All Eyes on South Africa for Omicron Research

ADF STAFF

Since South Africa first detected the omicron variant, the eyes of the world have been on the nation to see what the next development may be in the global pandemic.

Data coming out of the country is critically important for the international study of omicron’s symptoms, lethality, positivity and hospitalization rates.

First reported to the World Health Organization (WHO) on November 24, omicron has a significant number of mutations — at least 32 to the spike protein alone. Most research is focused on assessing the variant’s transmissibility and virulence.

“Omicron is spreading at a rate we have not seen with any previous variant,” WHO Director-General Tedros Adhanom Ghebreyesus said in his December 14 briefing. “We’re concerned that people are dismissing omicron as mild.

“Surely, we have learned by now that we underestimate this virus at our peril. Even if omicron does cause less severe disease, the sheer number of cases could once again overwhelm unprepared health systems.”

It did just that in South Africa.

Omicron’s discovery caused immediate concern because it corresponded with a strong surge of cases in the heavily populated Gauteng province.

Dr. Richard Lessells, an infectious disease physician at the University of KwaZulu-Natal in Durban, told the Center for Strategic & International Studies about the early alarm bells that followed South Africa’s diagnostic laboratory reporting and genomic sequencing.

“We’ve been tracking this virus from the very beginning and picked up variants before,” he said in a podcast. “The sequences came out, and clearly they looked very abnormal.

“They looked very different from what we had been seeing with delta. It was an extraordinary number of mutations, much more than we expect at this stage in the pandemic.”

Nationwide, COVID-19 cases peaked in mid-December, including a new daily record 37,875 cases reported on December 12.

But the sharp rise in cases was followed by a sharp decline.

Early December data in Gauteng, showed 8% of hospitalized COVID patients were treated in intensive care units, down from 23% during the delta wave. Just 2% were on ventilators, down from 11%.

Like many experts, however, Lessells warns not to jump to conclusions that omicron features less severe symptoms. That could be more a result of previous immunity to COVID-19 than the possibility the virus is evolving to become less virulent, he said.

Blood studies in early December showed that more than 70% of South Africans had been exposed and had some immunity to COVID-19. By December 23, that number rose to 80%.

“It’s clearly highly transmissible,” Lessells said. “It’s spreading very efficiently in a population that we have good evidence has high levels of immunity to previous versions of this virus.”

But the central question remains — how dangerous is omicron?

Ongoing laboratory and field studies and analysis of surveillance data will take time and international collaboration. Experts are focusing on whether omicron affects T cells, which are essential to the body’s immune protection against severe disease.

“It is really too early to tell,” Lessells said. “I’m hopeful and optimistic that because we have more tools available than we had last year, we’re in a better position to deal with these variants.”