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Comments overnight by Moderna CEO Stéphane Bancel that current vaccines could `struggle' to protect against the Omicron variant are hardly unexpected given the number of mutations in the spike protein, but have roiled global markets this morning with the DOW futures down 400 points at this writing.
That, combined with reports from additional countries reporting the Omicron variant (e.g. Japan, Sweden, Spain, etc.) - and the closure of some borders - has sent a chill through the markets as investors weigh the possibility of seeing a repeat of the global shutdown of March 2020.
After the emergence of a game changing variant in December 2020 (Alpha), followed by Delta late in the spring of 2021, the recent debut of Omicron shouldn't have come as a surprise to anyone. Scientists have warned repeatedly over the past year that the emergence of a vaccine resistant strain was inevitable.
Last July, in UK SAGE: Can We Predict the Limits of SARS-CoV-2 Variants and their Phenotypic Consequences? UK's SAGE (Scientific Advisory Group for Emergencies) on COVID released a series of detailed reports on where COVID was likely to go in the months ahead.
Among the scenarios considered:
Scenario Two: A variant that evades current vaccines.
This could be caused by:
3. Antigenic ‘shift’: Natural recombination events that insert a different spike gene sequence (or partial sequence) from human CoVs MERS-CoV (highly unlikely due to the low frequency of MERS-CoV infections), or from currently circulating endemic human CoVs (more likely due to the prevalence of these viruses). This would recombine into the ‘body’ of SARS-CoV-2 that is capable of high replication in human cells. The consequence could be a virus that causes disease at a level similar to COVID-19 when it first emerged but against which our current battery of spike glycoprotein-based vaccines would not work.
Likelihood: Realistic possibility.
Impact: High for a completely new spike, medium/low if a spike from a seasonal CoV is introduced since we expect a proportion of the population to have antibodies to these endemic viruses.
Also last July, in Nature Scientific Rpts: Rates of SARS-CoV-2 Transmission & Vaccination Impact the Fate of Vaccine-resistant Strains, we looked at a model that warned specifically of the dangers of relaxing NPIs (face masks, social distancing, etc.) during the vaccination phase of the pandemic.
There's no evidence, of course, that maintaining the hugely unpopular NPI policies throughout 2021 would have averted the emergence of Omicron, but this does speak to the known risks of seeing another challenging variant emerge.
Despite the (probably accurate) assessment by Moderna's CEO that vaccines will have to be tweaked to deal effectively with the Omicron variant, our current vaccines may still provide some (possibly substantial) protection against severe illness, and death.
Probably not as robust as against Delta, but we'll have to wait for the data before we know.
But even a modest attenuation in the severity of infection would make getting the vaccine worth it, and while I'd love a guarantee, I'm happy I'm going into this winter as protected as I can be. I never stopped wearing face masks in public, and avoiding crowds when possible, and that is certainly not going to change anytime soon.
There are substantial challenges ahead with Omicron, and there are no guarantees that something even more formidable isn't in the wings.
We may discover that Omicron is a milder variant, at least in terms of causing severe illness or death. Or that those outcomes are reduced by the vaccines. But we can't depend on that. Until we know, we need to assume it is at least as virulent as Delta.
I called my friends and family over weekend and urged them to resume wearing face masks, avoiding crowds, and to get vaccinated against both COVID and flu. I've also suggested they prepare for supply chain problems due to increased travel restrictions.
While this may feel like March of 2020 all over again, it really isn't.
We have vaccines that are likely to be at least partially effective, and new formulations (if we need them) aren't 8 months away. We know a lot more about treating - and preventing - COVID than we did 20 months ago.
We have the tools, and the knowledge, to substantially blunt Omicron's impact.
We just have to be willing to use them.
