New Coronavirus News from 26 Nov 2021

Classification of Omicron (B.1.1.529): SARS-CoV-2 Variant of Concern [World Health Organization, 26 Nov 2021]

The Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE) is an independent group of experts that periodically monitors and evaluates the evolution of SARS-CoV-2 and assesses if specific mutations and combinations of mutations alter the behaviour of the virus.
The TAG-VE was convened on 26 November 2021 to assess the SARS-CoV-2 variant: B.1.1.529.

The B.1.1.529 variant was first reported to WHO from South Africa on 24 November 2021.
The epidemiological situation in South Africa has been characterized by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant. In recent weeks, infections have increased steeply, coinciding with the detection of B.1.1.529 variant. The first known confirmed B.1.1.529 infection was from a specimen collected on 9 November 2021.

This variant has a large number of mutations, some of which are concerning. Preliminary evidence suggests an increased risk of reinfection with this variant, as compared to other VOCs. The number of cases of this variant appears to be increasing in almost all provinces in South Africa. Current SARS-CoV-2 PCR diagnostics continue to detect this variant. Several labs have indicated that for one widely used PCR test, one of the three target genes is not detected (called S gene dropout or S gene target failure) and this test can therefore be used as marker for this variant, pending sequencing confirmation. Using this approach, this variant has been detected at faster rates than previous surges in infection, suggesting that this variant may have a growth advantage.

There are a number of studies underway and the TAG-VE will continue to evaluate this variant.

WHO will communicate new findings with Member States and to the public as needed.

Based on the evidence presented indicative of a detrimental change in COVID-19 epidemiology, the TAG-VE has advised WHO that this variant should be designated as a VOC, and the WHO has designated B.1.1.529 as a VOC, named Omicron.

As such, countries are asked to do the following:
• enhance surveillance and sequencing efforts to better understand circulating SARS-CoV-2 variants.
• submit complete genome sequences and associated metadata to a publicly available database, such as GISAID.
• report initial cases/clusters associated with VOC infection to WHO through the IHR mechanism.
• where capacity exists and in coordination with the international community, perform field investigations and laboratory assessments to improve understanding of the potential impacts of the VOC on COVID-19 epidemiology, severity, effectiveness of public health and social measures, diagnostic methods, immune responses, antibody neutralization, or other relevant characteristics.

Individuals are reminded to take measures to reduce their risk of COVID-19, including proven public health and social measures such as wearing well-fitting masks, hand hygiene, physical distancing, improving ventilation of indoor spaces, avoiding crowded spaces, and getting vaccinated.

For reference, WHO has working definitions for SARS-CoV-2 Variant of Interest (VOI) and Variant of Concern (VOC).

A SARS-CoV-2 VOI is a SARS-CoV-2 variant:
• with genetic changes that are predicted or known to affect virus characteristics such as transmissibility, disease severity, immune escape, diagnostic or therapeutic escape; AND
• that has been identified as causing significant community transmission or multiple COVID-19 clusters, in multiple countries with increasing relative prevalence alongside increasing number of cases over time, or other apparent epidemiological impacts to suggest an emerging risk to global public health.

A SARS-CoV-2 VOC is a SARS-CoV-2 variant that meets the definition of a VOI (see above) and, through a comparative assessment, has been demonstrated to be associated with one or more of the following changes at a degree of global public health significance:
• increase in transmissibility or detrimental change in COVID-19 epidemiology; OR
• increase in virulence or change in clinical disease presentation; OR
• decrease in effectiveness of public health and social measures or available diagnostics, vaccines, therapeutics

Dr. Francis Collins on what we know about the Omicron variant so far [NPR, 26 Nov 2021]

By AUDIE CORNISH, FacebookTwitter, ELENA BURNETT and ASHLEY BROWN

NPR's Audie Cornish speaks with National Institutes of Health director Dr. Francis Collins about how the new COVID-19 variant might affect U.S. response and where the national strategy goes from here.

AUDIE CORNISH, HOST:
There is officially a new COVID-19 variant that the World Health Organization is classifying as one of concern. Today, the WHO put a Greek letter on it, dubbing it the omicron variant. There's still a lot of - there's still a lot scientists don't know about it, but since it was first identified in South Africa this month, it's also been reported in Europe and Asia. And the U.S. will ban travel from South Africa and other neighboring countries starting on Monday. Dr. Francis Collins, director of the National Institutes of Health, joins us now to give us the update.
Welcome back to ALL THINGS CONSIDERED.

FRANCIS COLLINS: Glad to join you.

CORNISH: So you've been in touch with officials in South Africa. We now have the information from the WHO. What have you learned about this new variant?

COLLINS: Well, yeah, I've been on Zoom calls and phone calls all day trying to learn everything that we currently know. It's a troubling variant. It has more than 50 mutations, the largest number of differences from the original virus that we've seen so far. And that, of course, makes you worry that the things that we've been doing to fight this off might not work quite as well with omicron.

CORNISH: Meaning social distancing and masking...

COLLINS: By the way, a lot of people are looking up...

CORNISH: ...Or vaccines?

COLLINS: I'm sorry?

CORNISH: When you say that makes you worry, does that mean you have concerns about the efficacy of the current vaccines available?

COLLINS: That would be the concern, although, let me be clear, there is no data at the present time to indicate that the current vaccines would not work. So this is just looking at those mutations and going, boy, we'd better really check this out.

