How worried should we be about Omicron, the new coronavirus variant?

CNN

By Katia Hetter, CNN

Since South African authorities announced the arrival of a new coronavirus variant that contains an unusually large number of mutations, countries around the world have mobilized by putting into place travel restrictions and precautionary measures.

There is much that’s still unknown about this variant, Omicron. While scientists are gathering more information, the public wants to know how worried they should be.

Is the alarm around Omicron warranted? What’s already known, and what are the key pieces of information still to be researched? Are there things we can do to prepare for it?

I discussed all of this with our expert, CNN Medical Analyst Dr. Leana Wen, who is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of a new book, “Lifelines: A Doctor’s Journey in the Fight for Public Health,” and the mother of two young kids.

CNN: What raised alarms for scientists about Omicron, compared to other variants?

Dr. Leana Wen: With new variants, there are three key questions to ask. First, is it more transmissible? If it’s more contagious, it could displace existing variants and become the dominant strain. This is what happened with the Delta variant.

Second, is it more virulent — could it cause more severe disease? If so, that’s obviously very concerning.

Third, is there what we call “immune escape,” meaning does it evade the protection of existing vaccines? The vaccines we have are highly effective against the variants that have already been identified. It’s unlikely that a new variant will render the vaccines totally ineffective, but there could be reduction in efficacy.

In the case of Omicron, what initially raised alarms for doctors and scientists in South Africa was the rapid rate of spread of this new variant. It appears to be outcompeting Delta in speed, but whether it will force out Delta and become dominant remains to be seen.

In addition, the large number of this variant’s mutations — over 50 in all — raises the question of immune escape, both to vaccines and treatments like monoclonal antibodies.

These are types of information that we will need to obtain through further scientific studies.

CNN: What else are researchers looking for, and how long will it take to find this information?

Wen: We need to answer all three questions above. Right now, we suspect this new variant is more transmissible, but that needs to be confirmed. Also, we have no idea about the severity of disease that Omicron causes. This is something we may get more information about in the coming days by tracking the clinical outcomes of the initial individuals found to be infected in southern Africa.

Studies are already ongoing to examine whether the antibodies produced by the vaccines will have an effect against Omicron. Dr. Anthony Fauci and others estimate that these studies will take about two weeks to come back.

There are other key facts that we will find out in the coming days and weeks. Many vaccine researchers believe that those who have received not just the vaccine but the booster will have a very strong antibody response that could cover additional variants. We’ll find out whether this is the case by assessing laboratory data and at real-life observations to see if people who are vaccinated and boosted are less likely to be infected with Omicron. In addition, we don’t yet know the degree to which recovery from prior Covid-19 infections could protect against Omicron.

There’s also the issue of testing and therapeutics. It appears that the PCR tests can readily detect Omicron. Can at-home, rapid antigen tests do this, too? Preliminary review by the Food and Drug Administration suggests they can. Will monoclonal antibodies, as well as the new oral Covid-19 pills, work against Omicron? Scientists are hard at work to find out answers to these questions.

CNN: If there is so much that’s unknown about Omicron, aren’t countries overreacting by implementing restrictions?

Wen: I don’t think so. For so much of the pandemic, we have been playing catch-up, reacting to things that happened instead of proactively preparing. Maybe Omicron will turn out to be a false alarm. Maybe this variant doesn’t spread that easily, or doesn’t cause severe disease, or doesn’t have immune escape. I hope this is the case, but hope is not a strategy.

From a policy perspective, I believe that governments need to prepare for a worst-case scenario. That means alerting clinicians to the possibility of omicron so they know to look for it, preparing hospitals for potentially added capacity, and instructing citizens on what they can do to better protect themselves. President Joe Biden has, for example, urged all adult Americans to get booster shots, and the US Centers for Disease Control and Prevention has changed their recommendation so that everyone 18 and older should get boosted.

CNN: Does preparing for the worst also include developing new vaccines that target Omicron?

Wen: Moderna and Pfizer have announced that they are already looking at Omicron-specific vaccines. In general, it’s a good thing to be proactive and start this kind of research. My hope is that we will find the vaccines we already have are effective enough against Omicron, especially with the additional protection of the booster dose.

CNN: What do you say to those who are losing hope, who see Omicron as setting us back to square one?

Wen: We are not starting over. Far from it. There is a lot that’s different now versus the beginning of the pandemic. We have vaccines, testing and therapeutics. We have infrastructure in place to respond to this variant and future variants. That said, we still need to be on guard and be prepared to deploy the tools we have.

CNN: Many people have travel plans. Should they postpone them?

Wen: If you have international travel plans, I advise you to consider that things are very fluid right now. With so many countries instituting travel bans or additional restrictions, you could end up stuck somewhere in mandatory quarantine or without easy flights out. People who are particularly vulnerable to severe illness might also want to postpone trips, especially with so much unknown about Omicron.

That said, if you are fully vaccinated and boosted, and it’s important for you to take the trip, you could still decide to do it. Make sure to check the guidelines for the location you are visiting and your country of origin, and be prepared to change your plans depending on the dynamics of the virus and various government policies.

CNN: Are there things that people can do to prepare for Omicron?

Wen: Know that the same measures that protect against other variants also protect Omicron, in that this is still Covid-19, a respiratory virus. Indoor masking, physical distancing and improved ventilation will reduce the likelihood of spread.

Federal health officials are strongly urging booster doses. Individuals who are unvaccinated should get vaccinated as soon as possible. That includes children who are newly eligible for the vaccines. Those who have been vaccinated and are at least six months out from Pfizer or Moderna or two months out from Johnson & Johnson need to get their booster shots.

We have gone through so much together and made tremendous progress. We can get through this next stage of the pandemic, too, including with this and other variants.

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