• 14/04/2022
• By wizewebsite
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Covid's omicron will dominate in January or February, it can break the immunity<

Among those infected with the new variant of coronavirus are children from primary school or nurses from the University Hospital Brno. The infection was detected by the Brno University Hospital, which can detect various variants of coronavirus among the samples taken. However, it also performs sequencing in which the infection is confirmed. She first discovered omicron in two of her nurses, then in two children of one of them.

Furthermore, the infection appeared in two pupils of the Adamov school, where the last case has now been confirmed. None of these infected traveled abroad. The first case was a woman from Liberec, the second a man with close contact with this woman.

The omicron variant, which the World Health Organization (WHO) has classified as a worrying type of infectious disease, has been reported as a worrying type of coronavirus for the first time on 9 November in South Africa.

1What do we know about the Omikron variant?

"Omicron is 2 to 3 times more infectious than the delta variant. Infection case numbers in the UK and Denmark, ie in populations that are demographically, infested, and vaccinated in the Czech Republic, double every 2 days. Fifty percent of new cases in London are caused by the omicron variant, "described immunologist Zdeněk Hel.

The Czech biochemist, head of the research group at the Institute of Organic Chemistry and Biochemistry of the Academy of Sciences, Jan Konvalinka told iDNES.cz that he also assumes that it will be the predominant variant by the end of January. "What this will mean for our hospitals or for us is a key question, but we do not know," he said.

"In any case, we know that in South Africa it is already an absolutely predominant variant, which has doubled its presence in the population every two to three days, which is an incredible speed," added Konvalinka.

2Protects vaccination against the new variant?

Immunologist Hel noted that omicron bypassed immunity after vaccination: "Published studies show a 5- to 40-fold reduction in neutralizing activity after the disease or after two doses of Pfizer. The good news is that the booster dose shows significantly better values, namely a 3x reduction in neutralizing activity, "said Hel.

Biochemist Jan Konvalinka sees it similarly. "We know that three doses of vaccination produce a strong enough immunity," he said.

The Omikron variant will dominate in the Czech Republic until the end of January, experts estimate. (15 December) | photo: Twitter Zdeněk Hel

According to Hel, the protective effect of the second dose of Pfizer vaccine is dropping to about 35 percent five months after administration of the omicron variant.

However, he also warned that the new variant more often bypasses the immunity acquired after infection with previous variants of the SARS-CoV-2 virus. "Preliminary data from the UK show three to eight times higher ability to break the immune barrier. Data from South Africa indicate a 4-fold risk of infection, "he warned.

The rapid spread in high-vaccination European countries suggests that vaccine-induced immune responses are also well avoided. Preliminary data from the UK suggest a 3- to 8-fold higher ability to break the immune barrier.

3How many mutations does the variant contain?

The variant is characterized by a large number of mutations with 26-32 changes in the S-protein region. Many of these mutations are found in areas known to be involved in immune escape. "Some of these mutations significantly reduce the ability of antibodies to neutralize the virus by blocking the binding of the spike protein to the target ACE-2 receptor," Hel commented, noting:

"On the other hand, CTL epitopes, ie sites of the virus that are recognized by cytotoxic T-lymphocytes, usually remain unchanged. The T-cell response obtained by previous vaccination or disease should be largely maintained. "

4What will be the mortality rate?

The variant is a serious problem, according to the immunologist, even if its pathogenicity and mortality are comparable to the delta variant.

However, according to experts, there are not enough relevant data at this time to judge whether omicron disease is milder, the same or more severe in immune-naïve individuals than delta disease.

5Who is she dangerous to?

According to Hela, it is likely to cause more frequent infections in people of younger age groups and in children. "It will be especially dangerous for individuals without post-infectious and post-vaccination immunity," he added.

According to the MeSES group, unvaccinated individuals at risk who are not yet suffering from the disease are at risk. Individuals at risk who were vaccinated in one of the first waves in the spring of 2020 have two doses of the vaccine and do not yet have a booster dose. "Unfortunately, vaccine protection in the elderly is declining faster over time, and it is possible that, almost a year later, protection will be insufficient even against the risk of hospitalization," said an interdisciplinary group.

6 Will monoclonal antibodies help?

Monoclonal antibodies from Regeneron and Eli Lilly, which are currently available in the Czech Republic, are not effective against the omicron variant, the immunologist stated. According to him, it can be expected that undergoing the disease and vaccinations can provide a significant level of protection.

However, according to experts, sotrovimab antibodies are also effective against the omicron variant. Sotrovimab is undergoing a rolling review phase by the European Medicines Agency and its launch in the EU can be expected in the near future.

"We recommend ensuring that sufficient sotrovimab is available. Its administration will be crucial in the prevention of severe conditions in patients at risk for age, comorbidities and immune naivety, and can help relieve wave pressure in intensive care, ”said MeSES.

7What will protect a person?

According to the immunologist, the increased degree of protection is likely to be provided: past delta infection in the last three months, a booster dose of vaccine administered in the last three months, or hybrid immunity acquired through disease and vaccination, in any order.

8What do we not know about the new variant?

To what extent will a previous infection or vaccination reduce the likelihood of a severe illness and the need for hospitalization.

Experts also question whether the variant is more or less pathogenic than delta: "We will get this information when data is available to a sufficient number of people. As I stated earlier, we do not yet have reason to believe that the omicron variant would be significantly less pathogenic than delta, "said immunologist Zdeněk Hel.

At the moment, therefore, experts are not sure how this variant from South Africa will actually behave: whether, like the previous ones, it will overwhelm hospitals and intensive care units, or whether its course will have milder consequences.

"The results we have are based on laboratory experiments," says biochemist Jan Konvalinka. "We know that two doses of vaccination will not produce antibodies that are effective enough to inactivate the virus, that's bad news. But we know that three doses of the vaccine, if the person was recently vaccinated, creates strong enough antibody immunity to inactivate the virus in tissue cultures. "

9: Recommendations for the next months?

According to MeSES, it is already necessary to prepare for the need to introduce additional anti-epidemic measures necessary for the "flattening" of the wave and its continuous braking, and to take them into account before the end of the year or in the first weeks of 2022.

"Many of the problems associated with the large wave of omicron cases are linked to the lack of medical staff, which needs to be strategically distributed among test sites, vaccination sites and hospitals. We recommend prioritizing steps that will enable capacity to be replenished by professional but non-medical staff, "said the MeSES group.

In many scenarios, almost complete congestion of the PCR test capacity and tracing system is likely as the omicron wave progresses. Therefore, PCR tests will need to be prioritized so that their use will bring maximum benefit, the group further recommended. It also recommends thorough comprehensive testing of all pupils, students and staff at the beginning of the new year before returning to class and work teams.

10Possible scenarios?

The necessary anti-epidemic measures can be roughly arranged according to which type of scenarios will be fulfilled, the interdisciplinary group pointed out.

Estimation of the need for new hospitalizations (in the interval of 14 days at the time of the peak of the wave) according to the virulence of the omicron variant and the immune status of the population. | photo: MeSES

Yellow scenarios - Make the most of cheap measures that can slow down the omicron without costly area restrictions. Even in this case, without an extreme number of hospitalized, the expected wave of threats to businesses, schools and disease threatens due to a wave of illness concentrated in a short period of time.

Specifically, MeSES recommends:

Orange Scenarios - Everything recommended in yellow scenarios. In addition, comprehensive contact reduction by reducing the most risky environments and events. (Opening hours restrictions, event size restrictions, collection restrictions, meeting restrictions. Possible exceptions: allow on-site test actions).

Red Scenarios - All that is recommended in yellow and orange scenarios. In addition, other area measures.

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