CORNISH: This is not the first variant. What have you learned from dealing with past variants that could be helpful here?

COLLINS: Very important question, Audie. What we have learned is that vaccines work really well against all the other variants - alpha, beta, delta. And it also is the case that getting boosted makes the vaccine work even better against those other variants. So message for people right now - if you haven't gotten boosted and you're six months out from Pfizer or Moderna or two months from J&J, this would be a really good time to sign up and take care of that in the next few days.

CORNISH: But why are there such red flags, then, for this latest variant?

COLLINS: Well, two things. One is that it seems to be spreading very rapidly in South Africa and other neighboring countries, which is a sign of something that maybe is particularly contagious. And the other is the fact that it has so many mutations, more than we've ever seen, which is, again, a red flag that it might be more difficult for our immune systems to recognize if we get exposed to it, even if we've seen the vaccine before.

CORNISH: Could the U.S. and other developed nations done more to get vaccines to parts of the world that had less access? And I ask this because the idea of vaccinations, which - was to prevent the kinds of mutations that could lead to more dangerous variants.

COLLINS: That's absolutely right. And we in the U.S. have done more than any other country to try to achieve that. We've already sent out more than 250 million doses and committed to more than a billion more; more than any other country. And we do need to do that just for self-interest, not to mention the fact that we are fortunate to have resources and we should be reaching out to all of our brothers and sisters all over the world.

CORNISH: But the U.S. is already on boosters while these countries - I think the vaccination rate in South Africa is in the sort of 35% range. I mean, is it better to be trying to prevent this kind of thing in other countries than to kind of keep dosing ourselves with vaccines?

COLLINS: Well, I talked to the folks in South Africa about this. They say at the present time, their problem is not access to vaccines. They have vaccines. They have the same problem we seem to have with people being hesitant to take them. And that is a terrible tragedy for our country and for theirs as well.

CORNISH: Speaking of which, in the U.S., COVID cases are up around 30%, at least compared to a month ago. I know you've been out promoting boosters, you've - as you've been doing here, singing the praises of vaccines and also vaccine mandates. But to really keep cases under control this holiday season and through the winter, where does the national strategy need to head from here?

COLLINS: Well, we need to do everything possible, Audie, to convince people who are still on the fence to roll up their sleeves if they haven't yet gotten immunized. And of course, mandates is one way that we're accomplishing that, although I think most of us wish we didn't have to do mandates when the evidence is so compelling. And booster wise, again, getting messages like this in front of people.

We're working, though, against a terrible onslaught of misinformation and, frankly, disinformation that's being spread by people with other agendas, which causes people to be confused and fearful in a situation where the data is actually really clear about what you should do. These vaccines are safe and effective, and the boosters really work.

CORNISH: We just have a minute left. What's your sense of what it would take to get to an endemic phase of this pandemic - right? - where the virus is still circulating but not disrupting everyday life?

COLLINS: Yeah. We'd need to see cases, hospitalizations and deaths drop way down from where they are right now. We're still losing a thousand people a day in the United States. That would mean getting immunization levels very much higher than they are and also practicing those other simple things in terms of mitigation, like mask-wearing indoors when you're around other unvaccinated people.

We have, of course, gotten to the point where a lot of people are tired of hearing all that, but the virus is not tired of us. And so we have to double down on that and keep these messages coming. We're all in this together.

CORNISH: That's Dr. Francis Collins, director of the National Institutes of Health.

Thank you for this update. Thank you for your expertise and time.

COLLINS: Thank you. It's nice to be with you.

(SOUNDBITE OF FRANZ FERDINAND SONG, "40'")

Statement by President Joe Biden on the Omicron COVID-19 Variant [The White House, 26 Nov 2021]

This morning I was briefed by my chief medical advisor, Dr. Tony Fauci, and the members of our COVID response team, about the Omicron variant, which is spreading through Southern Africa. As a precautionary measure until we have more information, I am ordering additional air travel restrictions from South Africa and seven other countries. These new restrictions will take effect on November 29. As we move forward, we will continue to be guided by what the science and my medical team advises.

For now, I have two important messages for the American people, and one for the world community.

First, for those Americans who are fully vaccinated against severe COVID illness – fortunately, for the vast majority of our adults — the best way to strengthen your protection is to get a booster shot, as soon as you are eligible. Boosters are approved for all adults over 18, six months past their vaccination and are available at 80,000 locations coast-to-coast. They are safe, free, and convenient. Get your booster shot now, so you can have this additional protection during the holiday season.

Second, for those not yet fully vaccinated: get vaccinated today. This includes both children and adults. America is leading the world in vaccinating children ages 5-11, and has been vaccinating teens for many months now – but we need more Americans in all age groups to get this life-saving protection. If you have not gotten vaccinated, or have not taken your children to get vaccinated, now is the time.

Finally, for the world community: the news about this new variant should make clearer than ever why this pandemic will not end until we have global vaccinations. The United States has already donated more vaccines to other countries than every other country combined. It is time for other countries to match America’s speed and generosity.

In addition, I call on the nations gathering next week for the World Trade Organization ministerial meeting to meet the U.S. challenge to waive intellectual property protections for COVID vaccines, so these vaccines can be manufactured globally. I endorsed this position in April; this news today reiterates the importance of moving on this quickly.
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