A Guide to Navigating All the Noise Around Omicron

(Bloomberg) -- The emergence of the omicron variant took the world by surprise on Nov. 24, and an information vacuum has developed as awareness of the strain currently far exceeds knowledge about it. 

It’s the opposite of what happened with the delta variant, which arrived on the global scene as more of an answer than a question. It explained why India was suffering such an overwhelming outbreak in March 2021 that seemed worse in intensity and scale than anything that came before. By the time everyone knew delta was a problem, it was already wreaking havoc across the world. 

Thanks to South Africa’s early sequencing and immediate disclosure, omicron will play out more like the original wild-type coronavirus that emerged in Wuhan, when no one knew exactly what was going to happen. But this time, the world is watching.  

We want to peer over the scientists’ shoulder in the lab to see whether existing vaccines produce neutralizing antibodies. We want epidemiological data that tracks hospitalization rates and intensive care bed capacity to see if serious infections are on the rise. And as the fight against Covid-19 takes on a new front, we want to know whether delta or omicron is our main foe: which is more infectious -- and more fit. 

Here’s what, who and where to watch for real, authoritative answers in the days and weeks ahead: 

Transmission

It’s critical to know when omicron first emerged to gauge the pace of its spread. Another key question is whether its dominance will carry over to other countries, or if it will go the way of beta and gamma, which caused outbreaks in South Africa and Brazil without spreading widely elsewhere. For now, new cases are most likely to be reported on a country-by-country or state-by-state basis, making it important to monitor regional or global bodies that analyze aggregated information. Broader insights will come from researchers studying the variant and health officials tracking the spread. 

What to watch and who to follow:

• World Health Organization briefings on its Twitter and Facebook pages
• The U.K., whose centralized health system and developed scientific infrastructure has made it a key disseminator of early information on vaccines’ effectiveness in the real world, puts out weekly surveillance reports
• ProMED, a global reporting system on infectious disease occurrences has a track record of being the first to spot new outbreaks
• The U.S. CDC has a section devoted to variant news, while California’s department of public health will most likely say if the country’s first detected omicron case has infected others. Europe, where dozens of countries have detected omicron at the border, will also be able to tell soon how quickly the variant is spreading
• South Africa is the vanguard of understanding how omicron spreads as it’s the only known place where cases are mounting in the thousands. Here are some key scientific figures and bodies to follow on Twitter:
  • Tulio de Oliveira, director of the Centre for Epidemic Response & Innovation in South Africa: https://twitter.com/Tuliodna
  • National Institute for Communicable Diseases in South Africa: https://twitter.com/nicd_sa
  • John Nkengasong, director of the Africa Centers for Disease Control and Prevention: https://twitter.com/JNkengasong
  • Shabir Madhi, vaccinologist at the University of Witwatersrand: https://twitter.com/ShabirMadh
  • Salim Abdool Karim, epidemiologist and member of the African Task Force for Coronavirus: https://twitter.com/ProfAbdoolKarim
  • Ridhwaan Suliman, senior researcher at the Council for Scientific and Industrial Research: https://twitter.com/rid1tweets
• Here are researchers elsewhere known for ahead-of-the-curve insight:
  • Trevor Bedford, scientist studying viruses at Fred Hutchinson Cancer Research Center: https://twitter.com/trvrb
  • Eric Topol, director of the Scripps Research Translational Institute: https://twitter.com/EricTopol

Virulence 

It takes a few weeks before an infection turns serious. Since omicron is so new, most people with it have relatively recent infections and the vast majority of cases are in southern Africa. Tracking hospital capacity and death rates there is likely to give an early indication of how severe omicron may be. However, factors such as widespread natural immunity from previous infections and a concentration of cases in young people may limit how applicable those findings are to other places. Countries that are aggressively monitoring imported cases may provide valuable insight to how the infection progresses. 

What to watch and who to follow:

• Marc Mendelson is head of infectious diseases at Groote Schuur Hospital in Cape Town: https://twitter.com/SouthAfricanASP; Richard Lessells is an infectious disease doctor at Krisp in Durban: https://twitter.com/rjlessells
• The Infectious Disease Society of America’s Covid-19 page has the best and latest guidelines on how to treat infection. Scott Gottlieb, the former FDA director, also has good insight https://twitter.com/ScottGottliebMD
• Virologists and doctors who’ll be able to unpack the threat:
  • Kristian G. Andersen, professor of immunology and microbiology Scripps Research: https://twitter.com/K_G_Andersen
  • Bloom Lab, studying the molecular evolution of viruses: https://twitter.com/jbloom_lab
  • Monica Gandhi, infectious disease doctor at UCSF: https://twitter.com/MonicaGandhi9
  • Brian Hjelle, a virologist and pathologist: https://twitter.com/hjelle_brian
  • Christian Drosten, director of the Institute of Virology at Charite: https://twitter.com/c_drosten
  • Ashish Jha, dean of Brown University School of Public Health: https://twitter.com/ashishkjha

Vaccines

Vaccines were developed using genetic material from the original wild-type virus first found in Wuhan. How well they will stand up to omicron is a critical question. Laboratory tests are underway to see if the antibodies people generate in response to an infection or immunization are effective at blocking omicron. Despite the well-publicized high number of mutations on omicron’s spike protein, hope is not lost: many experts also thought an updated shot would be necessary to corral delta, beta and other worrisome variants, but it turned out that the current vaccines avert severe infection and deaths across known strains. 

The initial lab results will likely be available in the first weeks of December. Knowing whether omicron can break through the protection and turn deadly at high levels could take a month or more. And while antibody levels decline over time, their ability to neutralize variants improves simultaneously. A third dose can bolster levels of these better-quality antibodies, suggesting it may take even longer to know how effective vaccines may be. Academic researchers and pharmaceutical companies are likely to disclose laboratory findings. 

What to watch and who to follow:

• Pfizer Inc., BioNTech SE and Moderna Inc. will disclose findings directly on how their vaccines react against the new strain
• Researchers at academic labs likely to be studying how vaccines react to omicron:
  • Muge Cevik, physician and infectious disease researcher at University of St. Andrews: https://twitter.com/mugecevik
  • Shane Crotty, vaccines and immune system scientist at the La Jolla Institute for Immunology: https://twitter.com/profshanecrotty
  • Linda-Gail Bekker, director of the Desmond Tutu HIV Center: https://twitter.com/LindaGailBekker
  • Peter Hotez, vaccine scientist in Texas: https://twitter.com/PeterHotez

The Next Variant

It’s unlikely that omicron will be the last variant that SARS-CoV-2 will throw off. The virus is constantly mutating, with most of the changes causing mild ripples. Researchers are aggressively tracking the pathogen as it evolves in real time and here’s where the next new variant will be spotted first:

What to watch and who to follow:

• GISAID, a open-source directory of variants worldwide
• The WHO’s page on tracking SARS-CoV-2 variants
• The South African lab that is sequencing many of the omicron cases: The KZN Research Innovation & Sequencing Platform, also known as KRISP

©2021 Bloomberg L.P.

With assistance from Bloomberg