While the recent flare-up of Covid-19 in Shanghai is entering the closing phase, the new coronavirus variant Omicron is sweeping the world, sparking much concern in various academic forums and among the general public. I’d like to share some of my views:
The discovery of Omicron variant is a very urgent matter and is, without a doubt, the result of the virus’ evolution. As the number of Omicron’s mutations is much larger than that of other known variants, the variant is expected to have evolved over a long period in its host. The SARS-CoV-2 virus leads to acute infections, so it can hardly survive or evolve in a body with normal immunity for a long time, nor are there findings of reassortment like influenza. So it is widely believed that this variant has long been carried by and evolved in bodies with immune deficiencies, such as AIDS patients. After coming into being, the new variant spread by circumstance and quickly outpaced the transmission of existing variants, becoming the dominant strain (90%+) among all recently recorded strains in South Africa.
Since Omicron carries a large number of mutations, it seems to have beaten other strains in short-term transmission in South Africa, including Delta. Therefore, the WHO has listed it as a virus of concern (VOC). That is to say, it will be treated with great concern.
But does this mean that the previous global efforts against the pandemic are all in vain? It’s hard to give an answer now. South Africa has not released enough genome sequences, so more data and lab data in the next two weeks are needed before we can make an accurate judgment.
The vaccination rate of South Africa is low, with only 24% of its population fully vaccinated, and a natural infection rate of about 4.9%, which is not enough for building a vaccination- and natural infection-based immunologic barrier. How can we talk about immunological barrier-breaking when there is even no barrier? If this happened in today’s Israel, the global fight against the pandemic would undoubtedly be at risk of starting all over again.
That is also why some countries with a vaccination rate of more than 80%, such as the U.K. and Israel, have tightened their restrictions for incoming visitors. In Israel, in particular, about 50% of its people have been given the booster shot. In other words, in the case of South Africa, once it is confirmed that the strain can break the existing immunologic barrier, we must adjust all vaccination systems and shift to the influenza vaccination mode by developing new vaccines promptly every year according to the virus variants. It means tougher challenges in the future.
According to Reuters, Israel announced on Nov. 27 that it would close its borders and prohibit the entry of foreign visitors in a bid to contain the virus, becoming the first country to close its borders due to the Omicron variant. Amid a potential ban of 14 days for foreigners entering Israel, the country’s Prime Minister Naftali Bennett has urged Israelis to be vigilant, as this variant was a major cause of concern.
While it can be judged that the emergence of the Omicron variant in South Africa is incidental, we still need two weeks to see whether it will threaten the initially established but still fragile immunologic barrier.
Why two weeks? This is because the results of global epidemiological data and data from virus neutralization tests can all come out in two weeks or so. Our team at Fudan University and other peer research teams in China are working concurrently on it. I agree with my friend professor Jin Dongyan, who is a virologist at the University of Hong Kong. He said, “Variants of the SARS-CoV-2 virus have actually been limited to some extent. Generally, many of its variants haven’t survived, and among its surviving variants, only a very few become dominant.” Since the outbreak of the pandemic, at least more than 100 variants have been identified, but only Delta has survived. Beta and Gamma variants, which were previously found with strong immune escape characteristics, have still lost the game on transmission speed with Delta and vanished at last. We’ll have to wait and see. Luckily, it won’t take too much time.
Lastly, what should China do? I believe that China would not be significantly impacted as its rapid response and dynamic zero-tolerance strategy can deal with variants of various types. No matter how the virus mutates, it is still Covid-19. China is now in a strategically advantageous position brought by the dynamic zero-tolerance strategy, as it speeds up efforts to build scientific support for the regular epidemic control in the next stage, including developing vaccines and medicines reserves to support the rest of the world, as well as public health preparedness. With science and solidarity, we are capable of containing Delta, now also Omicron.
Zhang Wenhong is director of National Center of Infectious Diseases and director of Infectious Diseases Department of Huashan Hospital affiliated to Fudan University.
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