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Can Omicron overtake the Delta variant of the coronavirus?

With a handful of cases now confirmed across the country, it’s clear that the ominous and mutated variant of Omicron has gained a foothold in the United States.

But whether those initial infections fade or turn out to be the beachhead of a new viral attack depends largely on how the strain compares to a now-familiar foe: the Delta variant.

Since it officially emerged last week, much of the discussion around the Omicron variant of the coronavirus has focused on what scientists admit they don’t know – whether it could spread more easily than it does. other strains, change the severity of the disease or escape vaccine protection more easily.

Yet an equally important question, suggests John Moore, professor of microbiology and immunology at Weill Cornell Medical College, is: what if this doesn’t measure up to the devil we know?

“Can Delta compete with Omicron, or will Omicron prosper against Delta?” Moore said Thursday at a forum sponsored by UC San Francisco. “She’s just a complete unknown at the moment.”

It is not certain that the Omicron will become the most popular variant in the United States

The Delta variant has long been the dominant strain circulating in the United States – and it was the source of a new wave of cases, hospitalizations and deaths that swept across the country over the summer.

But even the term “dominant” underestimates how prevalent Delta is. In the United States, it’s almost ubiquitous.

“I know the news is focused on Omicron, but we have to remember that 99.9% of cases in the country currently are from the Delta variant,” said Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention the United States. “Delta continues to generate cases across the country, especially among those who are not vaccinated. “

The reason for the supremacy of variety is simple. It is the most transmissible variant of the coronavirus to date.

And due to its infectivity, Delta was able to eliminate all other variants that otherwise could have spread more widely.

Look no further than the beta variant, which scientists also saw as a potential threat because it exhibited characteristics that some feared could jeopardize the effectiveness of COVID-19 vaccines. Scientists feared it would become a newly dominant variant.

“It never happened,” Moore said. “The beta has been crushed by Delta. Well, that could happen to Omicron.

Uncertainty swirls around the new strain

It is still unclear whether Omicron can spread as easily as Delta.

However, it is clear that Omicron overshadows his fellow coronavirus in the number of mutations he possesses. Scientists are still trying to figure out all the ramifications of this.

Omicron has not really been tested against Delta. Its increase in South Africa, for example, came at a time when the number of cases was relatively low in the region and Delta was not being transmitted as much as it is today in the United States.

“Omicron was born in South Africa in an environment where there wasn’t a lot of Delta to compete with,” Moore said. “We still have a lot of Delta infections, and we’re going to have more in the coming weeks.”

Always a cause for concern

This is not really good news. While the extent of the potential danger posed by Omicron is still being assessed, Delta has proven to be more than powerful enough to cut a devastating swath across the United States.

Even without taking Omicron into account, “we are already facing a winter wave caused by Delta that will kill 100,000 to 150,000 more Americans,” Moore said.

“Most of us think winter is pretty bad. So how much worse could it be? Well it could be a lot worse, but I think my money is on Delta dominating the winter pandemic. “

Some 6,000 Americans die each week from COVID-19, a trend the CDC says will continue or even worsen until Christmas Day. California averages more than 500 deaths from COVID-19 per week, and some scenarios predict an increase in weekly deaths later this winter, especially if too few vaccinated adults receive booster shots as their immunity goes down. weakens.

Nationally, 70.6% of Americans have received at least one dose of the vaccine, and nearly 60% are considered fully immunized, according to CDC figures. In California, these shares are 79.1% and 63.4% respectively.

“We already have a highly transmissible and dangerous variant at Delta in circulation,” said Moore. “So of course we’re going to have as a nation a really bad winter wave – in January, February – just like we saw last year with Alpha. But it will be concentrated in the third of the country that refused to protect himself.

All available data shows that those who are not vaccinated remain particularly at risk of COVID-19.

State health officials estimate that unvaccinated Californians are seven times more likely to contract COVID-19, more than 12 times more likely to require hospitalization, and 15 times more likely to die from the disease.

“Given the evidence to date that these vaccines have been very effective against all of the variants that we have seen, the one step I urge everyone to take is to get vaccinated if you are not vaccinated and ‘Go ahead and make this recall as soon as possible, ”said Barbara Ferrer, Los Angeles County director of public health.

Best and worst case scenarios

If Omicron is highly transmissible but produces less severe disease than Delta, this development would be a good thing, Moore said.

But it is not clear that such a situation would allow Omicron to outperform Delta.

“This is, again, the unknown,” he said.

In Moore’s mind, the worst-case scenario would be “if Omicron spreads quickly and causes serious illness and breaks vaccine protection.” This is really bad.

“But if Delta is just choking Omicron the same way it choked Alpha, then we should be supporting Delta: better the devil you know than the devil you don’t know – because we know vaccines can deal with it. Delta Very few vaccinated people die from Delta, ”he said.

He continued, “If Omicron is deadly, it would be better if Delta suffocate him. It’s a kinky way of looking at it … but if you eliminate the possibilities … what you are not rooting is the highly transmissible and deadly variant that runs through vaccines, because that’s what we feared from the start. “

Although anecdotal reports have been published since the appearance of the variant, officials say it is still too early to know how an Omicron infection will affect disease levels.

“Usually it takes a while for a serious illness to really require hospitalization,” said Dr Regina Chinsio-Kwong, assistant health worker for Orange County. “So we’ll find out, probably in two weeks, how bad Omicron can be on the system. But that will take time.”

South African doctors don’t seem to panic

Obviously, things could change, but Moore said he was noted as the chairman of the South African Medical Assn. said in an editorial published earlier this week that “no one here in South Africa is known to have been hospitalized with the Omicron variant”.

“It’s an interesting prospect. This may or may not turn out to be right. But that’s the point of view of someone in authority in South Africa who is in touch with the datasets, ”said Moore.

“So it’s possible that all of Omicron is a highly adapted variant that will spread but not cause serious disease. Perhaps this is a move this virus is making towards a non-pathogenic variant that resembles the viruses of the common cold – coronaviruses I don’t know if that will happen.

It’s also entirely plausible that Omicron could seriously ill and hospitalize more vulnerable people. Many of those recently infected were younger, otherwise healthier people who are not particularly likely to become seriously ill with COVID-19.

Moore said he read news reports that Omicron’s outbreaks in South Africa were linked to students coming together at parties to commemorate the end of their college year.

“Perhaps in South Africa, Omicron didn’t break into a nursing home full of elderly and vulnerable patients,” Moore said.

Could reinfection rates be worse with Omicron?

There is an early suggestion that Omicron is more capable of re-infecting people who have recovered from previous coronavirus infections, Moore said.

“Not a massive effect. But it’s statistically significant, ”he said, based on preliminary analyzes he reviewed. “And that would be consistent with the highly mutated nature of Omicron.”

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