How bad will omicron be? Scientists likely won’t know for months

It will take a while to get the full extent of the omicron variant of COVID-19, which as been identified in several countries around the world — which could be good or bad.

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National News

December 1, 2021 - 10:10 AM

Travelers arrive from international flights, including from South Africa, at Newark Liberty International Airport Tuesday in Newark, N.J. Photo by (Spencer Platt/Getty Images/TNS)

In a virus that has already killed 5.2 million people across the globe,  50 or so new mutations sound like a nightmare for humanity. But in the age-old battle between microbes and mankind,  that many genetic changes can turn the tide in any direction.

The next chapter of the pandemic could feature an omicron variant that spreads more readily than delta, blows past the defenses of a fully vaccinated immune system, and, like its coronavirus cousin that causes Middle East respiratory syndrome, kills more than one-third of those who get it. That worst-case scenario would be an unfathomable disaster, said Dr. Bruce Walker, an immunologist and founding director of the Ragon Institute in Cambridge, Mass.

At the other end of a wide spectrum of possibilities, humanity could catch a break. Omicron could turn out to be a benign variant that spreads as fast as delta, is easily tamed by vaccine, and barely sickens its victims while leaving them with some immunity and little risk of developing “long COVID.” In that case, “nature may have created a natural vaccine,” Walker said.

But it will take weeks and months — and the work of a legion of scientists across the globe — to begin to know whether the omicron variant will change the course of the pandemic, and how.

In the waning days of 2021, microbiologists, immunologists and genetic scientists will offer key early insights into the variant’s penchant for spread and its ability to thwart treatments and vaccines in the confines of a lab.

It will take until early 2022 for contact-tracing teams and epidemiologists to flesh out the emerging picture with real-world data on whom omicron sickens, and the extent of their illnesses. Then mathematical modelers will plug in what’s known, fill in what’s not, and forecast a range of outcomes.

Until those bits and pieces of evidence begin to congeal, all we have are anecdotes, said infectious-disease specialist Dr. Joshua Schiffer of the Fred Hutchison Cancer Research Center in Seattle, “and the anecdotes are not helpful.”

The impact of the omicron variant “really needs to be assessed in a systematic way, looking at very large numbers of people,” Schiffer said. “This is going to take a bit of time to parse.”

Once again, the coming months will provide the public a lesson in both the science of uncertainty and the uncertainty of science. Like a jigsaw puzzle, the complete picture of omicron’s impact will emerge only in pieces.

Almost two years into a pandemic, scientists need to take the measure of the SARS-CoV-2 virus yet again. This time, they have a variant changed by an unprecedented number of mutations with worrisome histories. And they are assessing its strengths and weaknesses in a diverse population of potential hosts that ranges from uninfected-and-entirely-susceptible to vaccinated-and-boosted.

“There are so many moving parts,” said Dr. Jonathan Li, a Harvard infectious-disease specialist who directs the virology laboratory at Brigham and Women’s Hospital in Boston.

It’s possible that omicron’s detection just happened to coincide with an isolated outbreak or superspreader event that prompted South African scientists to step up their collection of viral coronavirus specimens.

If omicron fails to gain more footholds as it lands in a wider range of places, its apparent role in driving South Africa’s latest outbreak may prove to have been a case of misattribution, Schiffer said.

Now that the omicron variant has been detected in several countries, its powers of transmission will be tested. If it’s found to be gaining ground, the next challenge will be for scientists to determine whether its increased spread is a function of some innate biological advantage that helps it spread from person to person and whether it’s specially equipped to evade the defenses of people who gained immunity from a vaccine or past infection.

A cursory check of omicron’s constellation of mutations raises deep concerns on both fronts.

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