Saturday, December 28

COVID-19: how Ómicron works and how to defend ourselves against this new variant

Ómicron sounds like an apocalypse. The WHO decided to name the different variants following the Greek alphabet: alpha: B.1.1.7; beta: B.1. 351; gamma: P.1; delta: B.1. 621.two; epsilon: B.1. 427 / B.1. 429; zeta: P.2; eta: B.1. 525; theta: P.3; lot: B.1. 526; kappa: B.1. 617.one; lambda: C. 21; mu: B.1. 621.

Next on the list had to be nu, but how it sounded like n ew (“new”) decided to move on to the next one, xi. But it turns out that the Chinese president is called Xi JinPing and it is better not to touch his nose.

The next letter of the alphabet was omicron. Therefore, the new variant B.1.1. 529 is called omicron. And with omicron came chaos.

In times of generalized pandemic fatigue, it is essential to remember that fear in communication does not usually function. We have verified this with climate change: catastrophic messages end up boring and many people disconnect, as in the children’s story of Peter and the Wolf.

Again, with omicron it is time for rigor, transparency (say what is known and what is not known) and, above all, of propose solutions .

Is Ómicron much more transmissible?

Since it was detected a few weeks ago, the variant is expanding very intensely in many countries. It seems that its growth is soaring, it is exponential, and that in a few weeks it will displace the delta variant, until now dominant.

However, although it is still too early to know, some data suggest that this high incidence is not assuming a higher mortality .

On this there are still contradictory data and it is difficult to know what will happen. The level of uncertainty remains very high. It is true that hospitalizations, ICU admissions and deaths occur with a lag of a few weeks.

The problem is that a much more transmissible variant, although less virulent, does not necessarily mean that it causes less deaths: if it grows at such a high speed, if there are many cases in a very short time, there may be more deaths .

A sixth intense and rapid wave in number of cases will generate a collapse in the health system, something that we have already seen has very serious consequences.

International health agencies rate the situation as very high risk. For this reason, some say that “we must prepare for the worst.”

We do not know if it is more serious, but we do not know if it will be milder

Although the number of hospitalizations remains low, there is no evidence that omicron is less virulent than the delta variant.

  • What are the symptoms of the variant So far known omicron

In Compared with other variants, preliminary results suggest that omicron multiplies 90 times faster in human bronchi, which could explain why This variant may be transmitted faster.

Gráfico de la variante Ómicron

However, the same study shows that the infection by or micron in the lung is significantly lower than with the original SARS-CoV-2. This could perhaps explain that it produces a lower severity of the disease.

Other preliminary studies also suggest that the sera of vaccinated individuals neutralized the omicron variant at a much lower level than any other variant.

However, in the same work they also point out that the sera of superimmune individuals (those who had been infected and vaccinated or who had been vaccinated and later were infected) they were able to neutralize the new variant.

Antibodies prevent infection, so this partial escape of the immune response (antibodies) could also influence its greater transmissibility .

Gráfico sobre las caracteristicas de 4 de las variantes del Sars-CoV-2

Against omicron, or against any other variant even more dangerous, what we have to do is remember what we already know … and do it : vaccines, masks, ventilation, distance, antigid test enos, self-confinement, sanitary reinforcement …

Vaccines work, of course they work

With the current incidence, if this sixth wave had caught us without vaccinating this would be a real carnage.

We have already verified it with the fifth wave, in which the number of cases increased (then delta, which was more transmissible, was dominant) but was not reflected in an increase in deaths as in previous waves.

The difference is that the Most of the most vulnerable older people were already vaccinated. Hopefully something similar happens now. In three or four weeks we will know.

With the tremendous transmissibility of omicron, it is most likely that many of us will get infected. If we become infected, it is best if the virus catches us vaccinated.

People without protection (without vaccine or without previous infection) are those who are at higher risk . Vaccines are not an impenetrable steel armor, we can get infected and we can infect others, although with less probability.

But that does not mean that vaccines are not working. These vaccines are preventing severe cases of the disease , reducing hospital admissions and ICU (intensive care unit) and reducing mortality.

That was his goal. That is why we must be vaccinated, not only to protect ourselves, but to protect others.

Mujer recibiendo la vacuna de la covid.

The Vaccines induce a powerful immune response. immunity is much more than antibodies .

Antibodies prevent infection and cellular immunity prevents disease severe and mortality. But both are needed.

Therefore, the most vulnerable people need antibodies and cellular immunity, because only infection can carry them to the hospital.

In older people their immune system also ages (immunosenescence) and they respond worse to vaccine stimuli.

It may also happen that the antibody response decrease over time. Therefore, a souvenir dose may be recommended, the famous third doses .

  • Because it is important the third dose against the contagious omicron variant

As we have said, it seems that the neutralization capacity of antibodies induced by vaccines may decrease with omicron. Other studies suggest, however, that the cellular response could control the new variant.

In any case, several studies with different vaccines (AstraZeneca, Johson & Johson, Modena, Novavax, Pfizer and Valneca ) suggest that a booster dose reduces covid – 19 serious in any age group and increases the neutralizing activity against omicron very significantly.

There is no doubt that the best way to protect against SARS-CoV-2, regardless of the variant, it is vaccination. The priority should be:

1) Convince those people who have not yet been vaccinated to get vaccinated.

2) Vaccinate with a third booster dose to those most vulnerable people (elderly, with previous pathologies, etc.).

In addition, it is important not to forget that this is a Global pandemic and what happens in South Africa, Peru or India influences us, so vaccines must be provided in those countries where vaccination rates are still very low.

Do we vaccinate children under 12 years?

