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Is omicron more aggressive? Do vaccines work? 10 essential questions about the new variant that puts the world on alert

No; the fact that the omicron variant accumulating dozens of mutations does not automatically make it more aggressive or lethal; and current vaccines, which can be quickly and easily redesigned, remain one of the best weapons to combat the pandemic of coronavirus, but not the only one.

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The researcher Isabel Sola clarifies in an interview with EFE ten essential doubts about the new variant of coronavirus responsible for covid-19, which has been detected in South Africa and it has spread to at least fifty countries.

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Isabel Sola works at the National Center for Biotechnology of the Higher Council for Scientific Research and co-directs the coronavirus group at this center, where she leads, together with Luis Enjuanes, one of the groups seeking a vaccine against SARS-CoV-2.

1.- The new variant presents dozens of mutations with respect to the original virus. Does the evolution of this coronavirus surprise the scientific community or is it the foreseeable evolution?

ANSWER.- That the virus changes is perfectly to be expected, but this variant has accumulated more mutations than others, and we wonder why; It is speculated that South Africa is a country where there is a high incidence of the Human Immunodeficiency Virus (HIV) and many people with a deficient immune system. Under these conditions, the virus has been able to evolve more freely. With a stronger immune system, the virus changes less.

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2.- Does the fact of presenting many more mutations than other previously detected variants automatically make it more lethal or virulent?

A.- You don’t have to. More changes have appeared. That means the virus has had more freedom to change, and those mutations give the virus an advantage. But some of those mutations can be neutral, and not lead to any behavioral change. Others can, yes, lead to a change in behavior, but it does not have to be more virulent; and it would even be possible for the virus to become attenuated and lose virulence. Attenuation is a fairly logical possibility in the evolution of a virus.

3.- Are the current surveillance and control measures (epidemiological surveillance, diagnostic tests, etc.) sufficient to control the evolution of this new variant?

A.- At the moment, caution. The non-pharmacological measures that we already know (mask, hygiene, distance or ventilation) are effective against any variant. Vaccines may remain effective as well. Now it is time to be cautious, and it is convenient to maintain vigilance to see how the virus behaves, how it breathes.

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4.- Is the alert and alarm reaction that has been unleashed in many countries in the face of this new variant from a scientific point of view?

A.- Yes, because the virus has changed and you have to know what these changes translate into. You have to think that any change that occurs in a virus is because the virus is good for it. One might think, it is a possibility, that the virus is going to be transmitted better. For now, and before that, be careful, alert, and your guard up high.

5.- Can it be maintained that the vaccines against covid-19 that are being administered are effective against the new variant?

A.- It is already being verified in the laboratories; what is done is to catch this virus and confront it with the serum of people who are already vaccinated to see if the antibodies that the vaccines induce continue to neutralize well and eliminate the virus. I would say that with the mutations that the virus already has, it could be that the effectiveness of the vaccines would decrease somewhat, but that it does not lose it completely and is similar to the one we have now, but they are conjectures, because we must be based on the experimental results that they are already being done. And that would not mean that vaccines no longer work, because immunity is antibodies and more, but they would already give us a very good idea of ​​how the virus can escape the immunity that we already have.

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6.- Can a vaccine be redesigned in a short time and mass-produced to better cover any variant?

A.- Yes. They are vaccines that are made using biotechnology and the changes are relatively simple. Then there is the question of what the regulatory agencies are going to require for this change. The flu vaccine formulation is changed every year without the need for repeat clinical trials. It is directly reformulated and produced.

7.- Should a redesigned vaccine go through the same testing phases and processes to obtain the same authorizations as the original vaccine?

A.- It will be necessary to see what the attitude of the regulatory agencies is, and if they directly accept the reformulation, in which case there would be massive vaccines in a few months, or if they require some type of trial.

8.- Having shown that the air is the main route of contagion of the virus, would it make sense to reinforce preventive measures in this regard or to recover some of the measures that have been relaxed in recent months? (mandatory use of masks, gauges, etc.).

A.- I think that it is necessary to recover non-pharmacological measures; not only because of this new variant, which we do not know how it will behave, but simply with the “delta” variant, which is the one that is circulating, we are verifying the incidence in many countries. Although people are being vaccinated, it is not enough. It is necessary to recover, if we want to maintain control of the situation, those non-pharmacological measures, and more so now that meeting dates, parties, celebrations are coming, which make us change our behavior. As long as the virus continues to circulate, these measures cannot be abandoned. Vaccination is important, but it is not enough. We cannot risk everything to one card, that of vaccination.

9.- Does it make sense to continue advancing in vaccination in the most developed countries (third and fourth doses) while in the poorest countries and continents the rates are so low?

A.- It is essential to face the problem of having a universal vaccination, because in countries where vaccination is very low, the virus can reactivate and new variants appear. It is necessary to reach a point of equilibrium, in which the most developed countries, where there is almost unlimited access to vaccines, are used in a rational way. There are groups in which it may be necessary to give third doses (older people or more vulnerable people) but perhaps it is not necessary to extend third and fourth doses to everyone, and those doses should be distributed more equally. You have to look beyond borders, because no one is going to be protected until everyone is.

10.- Does it make sense to continue talking about “herd” (or “herd”) immunity to the proliferation of new variants or is it a concept that no longer makes sense?

A.- It is a concept that must be taken in a relative way. It is not a magic number that when it is reached guarantees us absolute protection and forever. The more people are vaccinated, the more obstacles the virus will have to transmit itself and that allows better control of its impact on public health. To defeat the virus, the more people we are vaccinated, the better, and we have already verified that the greater the number of people vaccinated in a country, the lower the number of people hospitalized or deaths. That magic number would make sense if vaccines gave us one hundred percent immunity for life, and it was also a sterilizing immunity, but it is not the case.


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