It has been a little over a week since scientists in Botswana and South Africa alerted the world about the emergence of a rapidly spreading new Covid variant – casting a shadow over the forthcoming festive season.
Although there has been some concern from certain quarters regarding the possible risks, and companies have had to cancel their Christmas parties due to this, the Prime Minister of the United Kingdom and the Health Secretary insisted last week that they would continue as they were recently.
Some European countries have started to impose stricter travel restrictions, national restrictions, and mandatory vaccinations. Amid all this, it’s difficult to know what to make of the risks and how we should respond.
To provide some clarity, The Mail on Sunday spoke to the experts – and the prevailing attitude was that, while Omicron must be taken seriously, its emergence was not unexpected.
Some of the information is worrying, while others are reassuring. Importantly, current evidence does not support panic.
These are the facts.
Panic has erupted around the world over the discovery of an Omicron version of the Covid-19 viral virus. But is it justified? The Mail on Sunday interviewed some leading scientists from the UK, who expressed optimism.
Some may be disappointed by the advice to snog under the mistletoe at Christmas.
The new version is causing concern for some people. Do you feel the same?
Intense research into Omicron has only just begun, so it’s too soon to know much for certain.
So far there has been a lot of speculation ‘which isn’t helpful’, said Dr Julian Tang, a virus expert at the University of Leicester. ‘Relatively little is known about Omicron, even among scientists,’ added Professor Mark Woolhouse, an epidemiologist at the University of Edinburgh.
These are the facts as of now. South African health officials revealed that there was an increase in Covid cases related to a new Covid variant. Due to the large number and type of mutations, or changes, to the variant, it could be more transmissible, the scientists said – meaning it could spread faster than previous iterations.
The next day, the World Health Organisation (WHO) declared it a variant of concern, and named it Omicron – the 15th letter in the Greek alphabet – following its variant naming system.
Omicron could be even more infectious that the Delta dominant variant. This Delta variant was 60% more infective then the Alpha variant. The Alpha variant overtook Wuhan virus late 2020.
One million people have been given additional protection from the Omicron variant, including Prue Leith (pictured below receiving her booster shot at Dr Cath Rose’s Chipping Norton Health Centre in Oxfordshire).
It has since been recognized in over 20 countries, including Britain.
On Thursday, Dr Michelle Groome of South Africa’s National Institute For Communicable Diseases said there had been an ‘exponential increase’ in infections over the past two weeks. In mid-November, the country – where just a quarter of the population have been jabbed – was seeing roughly 300 new cases per day.
They had 2,858 reported cases last Monday. On Wednesday, it had reached 8,561, while Friday’s figure was 16,055.
Based on what’s being seen there, experts say the South African scientists’ initial assessment seems correct – Omicron is likely more infectious than the currently dominant Delta variant, which itself was 60 per cent more infectious than the Alpha variant which overtook the original Wuhan virus in late 2020.
This is what has been causing concern.
Omicron is even more contagious!
However, due to South Africa’s low vaccination rate it’s not possible to make direct comparisons with European countries.
‘We’d need to see more numbers before putting a figure on it,’ said Prof Woolhouse.
I have read ominous things about ‘vaccine escape’. Does this mean our jabs won’t protect us against Omicron?
Omicron’s rapid spread in South Africa suggests that Omicron may be able to overthrow existing immunity. But, it is not clear that Omicron vaccines are going to stop working.
Indeed, scientists we spoke to believe the jabs will still provide an ‘incredibly strong’ protection against serious illness, which is key. The booster program, which will offer every adult a third dose before January 31, is vital.
Omicron’s rapid spread in South Africa suggests that Omicron may be able to overthrow existing immunity. But there is no evidence that these vaccines are not effective.
We know that the South African study last week looked at medical records of approximately three million Covid-positive people. It found 35,670 suspected reinfections – people who’d caught Covid a second time after having tested positive three months or more before. The scientists concluded that Omicron is three times more likely to infect than the Alpha or Delta variants.
‘This is not overly surprising,’ said Professor Francois Balloux, director of the Genetics Institute at University College London.
‘The large number of mutations in the spike protein [is likely to] increase the Omicron variant’s ability to bypass immunity.’
The spike protein is part of the Covid virus that allows it to bind to healthy cells – much like a key entering a lock. These proteins cover the outside shell of the spherical viral particle.
The majority of Covid vaccines (including the Moderna, AstraZeneca and Pfizer jabs) are made to imitate the coronavirus surge protein. They work, in part, by teaching the immune system to create defensive cells called antibodies which recognise and attach to this part of the virus – stopping the key from ever entering the lock.
