Is Omicron a cause for concern? The Answer is yes it is cause of concern!

Is Omicron a cause for Panic! No it is not a cause for panic.

Is Omicron a cause for concern? The Answer is yes it is cause of concern!

Is Omicron a cause for Panic! No it is not a cause for panic.

At the best of times, listening to the news can be stressful. Many experience high levels of anxiety when the news is disturbing. How can we remain relatively anxiety-free while the media constantly bombards us with frightening headlines? The intention of the Media should be to inform the public about potential health risks and enable public to prevent them.

The “hype” around Omicron doesn’t correlate with the “clinical picture — we have seen in South Africa and other countries. Omicron has not killed anyone in 38 countries so far in 10 ten days of its existence. I would repeat- Omicron has not killed anyone in 38 countries so far in 10 ten days of its existence.

Well my friends

I am Dr Prabhudev

Former Director Jayadeva institute of cardiology-

Former VC Bangalore University

Former chairman Karnataka state health commission-

The emergence of the Omicron variant in India is a wakeup call — the pandemic is still active! But remember and be assured that India is in a better position than it was during the first and second wave of COVID-19 in terms of health infrastructure and clinical management. Our healthcare system is much more enabled than it was in the first and second wave of coronavirus. So we’re in a very strong position. Vaccination against COVID is India’s strongest tool.

But we shouldn’t squander advantage by being careless. People should cooperate with the government and the government should keep surveying the outbreak and if there are new variants emerging — enforce control.

Well there have been some positive developments this week regarding COVID-19 treatments.

· First, FDA — USA has approved a pill from Merck and Ridgeback Bio-therapeutics Company that could become the first oral antiviral COVID-19 treatment that can be taken at home on prescription. It has not yet come to India.

· Pfizer Pharma also has a COVID-19 pill awaiting FDA approval.

· Now an entirely new COVID-19 vaccine will soon be rolling out around the world, with easier storage requirements that could make a huge difference in poor countries. The current AstraZeneca vaccine requires refrigeration at minus 70 C.

About the Booster!

It is even more important now to introduce the booster dose. 30 other countries have done it. It prevents further outbreaks and loss of life. It is evident from the sero studies that the Antibody protection from vaccines is on decline — from 90% it has come down to 60 to 70%. Start the booster doses for all above 40 yrs who have had two doses and are six months after the second vaccination. Booster shots raise your antibody levels, which offers both longer protection and stronger immune response against COVID-19 variants.

Omicron shows higher transmission rates. But appear to be not as virulent as the Delta variant!

I reiterate No Need for panic. Stay calm. Stay vaccinated. Stay with COVID protocol.

India has become the 30th country in the world to record the Omicron cases. Till date 5 cases have been confirmed. One of them is a Bangalore doctor- an anaesthesiologist who attended a conference in a Bangalore. He has no travel history. He had a high viral load on CT scan and the sample was sequenced that showed the Omicron variant. His primary contacts- his wife also a doctor and his child have tested positive and are being treated. All are stable and recovering fast.

The COVID-19 pandemic brought the world to a standstill in the beginning of 2020. The virus has been mutating. It looked like the worst is behind us thanks to an extensive vaccination program.

Bolt from the blue there was news of a new strain from South Africa doing the rounds! Omicron variant is the latest mutation identified by scientists in South Africa. The news was bit of a shocker. WHO has stated that 373 cases of Omicron variants have been detected in 30 countries. Omicron is by far the most mutated variant till date- 50 mutations including ten on the spike!

I am presenting facts as known to- day to all of you.

Let me start answering some of your anxieties. All are worried about a possible third wave!

Will Omicron variant cause third wave in India?

Most Omicron infected people have only experienced mild symptoms. Yes the Cases in South Africa and Norway have more than tripled in four days.

There is growing anxiety among citizens. SA is different logistically — not many are vaccinated- less than 10% with many receiving only one injection. India has vaccinated nearly 110 crore population with one dose and 30 crores with both doses.

