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We can beat Omicron.You need to use the tools you have | Eric Topol

LThis week, South African scientists sequenced the virus and swiftly reported that there was a new variant with 50 mutations compared to the original Wuhan strain. It was soon named Omicron and was classified by the World Health Organization as a variant of concern. It has been used only in the previous four variants (alpha, beta, gamma, delta) of the thousands of variants noted in the evolution of Sars-CoV. -2 virus.

I know a few things about Omicron. That is, its sequence and abundant mutation sites, much more than previously of concern mutant strains, are part of viral RNA that substantially affect transmission or the immune system (or vaccine-induced immunity). )respond. Mutants containing other mutations have been picked up in the past, but all have been found to have no clinical consequences, so that’s all theoretical.

It can also be inferred that Omicron is derived from an immunocompromised host and must have a large number of mutations (from the first alpha mutant lineage) due to its rapid evolution in the human body. .. The phenomenon has been demonstrated in several previous cases of unsuppressed viral mutations in the human body due to inadequate immune system protection. And the individual’s chronic infection then spreads to other people.

Another thing we know is the outbreak in Gauteng, South Africa, where more than 15 countries have identified new cases, primarily from travelers, after Omicron was reported elsewhere in the world. But now there are multiple community submissions already documented.

To date, the pattern of hospitalization in Houten is the same as in the previous wave, neither bad nor good. Omicrons may have been present for months, but only recently have the first signs of a sudden rise in some places. Fortunately, it was diagnosed quickly and other parts of the world were warned much better than previous variants of concern.

It remains unclear whether the surge in cases is associated with high infections such as delta or antigenic escape such as beta. It behaves like a beta with some antigenic properties, probably due to a wide range of mutations or what is known as “antigenic drift”. The extent will be categorized in the coming weeks by laboratory studies examining cultures and serum viruses from vaccinated people to see how neutralizing antibodies work against Omicron. increase.

But regardless of the results of these lab studies or what the tracking of new cases around the world shows, we have all the tools to beat Omicron. This includes mitigation measures such as masks, especially medical grade ones, physical distance, ventilation and air filtration.

There are very powerful vaccines that are 95% effective against symptomatic infections, hospitalizations and deaths. Also, these mRNA vaccines are somewhat less effective in 5-6 months, but are fully restored to 95% on the third inoculation (booster).

In addition, its third shot induces significantly higher neutralizing antibodies, much higher than the second vaccine dose, and much broader activity against mutants. In addition, the response of T cells to vaccines is much less mutagenic than neutralizing antibodies, making them well suited for fully vaccinated people to reduce their risk of serious illness.

Beyond palliative and vaccination, to prevent hospitalization and death, taking early in the first few days of Covid infection, you will soon have a powerful pill with about 90% efficacy. The protective effects of pills such as Paxlovid are not expected to be affected by Omicron in a substantive way.

There are a number of fully validated rapid antigen tests that, like many other countries, need to be freely available to assist in the diagnosis of infectiousness in people with and without symptoms. This promotes early use of treatments such as anti-Covid pills. Therefore, we are in a better position to defend against Omicron than we were in the early days of the pandemic. We are probably at the forefront of developing a pan-salvecovirus vaccine that has the potential to protect against all future variants, with global prioritization, coordination, and funding efforts to accelerate the process. Is required. But the most important thing that is blocking us is human behavior. Reluctance and resistance to using all these tools.

Omicron is a source of concern, but our problem is currently the lack of containment of Delta in the United States, with more than 90,000 new cases and more than 50,000 hospitalizations per day. We are the newest source of infection in the world and are now all Delta. If more than 80% of the total population was vaccinated and a third vaccination was given to prevent significant decline, as some countries did, it would contain the Delta. The current problem is not using Omicron, and not using tools that are getting better and better over time.

  • Eric Topol is the founder and director of the Scripps Research Translational Institute, a professor of molecular medicine, and an executive vice president of Scripps Research.

We can beat Omicron.You need to use the tools you have | Eric Topol

Source link We can beat Omicron.You need to use the tools you have | Eric Topol

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