We are in an extraordinary situation. Although covid cases – 19 serious are very rare in minors, that does not mean that there have been no serious cases and even deaths.

Clinical trials have shown that vaccines for children between 5 and 12 years are safe and effective.

In addition, more than five million children have been vaccinated in the US and no serious secondary cases have been reported .

Niño siendo vacunado contra la covid.

Even if From the individual point of view, the need for childhood vaccination could be doubted, vaccinating minors can have other beneficial effects, not only preventive but even therapeutic: can help reduce the incidence disease , improve the situation in schools and reduce psycho-emotional stress l to which minors and their families are also subjected.

Some argue that vaccinating children to protect the elderly is an aberration, but vaccines have always had that social component : they protect each one and protect others.

We insist, the situation at this moment is not normal, we are immersed in a pandemic.

On this point, it should be remembered that in many countries, Spain among them, vaccination is not mandatory.

Vaccinating children is a decision that parents must conscientiously authorize. If you have doubts, ask your pediatrician for advice. But you have to respect their decision and not discriminate against anyone.

This sixth wave is not the fault of the unvaccinated. The unvaccinated are at greater risk, but they are not to blame for the increased incidence of the virus.

If vaccines do not They are preventing the circulation of the virus, what do we do?

Now is a good time to remember the image of Swiss cheese.

gráfico del queso suizo para combatir la covid
  • The strategy Swiss cheese to protect you from coronavirus

Vaccines are not the solution, but part of the solution

We do not have an impenetrable steel wall that blocks the virus , not even vaccines. Vaccines are not the only solution, they are part of the solution.

No single measure is perfect to prevent spread of the virus (each layer of the cheese has holes). But a overlap of measures compensates for individual defects and significantly reduces risk.

Recall that the virus is transmitted by aerosols, as if it were tobacco smoke. Let’s imagine a person next to us smoking.

Just as tobacco smoke moves around us and we end up breathing it, so the virus will move if we had an infected person next to us.

Therefore, a closed, poorly ventilated place, with many people, talking for a long time and without a mask is the best place to get infected . Masks have proven to be a very effective measure to prevent contagion.

Masks are necessary indoors and outside if there is no safety distance. Outdoors with a safety distance, the mask is not necessary.

The risk of infection outdoors is much lower than indoors. That is one of the reasons why there are more infections of respiratory pathogens in winter, because we spend more time together indoors.

It does not make sense, therefore, to close the parks as has been done in other moments of the pandemic. Any activity, better outside than inside.

Going down the street with a mask and taking it off when entering a closed space is like going with a helmet on the street and take it off when you get on the motorcycle because it bothers to drive .

What if it makes more sense is to favor CO₂ meters indoors. One way to measure the quality of the air we breathe is to measure the concentration of CO₂ that we expel when we breathe.

The higher the concentration of CO₂, the greater the amount of air already breathed by another person.

Gente con mascarilla.

As at We do not see the virus and we cannot measure its concentration in the air, the measurement of CO₂ is a good indicator. We carry more than 20 months of pandemic, why have CO₂ meters not been installed in closed public places?

To improve air quality, cross ventilation is still essential.

Yes not possible, filter system can be used. Why haven’t air filtration systems been installed in closed public places?

Do we do an antigen test?

Antigen tests have been available for several months. Used properly, they allow detecting people in their most contagious phase.

If the test is positive, you should isolate yourself and stay at home .

If it is negative, do not relax. There may not be enough viral load yet. The best thing would be to repeat it the following days. In the case of a celebration, it is best to do it shortly before the event.

This type of test can be very useful in situations such as the current one in which there is already a collapse in the health system. Why are they still not sold outside of pharmacies, as in other countries?

If it is convenient to repeat the test, why are they not cheaper or even distributed free of charge among the population , as in other countries?

But there is also good news, although it is very preliminary.

For example, the oral drug Paxlovid maintains an efficacy of nearly 90% of avoiding hospitalization and death from covid – 19 in a study conducted in more than 2200 high-risk patients. The efficiency amounts to 94% in greater than 65 years.

Strengthening the health system is not the responsibility of the citizen

This time of year, in the northern hemisphere, is the season for snot, colds, colds, bronchitis, pneumonia, flu … and coronavirus.

Mortality statistics throughout the year (before the pandemic) show that more people always die in winter than in summer, there are hundreds of viruses and bacteria that are transmitted through the air and cause this type of respiratory problems.

It is foreseeable, therefore, that every year there will be a peak of incidence and that the health system will suffer some tension and accumulation of patients.

This winter, in the midst of a global pandemic, the collapse of the system was more than foreseeable. The vast majority of citizens have been obedient, we have complied and we have been vaccinated.

Whose responsibility is it? that now the health system is full? Obviously the virus, but we have already more than 20 months of pandemic.

There are personal responsibilities (getting vaccinated, wearing masks, physical distance, avoiding contagion, avoiding crowded spaces, confining oneself in the case of presenting symptoms, informing the health service in the case of contagion, complying quarantines…).

And there are managers (reinforce the workforce of trackers, doctors / nurses, primary care and emergencies, diagnostic laboratories, ICU beds, provide CO₂ meters, ventilation and filtration systems, provide and / or facilitate access to antigen tests, adapt the legal system, coordination, effective communication …).

All this Combination of measures and responsibilities will help us to better control the pandemic, regardless of the shift variant.

The situation is very delicate. Let’s be responsible and take care of ourselves.

Ignacio López-Goñi is Professor of Microbiology at the University of Navarra, Spain.

This note originally appeared on The Conversation and is published here under a Creative license Commons. You can read the original article here .


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