Given the fast pace of vaccination in India and high exposure to Delta variant as evidenced by high sero-positivity or high Anti body titres, the severity of the disease is anticipated to be low. We may see a surge in Infections and not a surge in severity.

Next anxiety is Will Omicron be as deadly as Delta?

Analysing the picture seen in SA May not be as deadly!

Omicron- the new variant of COVID-19 does not escape RT-PCR or the Rapid Antigen Test. CT scan would helpful. I suggest that all those persons with high viral load on CT should have genome sequencing. This variant would be identified only through genome sequencing and through the S-gene target failure. Missing S-gene is one of the indicators for the detection of this variant. RT-PCR laboratories should use S gene drop detecting kits for early detection of Omicron. This way, Omicron can be detected even before genome sequencing.

Transmissibility: Appears more transmissible compared to other variants, including Delta. There may be an increased risk of reinfection with ‘Omicron’. We may not see an Omicron Pandemic.

Severity of disease: It is not yet clear whether infection with Omicron causes more severe disease. Preliminary data suggests that there are increasing rates of hospitalization in South Africa. It has been reported to that few omicron patients infected in South Africa were suffering AIDS and were not vaccinated for COVID. The general vaccination in Africa is at the basic level- less than 10 %.

The virus variant is already seen spreading in thirty other nations like Israel, the United Kingdom, Belgium, Botswana, and Hong Kong. The WHO considers this as a Variant of Concern.

The symptoms are “pretty much the same” except omicron may not affect people’s smell and taste as much as previous variants did. You may have troublesome throat, cough, fever, body ache, tiredness.

There are a lot of mutations 50 on surface and ten in the spikes itself. It is through these spikes that the virus gets a foot hold in lung cells of the host. These spikes generate antibodies or changes in virus genome where it can affect the antibodies.

The patients infected by Omicron in South Africa seem to be having only mild symptoms. It may not become as lethal as delta variant. It might be something we can live with, without having too much fear compared to delta variant. The plus point is we are more extensively vaccinated and it gives overall protection.

Theoretically vaccines in India — Covaxin and Covishield will be quite effective against omicron variant as well. In case of double vaccinated people, cases of serious infections and mortality should be low.

What is the treatment of the omicron variant?

Corona pill is still on the way! The experience gained in treating the first and second wave has taught all of us plenty of lessons in the practical management of the disease. We have the infra-structure.

Don’t forget — Omicron variant is also a corona virus. There is mutation at the spike. This does not make it a different virus. The treatment is basically that of COVID. If the mutations throw up any focussed symptoms the treatment also needs to be focussed on that. Paracetamol, antibiotics to prevent add on infections, Broncho dilators, Fabiflu tablets, Remedesvir, Vitamins and zinc and Oxygen supplementation. Steroids if required and oxygen supplementation and if required ventilator assistance.

How to prevent Omicron infection?

Follow COVID protocol in letter and spirit.

Get fully vaccinated- vaccines save lives. They prevent us from horrible deaths.

Go for Travel restrictions

Let us look at — How this Omicron came about? Why do viruses mutate?

Mutations are an attempt by the virus for survival.

An unvaccinated population provides a breeding ground for viruses to mutate. This happened with the Delta variant, which was first detected in India in October of 2020. Just as the country thought it could declare victory over coronavirus, the new variant, which was at least 50 per cent more transmissible than the first, swept through first India and then the world in the early months of this year.

It is important that By April 2021, only 8.5 per cent of the Indian population had been vaccinated, even though the country is one of the biggest producers of vaccines. Today India has vaccinated 110 crore populartin with first dose and 30 crores with both doses.

I congratulate the Karnataka health department for successfully vaccinating 67.3% of eligible population in Karnataka. The vaccination had Crossed seven crore doses on November 20. The State is now in the seventh position in the country. We still have about 39.5 lakh people who are due for the second dose.

What are the important messages in the history of pandemic as on today!

· No one is safe until everyone is safe.

· Vaccines impedes the development of Mutations.

· Unvaccinated People are the breeding grounds for more mutations. Viruses replicates quicker in unvaccinated people.

