The fourth wave in Germany has weakened somewhat. The incidence is still at a very high level, with around 4800 Covid patients in intensive care units. What the new Omikron variant means in this mixed situation.
Instead of speculating about a possible milder course of the disease, measures must be implemented immediately to slow down the advance of Omikron, demand experts. With Omikron, a corona variant is spreading internationally, from which even vaccinated and convalescent people do not have optimal protection. The part of the population susceptible to the virus is likely to increase significantly compared to the situation with the delta variant. Since Omikron is relatively new, many properties cannot yet be described with certainty. “There are more questions about Omikron unanswered than answered,” said the infectiologist Jana Schroeder from the Mathias Hospital Foundation in Rheine. In principle, new findings appear every day – mostly not yet checked by external experts. Questions and answers:
What makes Omikron so special?
The variant has a noticeably high number of genetic changes at key points. More than 30 mutations affect what is known as the spike protein, which the virus uses to enter human cells. The problem: The previous vaccines are aimed at the spike protein of the coronavirus from the beginning of the pandemic. If a virus changes in such a way that antibodies from convalescent and vaccinated persons respond less well, experts call this immune escape. In addition, there are indications from genetic analyzes, among other things, that Omikron is per se more contagious than Delta, said modeler Dirk Brockmann from the Humboldt University in Berlin. The immune escape alone cannot explain the growth rates.
What protection can vaccinated people still expect?
According to many experts, protection against serious illness should also be maintained at Omikron. “However, there are still no data to prove this,” said Schroeder. Previous laboratory tests indicate that the variant threatens infections in vaccinated persons. Omikron is more likely to be able to overcome the first line of defense, the antibodies. The immune system of those vaccinated has other means to defend itself. Protection against the virus being passed on by vaccinated people is likely to be significantly impaired at Omikron, Schroeder expects. In particular, people who have only been vaccinated twice shouldn’t feel too confident and neglect testing. “It would be best if people behaved as carefully as they did at the beginning of the pandemic, when there was no vaccine.”
What do the results for Omikron look like in concrete terms?
The manufacturers Biontech / Pfizer rated two vaccine doses as insufficient protection against infection. A population study from the UK found that effectiveness against symptomatic infection with Omikron drops to 34 percent 15 weeks after the second dose of Biontech. People who had been vaccinated with two doses of the Astrazeneca preparation were no longer protected from symptomatic infection. Two weeks after a booster vaccination, the effectiveness of both preparations rose to over 70 percent.
What does a booster do?
With the booster vaccination, antibody levels can be raised again to protect against infection, but according to previous knowledge, it is not perfect. Omicron cases are already known in people who have been vaccinated three times. The virologist Sandra Ciesek from the Frankfurt University Hospital therefore warned that concentrating on the booster campaign would not be enough, also because the protection was decreasing again.
How widespread is Omikron?
“Omikron is spreading at a speed that we have not seen in any previous variant,” said World Health Organization head Tedros Adhanom Ghebreyesus in Geneva on Tuesday. According to WHO, 77 countries have reported evidence. However, Omikron is presumably already in most countries, just undetected. In South Africa and Great Britain, for example, significant increases in the number of cases are attributed to Omikron.
What is the Omikron situation like in Germany?
In this country, the prevalence seems to be very low according to the latest available data, but by no means all positive samples are examined for variants. There is also a time delay in the evaluation. According to the RKI, the Delta variant still clearly has the upper hand. By December 7th, a total of almost 30 records were found through complete genetic analyzes, plus 36 suspected cases. According to the RKI, however, the proportion of cases for which whole genome sequencing was carried out has recently continuously decreased. Recently, at two percent, it was well below the targeted five percent.
What development is assumed?
In the UK, experts assumed the number of cases would double every two to three days, possibly even faster. According to the EU health authority ECDC, Omikron is likely to become the dominant variant in Europe as early as the first two months of 2022. Brockmann described the situation for Omikron in Germany as follows: In the boosted part of the population – around a quarter – the probability of transmission is reduced, but not permanently. The pathogen could be transmitted to the rest of the people, also “because the first and second vaccinations are practically ineffective in terms of the spread dynamics,” said Brockmann.
What else do you have to consider for Germany?
What differentiates Germany from Great Britain and other countries, for example, are the measures in force, said Schroeder. “We are not letting the virus run free at the moment.” However, she considers the omens to be problematic: The health authorities are already at their limit when it comes to tracking contacts in the current delta wave, and laboratory results sometimes make the wait longer. “If a new, more contagious variant like Omikron is added to this situation, it cannot be contained as effectively as in a time of low incidence.”
Eugen Brysch from the German Patient Protection Foundation criticizes the elimination of extra tests for people who have been vaccinated three times in access rules. In this way, the “infection radar” is switched off, so to speak. “We know that infections precede hospital admissions.” This step before Christmas with more contacts is extremely dangerous. In addition, the corona data over the holidays is unlikely to be meaningful for a while due to delay in reporting and closed medical practices, as in the previous year.
How severe are omicron infections?
There is still no definite answer to this for Germany. There are first observations of relatively mild courses in South Africa. But experts tend not to assume that this is a property of the virus. This is because the information is based on a relatively small number of cases among rather young people affected. In addition, most people in South Africa are already considered to have recovered from Corona. The WHO recently stated, “When the clinical profile of patients changes, the way Omikron works may change.”
For a relatively old society with many unvaccinated people like in Germany, the picture can therefore turn out differently than in South Africa. British experts also emphasized that many infections only happened recently, but that it takes some time before hospitalization or death. Even if Omikron should cause less serious illness, the sheer number of cases could overwhelm unprepared health systems, warned the WHO.
What about children when they become infected with Omicron?
Nothing certain can be said about this either, the first reports of severe progress in young children are, according to German experts, to be regarded as preliminary. In the case of earlier variants, too, there were similar reports at the beginning, which then did not come true. Virologist Christian Drosten recently said that he does not expect Omikron to be harmless for people whose immune system is neither vaccinated nor prepared for Sars-CoV-2.
What is the situation like in South Africa where Omikron was discovered?
The fourth wave of infections has South Africa under control. The government has now allowed booster vaccinations. The epicenter of the infection process is the Gauteng Province – the area around the metropolis of Johannesburg and the capital Pretoria. With the summer holidays, which many residents of the economically and politically most important region now spend on the country’s beaches, the number of cases there also increases significantly. The province of KwaZulu-Natal around the port city of Durban and the Western Cape around Cape Town are particularly affected.
What do experts advise against Omikron?
Keeping the wave flat: That is the motto that many scientists and the WHO give. It depends on the combination of measures: “Do it all. Do it consistently. Do it well (do everything. Do it consistently. Do it well),” said WHO chief Ghebreyesus. Vaccination alone will not get a country out of this crisis. It also needs masks, distance, ventilation, hand hygiene. Several experts consider vaccines adapted to Omikron to be necessary. German experts called on Wednesday for quick, precautionary action. You have to be prepared for all possible scenarios. Even in the worst case, such as increasing hospital occupancy.
Source From: Stern