Scientists have long known that the more changes there are to the spike protein, the more likely it is that Covid antibodies, even in a fully vaccinated individual, will not recognise the virus, allowing it to slip past the body’s defences. Omicron has 32 variants of the spike protein, making it more difficult to distinguish from other versions. This is why experts suspect that current antibodies may not be effective against it.
How much this is the case isn’t known. The immune system does not only develop antibodies to combat viruses, but also other cells.
The Covid vaccines also trigger the creation of T-cells and B-cells – fighter cells that attack foreign invaders – and experts believe that these cells will still be able to identify the Omicron variant, neutralising it before the majority of fully vaccinated people become seriously unwell.
Similar patterns were observed with the Delta version, which was introduced in March to the UK. Early lab studies suggested mutations to the spike protein would allow it to slip past many of our antibodies, and scientists estimated the jabs would be only 67 per cent effective – a massive fall from the initial 90 per cent touted by the manufacturers.
Half a year later, however, experts think that protection from Delta caused by vaccines has fallen to just three percent.
‘We have our T-cells and B-cells to thank for this,’ said virologist Dr Tang, ‘and I expect we’ll see the same with Omicron.
‘The majority of the vaccinated population will still be protected from the worst of the disease.’
Do you believe Omicron causes milder illnesses than the previous versions?
Again, early signs from South Africa suggest that Omicron-infected people are only experiencing mild symptoms. Experts caution against making predictions and making comparisons at this stage.
Based on the current evidence, little is known about the severity of infection – with or without vaccination – caused by Omicron. Prof Balloux said: ‘South Africa has a low vaccination rate but a large proportion of the population has been infected during previous Covid-19 waves. South Africa has a relatively young population, at 27.6 an age. [compared with 40 in the UK]. More data will be needed before we can make robust predictions about the potential threat posed by a global spread of Omicron.’
Speaking at a press conference on Wednesday, the WHO’s Dr Maria Van Kerkhove said: ‘We have seen reports of cases with Omicron that go from mild all the way to severe. There is some indication that some the patients are presenting with mild disease, but it is early days.’
The severity of Covid illness depends on a multitude of factors, which is what makes this a particularly difficult question to untangle – and a proper answer may not come for many months
The severity of Covid illness depends on a multitude of factors, which is what makes this a particularly difficult question to untangle – and a proper answer may not come for many months.
The main concern is that, even if it’s not causing severe illness in general, Omicron could spread rapidly through the vaccinated population, increasing the chances that it will reach vulnerable people whose immune systems have not been sufficiently trained by the vaccines, or the unvaccinated.
Professor Penny Ward, a pharmaceutical expert at King’s College London, said: ‘It may be a while before we know the effect on older, more vulnerable people.’
Is Omicron growing quickly in the UK
At the time of going to press, there have been more than 150 cases of the Omicron variant detected in the UK, but scientists believe there are already many more that haven’t been picked up.
One cluster was found in Scotland. Individual cases were seen in Liverpool and Nottingham.
However, most of them were seen in London. An Israeli doctor was one of those who visited a conference, before returning to Tel Aviv. He was then diagnosed.
Experts say these will just be ‘the tip of the iceberg’ because roughly only one in seven PCR tests are analysed for variants.
Delta continues to see nearly 50k new cases every day, so it is likely that it will be a while before this technology can catch up.
‘We know from experience of Alpha and Delta that by the time you’ve learnt it’s here, the horse has already bolted,’ said Dr Tang. ‘Considering we have so few restrictions in place, it’s likely this virus will propagate at speed.’
But it is likely to take some time for it to catch up with Delta. Delta still has nearly 50,000 new cases every day.
Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, said: ‘It’s unlikely we’ll see big Omicron numbers before January.’
Were there any more restrictions?
On Monday, Health Secretary Sajid Javid confirmed that hospitalisations would be ‘what matters more than anything’ when considering further measures.
Based on our knowledge so far, they are not likely to increase for some time.
Experts told us that the variant would need to reduce vaccine effectiveness before any major social restrictions, such as lockdowns in the UK were required.
Studies show the booster jabs, which have now been given to nearly 90 per cent of Britons over the age of 70, provide an unprecedented level of protection against the virus – and even if Omicron ‘dents’ this, we’re starting from an ideal position to fight it off, said Dr David Strain, clinical Covid lead at the Royal Devon and Exeter NHS Foundation Trust.
Experts told us that the variant would need to reduce vaccine effectiveness significantly before any major social restrictions, such as lockdowns in the UK were required.
In November an Israeli study showed that the protection against symptoms of infection was up to 94% with a third dose.