The faster we get everyone immunized, the less chance the virus has to mutate.

The COVID-19 vaccination effort continues. To bring this pandemic to an end, a large share of the world needs to be immune to the virus. The safest way to achieve this is with a vaccine. Now the challenge is to make these vaccines available to people around the world.

Africa has the slowest vaccination rate of any continent, with just 10.5 percent of the population receiving at least one dose of a vaccine. The result is OMICRON virus to the world! Every infected person is one more chance for the virus to mutate. It increases the chances that a new variant emerges that spreads faster, makes people sicker, or can get around immunity.

There is a general talk that mutated variant is not more virulent than the original virus. It is not true in the case of corona virus. The delta variant which is the 4th variant of corona virus was deadlier that the original virus that caused the First wave of COVID. Omicron may not be as deadly.

The good news here is that while fast mutation rates are typically a hallmark of RNA viruses, coronaviruses are the exception to that rule. They actually mutate very slowly compared to other RNA viruses. Looking at all the genomic sequences from around the world, on average there are just two nucleotide changes out of the 30,000 total nucleotides in its genome per month.

Are all mutation deadly?

NO all are not dadly!

Just because there are a few changes in the genome doesn’t mean the virus is really changing. A lot of those changes won’t affect how the virus spreads or how deadly it might be. In fact, it’s possible some mutations might make it less dangerous.

But the concerning thing is that a few of the changes we see are in the spike protein. That’s the protein responsible for getting the virus into your cells, and it’s the major target for your immune system to make antibodies against. It’s also the part of the virus the vaccines are delivering to get your immune system primed and ready. Changes in the spike gene could lead to viruses that spread faster.

What are mutations?

Mutations are random changes in viral genetic code (either DNA or RNA). The majority of mutations are harmful to the virus, others are neutral, and some can make the virus more infectious, evade the immune system, or become capable of jumping across species. As more immunity builds up across the world through vaccinations, fewer people are likely to get infected thus giving the virus less opportunity to replicate and mutate.

So far the vaccines have worked very well against the variants. While it considered unlikely that a variant could completely evade immunity, it is possible that a variant could emerge that evades immunity more than we are currently seeing.

Vaccine hoarding has inhibited global recovery

In October of 2020, the India proposed a patent waiver at the World Trade Organisation for all Covid-related technologies. This was in direct response to the vaccine inequality. There was a firestorm from Big Pharma. Pharmaceutical companies are fiercely protective of their Patents and intellectual property. The pharma giants have not given the generic biotech companies the trade secrets along with the patents.

Canada has been found to have the biggest per capita hoarding of the eight vaccines currently available, with enough vaccinations for five complete immunisations per citizen. America and the UK are not too far behind Canada in vaccine hoarding, with four vaccinations and three vaccinations per citizen, respectively.

Only 0.3 percent of the vaccine supply is going to low-income countries. Currently, 67 countries have made no purchases of the vaccine themselves, and so are wholly reliant on the WHO’s Covax program. The WHO has said we need to vaccinate at least 70 percent of the world to manage coronavirus properly. Yet at the rate we are going, it would take five yrs. to meet the target!

We are still not at the end of the pandemic, we do not currently know if the vaccination will be required every year. In addition, with the rise of new variants, there is still uncertainty over how effective the different vaccines will be against these as they emerge. It is also well worth appreciating that without all countries being vaccinated, global recovery will not be possible.

Vaccine inequality is a moral travesty. It is a catastrophic moral failure. Maybe this new South African variant will be what it takes to break the cycle and make the world pay attention to vaccine inequality. But if the virus’s almost two-year history is anything to go by, vaccine inequality will become as endemic as the virus itself. No one is safe until everyone is safe.

Former director of Sri Jayadeva Institute of Cardiology, Former VC of Bangalore University and former chairman of the Karnataka State Health Commission

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Dr Prabhu Dev

Dr Prabhu Dev

Former director of Sri Jayadeva Institute of Cardiology, Former VC of Bangalore University and former chairman of the Karnataka State Health Commission

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