing the ladder, we arrive at a variant of concern (VOC) which contains both delta and omicron for now. At the top but with no examples yet would be variants of high concern (VOHC). As the variant emerges it is placed into one of these four tiers based on WHO criteria, and as time passes it may move down the scale. Epsilon for example is the only variant to have been a VOC, VOI, and now a VBM. If you think the full court fear mongering was bad thus far just wait until we hit a level four variant (VOHC).
Viruses being simple strands of RNA with a high error rate constantly walk the line between mutating themselves to death and simply mutating enough to gain an edge. It mutates so much that even thinking of the virus as a single species or one variant or another does not do justice to the phenotypic diversity it expresses. Viral quasispecies may be the best way to imagine covid, a mutant swarm with dominant variations winning out. Autopsies have demonstrated different strains being dominant in different tissue from the same host. Virus variants are competing against one another for survival and for them the most transmissible wins, thus as variants have evolved the most successful ones have been more and more transmissible. Fears of increased death or hospitalizations seem misplaced since no previous variant has been more virulent as of yet. Since a more virulent virus is likely to be less transmissible by nature that should bode well for both humanity and the virus.
Despite the media panic omicron has not delivered and weeks out from its discovery we don’t have a single death associated with it as of yet. Early data indicated that it may cause less severe symptoms and shorter hospital stays, this appears to be holding up as it spreads across the world. The best way for this virus to transmit faster is to cause less problems for the host, not more. Unfortunately, more transmissible still means more infections thus more mutations leading to the next variant. Pi would be next unless they skip that one because it does not sound very threatening. Despite their mutations these are still coronaviruses and many of our current treatments and the new oral therapeutics will likely remain effective.
Merry Christmas and thank you for reading!
Jacob Hyatt Pharm D.
Father of three, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
https://substack.com/discover/pharmacoconuts
Bitcoin GtjoZgxE7WpTkWRE6JiEiXfUpqbWKxH4g
Litecoin ML1N31UVz6sRfo2m2oLaorXgPexUtv3Q3t
Further Reading and References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639363/
Vaughan A. Omicron emerges. New Sci. 2021;252(3363):7. doi:10.1016/S0262-4079(21)02140-0
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135314/
Domingo E. Quasispecies and the implications for virus persistence and escape. Clin Diagn Virol. 1998;10(2-3):97-101. doi:10.1016/s0928-0197(98)00032-4
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172439/
Ojosnegros S, Perales C, Mas A, Domingo E. Quasispecies as a matter of fact: viruses and beyond. Virus Res. 2011;162(1-2):203-215. doi:10.1016/j.virusres.2011.09.018
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797082/
Domingo E, Perales C. Viral quasispecies. PLoS Genet. 2019 Oct 17;15(10):e1008271. doi: 10.1371/journal.pgen.1008271. PMID: 31622336; PMCID: PMC6797082.
Chen J, Wang R, Gilby NB, Wei GW. Omicron (B.1.1.529): Infectivity, vaccine breakthrough, and antibody resistance. ArXiv [Preprint]. 2021 Dec 1:arXiv:2112.01318v1. PMID: 34873578; PMCID: PMC8647651.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8640673/
Karim SSA, Karim QA. Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic [published online ahead of print, 2021 Dec 3]. Lancet. 2021;398(10317):2126-2128. doi:10.1016/S0140-6736(21)02758-6