The effect of this is already being seen in the UK, where hospitalisations are now falling – particularly in older age groups – even as Covid cases rise.
Dr Strain explained: ‘The boosters put us in a wonderful position before this new variant arrived. Omicron has dented that campaign somewhat, but if you are fully boosted you are still in an ideal position to defend against it.’
Disease modellers believe that the strength of the boosters is such that the NHS could ‘tolerate’ even a large wave of Omicron.
Prof Woolhouse said: ‘Healthcare settings could probably bear some fall-off in protection, given just how effective the boosters appear to be.
‘However, I’d like to see some numbers before I say that with certainty. Studies looking at how effective the boosters are against this variant are a priority right now.’
The Government of South Africa announced on November 25 that it will temporarily ban travel from six countries in southern Africa and reintroduce PCR testing for all passengers upon arrival to counter the spread.
Last week, masks were again required in public indoor spaces including public transport and shops.
Ministers claim that the measures will save the UK time and allow scientists to race to determine the variant.
We’ve been told that boosters are vital – but the rules keep changing. What will it take to know where and when boosters are available?
The Government last week announced that every adult would receive a booster Covid vaccine within three months of their first dose. The entire adult population should have the chance to receive a third dose before January.
NHS England released an update on Friday to inform the public that the rollout will begin in December 2013.
To date, only the 40-year-old and older; 16-year olds with Covid risk; social workers and frontline medical staff who have had their booster more than six month ago; and those under age 16.
The invitation should be sent to these groups via email, SMS or text message.
People will be invited down the age ladder after 13 December, just like with the first vaccine campaign. It will also be sent via email or text.
At present, if you look at the NHS Covid vaccine booking website, it states in a yellow box at the top of the page: ‘The NHS is working on plans to offer a booster dose to everyone aged 18 years old and over… Please wait to be contacted by the NHS.’
The Government recommends that people book a jab appointment or locate a walk-in service through the NHS website (go to nhs.uk, scroll down and click ‘Find out about Covid-19 vaccination’ – or Google ‘book a Covid jab’, and click on the top result, titled: Book or manage a coronavirus (COVID-19) vaccination).
The process is relatively straightforward and requires people to enter their name, age, and address (the nhs.uk booking form asks if you know your NHS number, however it’s not a problem if you don’t have this to hand).
After this, you’ll be sent a list with nearby clinics that can provide the booster. This could be any GP, pharmacy, hub at a hospital, community center, or walk-in clinic.
If you have difficulty accessing the Internet, anyone can still book your booster jab via their GP. However, family doctors request that this be done only as a last resort.
Dr Dean Eggitt, a Doncaster-based GP, said: ‘If you ring up your surgery for help with a booster jab, they should be able to organise it for you, but you could be waiting on the phone for quite some time so it is far speedier to do it online.’
The new system will give priority to housebound individuals who have been diagnosed with a disability. This information should be shared with your GP so that they can arrange a home booster. Contact your GP if the situation is not clear. Patients admitted to hospital without a booster may also get their shots in hospital.
In some areas, such as the Isle of Wight and Hampshire, special ‘booster buses’ have been deployed, offering jabs to eligible passers-by in different locations on each day.
Is there enough vaccines for everybody?
The real problem is finding the right people to give them. According to the government, enough vaccines are available to provide every adult in England with a booster shot by January end.
In order to achieve this goal, it will be necessary to double the amount of boosters that are administered each day from 350,000 to 500,000.
Speaking on Tuesday, Prime Minister Boris Johnson said that 1,500 pharmacies would begin providing boosters alongside temporary vaccine centres that will be ‘popping up like Christmas trees’, as well as 400 military personnel and a ‘jabs army’ of volunteers
Speaking on Tuesday, Prime Minister Boris Johnson said that 1,500 pharmacies would begin providing boosters alongside temporary vaccine centres that will be ‘popping up like Christmas trees’, as well as 400 military personnel and a ‘jabs army’ of volunteers.
GPs will also be called on to carry out more boosters, and will be offered up to £30 per vaccine given. However, doctors warn that this could impact the quality of patient care.
Dr Eggitt said the challenge was enormous: ‘If we’re expected to vaccinate on this ambitious timeline, practices will have to make the decision over what they will do less of, and that may include measures such as temporarily suspending routine health checks.’
But what about Christmas? What about Christmas?
Yes, but it wouldn’t hurt to be careful, say experts. While it’s too early to know how rapidly the Omicron variant will become popular, experts predict that it will be several months before widespread adoption. This is based upon the experience of the Delta variant.
