Can Omicron overtake the Delta variant of the coronavirus?

With a handful of confirmed cases across the country, it’s clear that the Omicron variant has taken root in the United States.

But whether those initial infections subside or become a beachhead for a new viral attack depends largely on how Omicron fares against a now-familiar foe: the Delta variant.

Since it emerged last week, scientists have been working to determine whether its numerous mutations help it spread more easily than its predecessors, make its victims sicker, or reduce the effectiveness of COVID-19 vaccines and drugs.

However, there’s another question that’s equally important in predicting Omicron’s impact on the pandemic: what if it doesn’t stand up to the devil we know?

“Can Delta beat Omicron, or will Omicron succeed in the face of Delta?” said John Moore, professor of microbiology and immunology at Weill Cornell Medical College. “It’s just a complete unknown at the moment.”

The Delta variety has long been the dominant strain in the US – and it was the culprit behind a renewed spate of cases, hospitalizations and deaths that swept the country in the summer.

Dominant undercuts how widespread Delta is. In the United States it is almost ubiquitous.

“I know the news is focused on Omicron, but we should remember that 99.9% of cases in the country right now are from the Delta variant,” said Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention. “Delta continues to push cases across the country, particularly among the unvaccinated.”

The reason for the tribe’s supremacy is simple: it is twice as transmissible as the original SARS-CoV-2 virus. As a result, it was able to push aside other variants that might otherwise have spread more widely.

Look no further than the beta variant, which scientists considered a potential threat as it appeared like it could jeopardize the effectiveness of COVID-19 vaccines.

“That never happened,” Moore said. “Beta was suppressed by Delta. Well, that could happen to Omicron.”

In Africa, Omicron has been linked to a precipitous rise in new infections, suggesting it is indeed highly transmissible. But it might have faced less intimidating competition in Africa than in the United States.

The alpha and beta variants remain widespread in Africa, accounting for almost half of the new infections studied there. It’s possible that Omicron can beat them but will be hindered by Delta.

That’s not very good news. Delta has proven it’s more than capable of carving a devastating swath across the United States

Even disregarding Omicron, “we are already facing a Delta-powered winter flood that will kill another 100,000 to 150,000 Americans,” Moore said.

Omicron’s rise in South Africa came at a time when new infections were relatively low, a context that could lead to an overestimation of its transmissibility. As scientists ramped up their virus sample collection around an outbreak, they may have detected a high rate of spread that was unique to that cluster but does not recur in a broad population.

There were early signs that Omicron is better able to reinfect people who have recovered from previous coronavirus infections.

“No massive effect. But it’s statistically significant,” Moore said, based on preliminary analyzes that he reviewed. “And that would be consistent with the highly mutated nature of Omicron.”

A new threat assessment from Britain’s Health Security Agency says models developed by Oxford University scientists suggest Omicron could replicate faster in the body by binding more tightly to the ACE2 receptor on human cells. This binding affinity appears “to occur to a much greater extent than any other variant,” the report states.

Scientists have long argued that in a virus’s endless quest to infect new hosts, genetic mutations that increase transmissibility best ensure its survival. New variants give the coronavirus new ways to spread and secure its future, said Wesleyan University microbiologist Frederick Cohan.

There are many ways to do this, and the virus needs to make the right change to improve its prospects, Cohan said. It could make itself more transferrable by floating in the air longer or moving through the air more easily. It could keep infected people contagious longer. It could cause a milder disease and keep spreaders in wide distribution.

Widespread vaccination slows transmission by making the virus work harder to find its next victim. But if Omicron – or another variant – finds a way to overcome the protection offered by vaccines, the reward will be a larger pool of potential hosts.

In a sense, a vaccine-resistant variant would regain the target-rich environment that the original strain had when the pandemic began, Dr. Jonathan Schiffer, an infectious disease expert at the Fred Hutchinson Cancer Research Center in Seattle.

“The virus that could win now is not necessarily the same variant that won in the past,” Schiffer said.

It is not yet known whether people who have omicron are more or less likely to become seriously ill than people who have delta.

The President of the South African Medical Assn. said in a newspaper article this week that “no one here in South Africa is known to have been hospitalized with the Omicron variant”.

That’s encouraging, but officials say it’s too early to know if Omicron will make people sicker than Delta. It’s possible that Omicron was more relaxed about its victims in South Africa because it was infecting younger, otherwise healthy people who aren’t particularly likely to become seriously ill with COVID-19. If the new variant encounters a more vulnerable population, the picture could change, Moore said.

“It usually takes some time before a serious illness really requires hospitalization,” said Dr. Regina Chinsio-Kwong, Orange County Assistant Health Officer. “So probably in two weeks we’ll find out how heavy Omicron can be on the system.”

https://www.latimes.com/california/story/2021-12-03/can-omicron-overtake-delta-variant-of-coronavirus Can Omicron overtake the Delta variant of the coronavirus?

Russell Falcon

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