"Omicron" explained in 4YourInfo by LION1105
Welcome!
Today we're going to talk about a new variant out of South
Africa called omicron by the world health organization.
Its official name is b1.1.529 and it was discovered initially on November 11th now this is based on full sequencing of the genome of this sarskov2 virus and it's based on over a hundred sequences meaning that they fully sequenced at least 100 subjects to find out the entire genome of this particular variant and these sequences have been found in primarily the countries in the south African area of Africa but also have been seen in Israel, Hong Kong and Belgium and while originally found in these countries they have now been discovered in other countries including Italy, Germany, France and based on previous experience with delta it's safe to assume that it is likely already circulating in other countries as well and the concerning thing about this particular variant is that it has several mutations more mutations than we've seen in a virus that is now starting to increase in terms of prevalence in the areas such as South Africa and where it's being detected currently.
I think it's worthwhile to review again how these mutations are actually occurring so here we have a SARS kovi to the viral particle that infects a human being and what it does is it reproduces itself inside of that human being and it's well known that in a single human being there can be up to a billion to a trillion different copies of the SARS kovi 2 virus the problem is that the replication of this virus is not perfect and so there may be mutations even a few mistakes means that they're going to be variants that are made inside the human being and these mistakes or these mutations mean that different amino acids are going to be inserted in these proteins and these proteins are going to have slightly different shapes and most of the time these shapes mean nothing they don't enhance the ability of the virus to infect or to replicate any better than the original copy but occasionally you're going to get a mutation and amino acid substitution that's going to mean a different protein that's going to be an improvement in terms of infectivity on the previous original version they may or may not code for different proteins and that means it looks different specifically to the immune system it may also look different based on the receptor and as we know the spike protein which is this pink protein on the surface of the viral particle interacts specifically with the ace2 receptor and the ace2 receptor is a protein receptor on the surface of our cells mainly found in our gi tract in our respiratory tract and our vasculature and so mutations in the spike protein may be consequential in terms of helping binding or inhibiting binding depending on the mutation it's also the area by the way that is the interactive aspect of where the antibodies that are produced in the human body will interact and potentially neutralize the sars cov2 and when I say neutralize I mean preventing the sars cov2 virus from infecting human cells so the problem is that when these viral particles are produced they may have slightly different properties they may have slightly different proteins on the surface either inside the viral particle or outside the viral particle and so there may be a slight mutation on the tip of that spike protein and so there are three major areas that we can divide this viral particle up into there is the virus itself and you can have mutations anywhere within that viral a particle that can produce a different protein there is the spike protein which is specifically this entire spike protein on the surface and then there is the very tip of the spike protein which is known as the receptor-binding domain and that's a very important area on the virus particularly because that's where our immune system is going to recognize the SARS cov2 virus so after the replication process occurs over and over again in the human body there are going to be mutations that are made and if those mutations are advantageous in other words if those mutations change the proteins in areas that make it either easier to bind or able to avoid the immune system that can give the viral particle an advantage of survival and also transmission and that is the concern here with what is going on currently in South Africa and around the world so what I want to do to demonstrate what's going on with these variants of the SARS cov2 viruses we're going to look at the alpha variant the delta variant and this new variant called omicron and what we're going to do is look at the number of mutations in these variants compared to the original virus so the alpha variant was one of the first variants and the number of mutations in the alpha were 23. in terms of the delta variant it was 17.
This one omicron has about 50 different mutations so in terms of the spike protein which determines transmissible and also the effectiveness of vaccines the alpha variant had nine mutations the delta variant had seven and what we're seeing in omicron is about 32 mutations that we see now specifically in the receptor-binding domain which is that tip of the spike protein which is very important alpha had one mutation there delta had two mutations and the omicron variant that we're seeing now has 10 mutations so that gives you an idea about just the amount of mutations that we're seeing now in this variant which is quickly outpacing even delta in places like south Africa and so what scientists are trying to grapple with right now are these three questions regarding this new variant is it more transmissible in other words what is the transmissible of this virus and that has to do with how well does it spread from person to person currently, the delta variant is fairly transmissible I mean there are some viruses that are more transmissible than the delta variant and that would be like measles but that's extremely transmissible the question is how transmissible is this variant and number two what about vaccine evasion how well does it evade the ability of the vaccine to work and we're going to have to break that down into different aspects in other words how easily is the virus able to infect somebody who's vaccinated how easily is the virus able to be transmitted to another person from somebody who's vaccinated and what is the protection of the vaccine in terms of keeping people out of the hospital all of those are questions that we don't know the answers to at the time of this recording and of course implied with vaccine evasion is also immunization against natural infection as well so the question is is whether or not natural infection will give rise to antibodies that will also be effective against this repeated infection again with omicron variant of stars cov2 and that's a question that has still not yet been answered and then finally is there a change in the virulence is it more deadly in other words so let's talk about these three questions and what needs to happen in terms of transmissibility we can see already in south Africa based on some of the initial data that's coming through that this variant is taking off that is not saying too much because the delta variant is also taking off currently in south africa however they are at a lull right now things have actually dropped off somewhat as you can see here on the website Worldometer the case rates on a daily basis have moved up to just over a thousand and it's actually at one of the lowest points here on the graph but it is increasing you should also realize that only about 24 of the population in south Africa is vaccinated and so when the vaccination rates are low we can see that even in a variant that is susceptible to vaccination you are still going to see it taking off so we don't know the answer to that question the question of whether or not there is resistance and to what degree there is resistance to vaccination what it's going to take to answer this first question is looking at epidemiological studies and we're already starting to get some of