This means the chances of catching Omicron right now are incredibly small, and that will still be so in three weeks’ time. Socializing with your family remains a safe activity.
‘I really don’t think Christmas is anything to worry about,’ said Prof Hunter.
‘During Christmas and Boxing Day you’re actually mixing with fewer people than you do on a normal day – so if anything you’re reducing your chances of catching it during this period.’
Scientists warn that Delta, which is responsible for more than 50,000 cases per hour, poses a greater threat to human health.
Scientists say that the Delta’s presence is more of a concern than ever, as it has over 50,000 cases per day.
Ministers have sent mixed messages, with Work and Pensions Secretary Therese Coffey warning the public not to ‘snog’ under the mistletoe, and Mr Javid countering that ‘it’s got nothing to do with the Government who you kiss’.
However, he encouraged people to do lateral flow testing before they attended Christmas parties.
Prof Hunter said: ‘I think if you are older, and concerned about your health and Omicron, I would probably recommend giving crowded Christmas parties in busy bars a miss, because the number of people you will be mixing with is much larger.
‘I wouldn’t tell anyone to cancel their Christmas Day plans.’
Prof Woolhouse said: ‘There’s nothing in the data to suggest any need for a policy change before Christmas. Deaths and hospitalisations continue to fall.
‘I agree that taking a lateral flow test before attending a Christmas party would be wise – we know these tests will flag up this new variant, as well as others.’
Are there more jabs that are needed after the booster has been administered?
Possibly. The UK purchased extra booster jabs of Moderna and Pfizer from Thursday. They will be used in 2022 and 2023. While vaccine developers have already begun to plan to modify their existing jabs for the new version, this doesn’t necessarily mean they will need new vaccines.
Moderna and Pfizer jabs are easily modified to adapt to the new mutations. Last week Pfizer said it was investigating the Omicron variant to assess whether an ‘adjustment’ was needed. The American company claimed that it can develop new dosages within six weeks, and ship them in less than three months.
Moderna, Oxford-AstraZeneca and Pfizer have both stated they are currently evaluating how well their Omicron vaccines work. However, Ugur Sahin, chief executive and co-founder of Pfizer’s German partner BioNTech, said: ‘We think it’s likely that vaccinated people will already have substantial protection against severe disease caused by Omicron.’
Professor Lawrence Young of Warwick Medical School is a virus expert and said that it was prudent for manufacturers to modify future boosters for Omicron regardless of the outcome. ‘There are only so many mutations that can occur to the spike protein, and Omicron has the most we’ve seen yet by far. Any vaccine that can be adapted to match it will have a good chance at fighting off any future variants too.’
The number of questions seems to exceed the answers. What will be the next step?
Experts believe it may take months to get a better understanding of Omicron.
Researchers around the world are now studying the variant. Omicron will examine blood samples of people who are either infected by the virus before they get vaccinated or have never been exposed. This is to determine how these two interactions work. They will first examine the effectiveness of existing Covid antibodies in neutralizing this new variant. Laboratory tests cannot determine how strong the protection that prior immunity offers. These tests do not give us any information about the disease severity.
Professor Penny Ward, a pharmaceutical expert at King’s College London, said: ‘The only way we can know how many people will end up in hospital or dead as a result of the variant is through real-world data involving people.’
It is clear that the bigger the number of people who contract the virus, then the better. Last week, Professor Wendy Barclay, a virologist at Imperial College London, said: ‘It will take several weeks if not a few months before we have clearer answers.’
This blasted pandemic will never stop.
Government scientific advisers warned Ministers that Covid would be a threat to the NHS ‘for at least a further five years’, according to documents released on Friday.
After that, the scientists – members of the Government’s virus modelling group Spi-M – said it was likely the virus would settle into a ‘predictable endemic state’ – where the virus continues to circulate in the population but does not threaten to overwhelm the health service.
The Government have already bought two more years’ worth of vaccine supply, for annual boosters in 2022 and 2023
The Government have already bought two more years’ worth of vaccine supply, for annual boosters in 2022 and 2023.
‘After Omicron there will be another variant, and another after that,’ said Prof Woolhouse.
Scientists compare Russian Flu to the pandemic of 1890s that killed around one million people. Modern research shows that Russian Flu is a type of coronavirus called OC43. This virus has a structure similar to that that causes Covid. Professor Young said: ‘The Russian Flu pandemic went on for roughly four years and then petered out. I’d expect us to see a similar pattern.’
However, Prof Woolhouse did have some hope: ‘The majority of deaths from Russian Flu happened in the first two years. Based on that, and the strength of our vaccines, I’m confident the worst of this pandemic is behind us.’