Saturday, November 27, 2021

ECDC Initial Threat Assessment Brief On COVID Omicron Variant (B.1.1.529)

 

#16,352

Within hours of the WHO decision to name COVID variant B.1.1.529 `Omicron', and label it a VOC (Variant of Concern), the ECDC has published their initial Threat Assessment on this emerging strain.

As with everything else we've seen published the past couple of days, there remain huge gaps in our understanding of how much of a threat Omicron really poses. But there are enough `red flags' that the ECDC is already warning that the impact from the further spread of this variant could be VERY HIGH.

The ECDC summary, and the link to the PDF report follow. I'll have a brief postscript after the break.

Threat Assessment Brief: Implications of the emergence and spread of the SARS-CoV-2 B.1.1. 529 variant of concern (Omicron) for the EU/EEA
Risk assessment
26 Nov 2021 
 
A SARS-CoV-2 variant belonging to Pango lineage B.1.1.529, with a high number of S-gene mutations compared to the original virus was detected at the beginning of November 2021. On 26 November 2021 the variant was designated a variant of concern (VOC) and assigned the label Omicron by the World Health Organization (WHO).

Executive summary

The variant is characterised by 30 changes, three small deletions and one small insertion in the spike protein, of these, 15 are in the receptor binding domain. This variant was first detected in samples collected on 11 November 2021 in Botswana and on 14 November 2021 in South Africa. As of 26 November 2021, travel-related cases have also been detected in Belgium, Hong Kong and Israel. The Omicron variant is the most divergent variant that has been detected in significant numbers during the pandemic so far, which raises concerns that it may be associated with increased transmissibility, significant reduction in vaccine effectiveness and increased risk for reinfections. As of 26 November 2021, ECDC has classified this variant as a variant of concern (VOC) due to concerns regarding immune escape and potentially increased transmissibility compared to the Delta variant.

Risk assessed


What is the risk associated with the introduction and possible community spread of the SARS-CoV-2 variant Omicron in the EU/EEA?

There is considerable uncertainty related to the transmissibility, vaccine effectiveness, risk for reinfections and other properties of the Omicron variant. However, given its immune escape potential and potentially increased transmissibility advantage compared to Delta, we assess the probability of further introduction and community spread in the EU/EEA as HIGH. In a situation where the Delta variant is resurgent in the EU/EEA, the impact of the introduction and possible further spread of Omicron could be VERY HIGH.

In conclusion, the overall level of risk for the EU/EEA associated with the SARS-CoV-2 variant Omicron is assessed as HIGH to VERY HIGH. Options for response Based on the mutation profile of Omicron, partial immune escape is likely. Due to the uncertainties concerning Omicron immune escape properties, a precautionary approach is important and the timely and urgently reinforced implementation of non-pharmaceutical interventions (NPIs) in the EU/EEA is strongly advised.

Genomic surveillance remains of utmost importance for early detection of the presence of this variant, to enable the following of epidemiological trends and guide containment measures. At this early stage, avoiding travel to and from the known affected areas, as well as increased testing (with sequencing of confirmed cases), and contact tracing of COVID-19 cases with an epidemiological link to the affected areas is strongly advised.

Due to the ongoing active circulation of the Delta variant, EU/EEA countries are urged to give utmost priority towards vaccination of individuals initially targeted by COVID-19 vaccination programmes that remain unvaccinated or not yet fully vaccinated. Countries should consider a booster dose for those 40 years of age and over, first targeting the most vulnerable and the elderly and could then consider a booster dose for all adults 18 years and older at least six months after completion of the primary series.

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Although the Omicron variant has only been detected in small numbers in a handful of countries, it is highly likely it has already established an unrecognized beachhead in many other regions, and we will begin to see increased numbers reported in the days and weeks ahead. 

Right now we don't know how protective the current vaccine is against this variant, but I'd rather face it fully vaccinated than not. We do know that face masks, avoiding crowds, and good hand hygiene can help lower your risks of infection, and should be part of any layered defense against infection. 

While this is hardly the news anyone wanted to hear, we are in far better shape today - with new therapeutics and a better understanding of how to treat patients - than we were in early 2020. Hopefully vaccines - even if they prove less effective - will help mitigate the worst impacts of this new strain.  

Like it or not, Omicron looks like it could be a serious challenger to Delta.  And we must be prepared to meet it.