those in place as we speak and we'll know more in the next week or so about whether or not this specific variant is increasing and is more transmissible in terms of vaccination that is going to take a number of studies to look at the first thing that we have to understand is that there are a number of things that vaccines do and can help with in terms of their efficacy the first thing that we should look at is their ability to prevent infection and this is primarily done through antibodies and of course those antibodies deal with the spike protein and specifically the receptor binding domain one of the ways that scientists have of trying to figure this out is to put in a test tube the viral particles and mix them with antibodies from subjects who have been vaccinated and what they can do is they can see what is their ability to neutralize in other words bind to the spike proteins to prevent those spike proteins from binding to the ace2 receptors in humans that experiment is going to be done in the next week or so and we're going to have some more information hopefully about whether or not these viral particles this specific variant called the omicron variant is going to be able to evade vaccination and they're going to have to do it with different types of vaccines they'll do it against all the different types of vaccines and see whether or not the antibodies that are produced in those subjects can prevent the ability of that viral variant to infect now the way that this is going to happen is it's not going to be a yes or no it's not going to be yes it prevents it no it doesn't we almost certainly expect there to be a reduction in the efficacy of the vaccines just because of the number of mutations that we're seeing in the spike protein but is it going to be a reduction from 90 to eighty percent or is it going to be a reduction from ninety percent down to twenty percent we don't know the answer to that until we do these types of studies realize however that this is only part of the story because we're only talking about one aspect of the immune system although it's an important aspect specifically the ability for antibodies to neutralize the virus is very important in terms of preventing infection however even if they fall short there remember that there are other aspects of the immune system like the t cells and other parts of the immune system like the natural killer cells which are part of the innate immune system but these other aspects of the immune system are very important in terms of preventing morbidity or disease or hospitalization and death so as has been said before the t cell response to these viruses is very broad and it may very well be that even though the vaccine induced or even natural immunity induced antibodies against the spike protein may fall somewhat short if it's found that there is still this broad t-cell response which may prevent the worst outcomes of infection with SARS kovi 2 like hospitalization and death those studies are not going to be known for some time because what we'll have to do is test those patients who have the virus see whether or not they have this particular variant and then see what the natural course is when they become infected and when they go on further to either be hospitalized or even die in the hospital as a result of their infection and so those studies are going to take a little bit longer for us to know the answer the other aspect of vaccine evasion is the ability to prevent transmission of the infection from an individual who has been vaccinated or may have natural immunity and the issue there is looking at the ability of the individual who's vaccinated to prevent that transmission the virus to another individual again that's going to take some epidemiological studies and those are yet forthcoming so just to review when we're talking about vaccine evasion there are many endpoints that can be looked at from vaccines it can prevent infections they can prevent transmission they can prevent hospitalization to a certain degree and also prevent mortality of course nothing is a hundred percent the question is is how much of a reduction will there be with this variant that is coming out of south Africa and is now in other parts of the world and the answer to that is we won't know until we have these studies probably the first studies that are going to be done are going to be these studies in a test tube looking at neutralization and that's going to give us some answers early on at least but remember that they will not touch the ability of t cells and natural killer cells in terms of their ability so we'll need to wait for further information even after these in vitro studies are done finally in terms of virulence it would be very rare for variants to cause a mutation that actually causes the host to die faster or make it more virulent now that's not saying that this can't happen but at this point we don't have any evidence that is what is going on in this new variant currently we don't know what the virulence is for the omicron variants there are some early reports that hospitalizations are up in south Africa related to covet 19 but there seems to be less severe cases being admitted to the hospital this is preliminary and more information is going to be needed before we can make a determination on omicron and virulence so.
Unfortunately we don't have a lot of answers at this
point but those answers are being looked at and they're being worked on
currently so one of the things i want to talk about are variant independent
therapies in other words here are some things that work regardless of whether
or not there is a new variant and so what are the things that actually are
dependent on whether or not there is a new variant or not obviously the
vaccines are dependent on the particular type of variant so that if there is a
change in the protein structure it's possible that those vaccines may not work
as well by the way that's also the case for natural immunity natural immunity
in some degree is also variant dependent so what are some things that will work
in terms of SARS cov2 that have nothing to do with whether or not it is a
variant or not here are some things that may work independently of the genetics
of SARS cov2 and so I've listed these under variant independent therapies of
course final testing will need to be done to confirm that this is the case but
it seems reasonable to put these medications in this category for now there is
pax lovid which is being developed and going for emergency use authorization
and that's a medication that can reduce mortality and hospitalizations it is
reported by 89 percent so that would be a medication that probably is going to
be looked at very seriously for possible emergency use authorization there's
also another medication called maneuverability that medication has recently been
shown to reduce hospitalizations by 30 percent and there's a video that we did
on that medication if you want more information about that there's also another
medication called fluvoxamine which reduced hospitalization also by about 30
percent some other advantages with fluvoxamine is that it's been around for a
long time it's been fda approved for other indications and it's relatively
cheap these medications would have nothing to do with the different types of
variants in terms of their ability to bind it would be presumed that these
medications would still be able to work even in the case of variants and of
course i would be remiss if we didn't talk about things that can optimize your
immune system we know that your immune system is highly tied to a number of behaviors
that we do and so getting ready for any type of infection is important and
things that you can do to enhance your immune system would be in the realm of
making sure you get enough sleep is exercising three times a week for about 20
minutes a day if that's possible and if your physician is okay with you doing
that is having a good diet and healthy lifestyle.
Information Source: medcram
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