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Does omicron pose a risk to the vaccinated? Too early to tell, epidemiologist says

DAVID FOLKENFLIK, HOST:

The United Kingdom, Germany and Italy are all reporting confirmed cases of the new omicron COVID variant today. It's the latest evidence that omicron is quickly spreading far from southern Africa, where it had been identified earlier by scientists in Botswana and South Africa. Yesterday, omicron was declared a variant of concern by the World Health Organization. The U.S. and other nations have responded by announcing new travel restrictions and testing requirements for arriving airline passengers.

Let's underscore this. There's still a lot we don't know about the new variant. So we want to begin today by going through some of the big questions that remain about this strain, and to help us with that, we have once again called upon Bill Hanage. He's an associate professor of epidemiology at Harvard's T.H. Chan School of Public Health. Bill Hanage, welcome.

BILL HANAGE: Thanks for having me on the show, David.

FOLKENFLIK: For starters, can you tell us the basics of what we do know at this point about the omicron variant?

HANAGE: Well, I want to start by reiterating exactly what you just said, which is there's a heck of a lot that we don't know. What we know is that a few days ago, the South African authorities reported that they were seeing a large number of cases of a variant with a very large number of mutations, way beyond what you would expect, and that they had reason to think, from a particular set of test results, that this had not spread just in one small location but was in several regions around the country. Shortly after that, we heard that cases of omicron had been introduced to Hong Kong and also Belgium. And basically, things have been moving very quickly since then, and we're still scrambling, trying to figure out exactly what sort of beast we're dealing with.

FOLKENFLIK: There have been COVID variants before, like delta, that have caused concerns. Why is this one considered particularly worrisome to scientists like yourself?

HANAGE: Well, a lot of it has to do with just the sheer number of mutations it has because it's much too early to actually have really good epidemiological evidence. But if you look within the spike, which is the protein which is targeted by the vaccines, we see that there are about 30 or more mutations - 10 of them in the receptor-binding domain, which attaches to cells alone. And lots of these are mutations we've seen before. And so if you put them all together, this looks particularly worrying. However, I want to emphasize that how something looks doesn't necessarily translate into how it behaves. I can give you an example of that.

FOLKENFLIK: Sure.

HANAGE: Do you remember beta?

FOLKENFLIK: Yes. Yes, I do.

HANAGE: Yeah. Beta was the variant that everybody was worried about before because it was the one that was best able to sidestep neutralizing immunity or neutralizing antibodies. However, beta didn't really go anywhere. This is only the most recent thing, and we're only starting to learn how transmissible it is. It looks like the answer is quite transmissible, but how exactly how transmissible we don't know yet.

FOLKENFLIK: At this point, without being unduly alarming, is there any reason to think that the omicron variant could overcome the vaccines that have been plunked in people's arms and are currently coursing around their bodies?

HANAGE: I think it's unlikely to think that it will totally overcome it. Having said that, I don't think that we know enough at the moment to be absolutely sure about the quality of protection that they will provide. Let me take a step back and just point out the really important things that we don't know and that we're going to be finding out. The first thing is going to be exactly how this virus interacts with neutralizing antibodies. We're going to get that information on a time scale of a few weeks.

The next thing we want to know is how transmissible it is. That'll be a little bit longer. But the epidemiology will be done, and we'll be starting to figure that out a little after that. The data upon the severity of infections is going to take much longer to come in, and that's the thing which is really important because even if it's able to cause infections in vaccinated people, I mean, delta could cause infections in vaccinated people, but they were mild. They were milder than they would have been in the alternative, unvaccinated state, and that's what really matters.

FOLKENFLIK: Ahead of this long holiday weekend here in the U.S., there were already concerns that people are traveling more. There could be spikes in COVID cases around the country. Now there's news of this new variant. What should Americans be paying attention right now in thinking about the pandemic?

HANAGE: One thing that I think is worth remembering is that we have, for a long time, had people talking about when the pandemic is done. But pandemics don't end in that way. You don't get a sort of 21-gun salute to say, ooh, it's over. Instead, it's a long, drawn-out process of fighting whatever the virus throws at us next. There's still a lot of stuff that can be done. Vaccines are likely to be at least somewhat protective and quite possibly very protective against it. So if you haven't got your shot, get your shot. If you have, just be prepared to roll with what happens and what comes at us next.

FOLKENFLIK: So how should Americans envision managing life in the pandemic for the foreseeable future? Will there always be a new variant to worry about?

HANAGE: Well, this is the issue that I rose earlier. I mean, it's not only the existence of the new variant. It's the type of disease it causes. The boosters seem to generate a lot of protection, and we haven't got any evidence of how this variant transmits within a context like that yet. It may also be the case - I want to point out - that - and this is something which is very important - not all networks are alike.

I've long been trying to argue for folks to be using things like rapid tests if they are in contact with groups of older people, especially older, unvaccinated people, or those who have not yet received boosters. That kind of thing is going to be the case going forward. Whether or not this is going to cause a serious public health problem in the coming months I don't know enough to say at the moment, and I don't think anybody does, honestly.

However, I can tell you the kind of things we're going to be looking at - first of all, lab studies of neutralization by antibodies generated through vaccination. And then there'll be the epidemiology information about the transmission and, importantly, the information about the type of disease which it causes. Those things could conceivably be very optimistic, or they might not. But at the moment, we don't know. And that uncertainty is something which a lot of people find it hard to deal with. But unfortunately, it's part of living through a pandemic.

FOLKENFLIK: We've been hearing from Bill Hanage. He's an associate professor and epidemiologist at Harvard's T.H. Chan School of Public Health. Professor Hanage, thanks so much for speaking with us today.

HANAGE: Thanks for having me. Transcript provided by NPR, Copyright NPR.