Covid-19: Vaccines, variants and mutations

"On average, Omicron is less severe," Tedros said, "but the narrative that it is a mild disease is misleading."

In Summary

•Bruce Aylward, a senior WHO official, warned that high levels of transmission give the virus more opportunities to replicate and mutate, raising the risk of another variant emerging.

•Globally, new infections increased by 20% in the last week, with nearly 19 million total reported cases.

The COVID-19 pandemic will not end as omicron variant infections decline in some countries, according to WHO Director-General Tedros Adhanom Ghebreyesus during a press conference on Tuesday, January 18. He warned that as the virus mutates, widespread infection will almost certainly result in new variants.

"This pandemic is far from over," Ghebreyesus warned, cautioning against dismissing the Omicron variant as insignificant. Despite causing less severe disease in those infected, Omicron is far more contagious than previous strains.

Dr. Bruce Aylward, a senior WHO official, warned that high levels of transmission give the virus more opportunities to replicate and mutate, raising the risk of another variant emerging. Globally, new infections increased by 20% in the last week, with nearly 19 million total reported cases.

"On average, Omicron is less severe," Tedros said, "but the narrative that it is a mild disease is misleading."

"Make no mistake: Omicron is causing hospitalizations and deaths, and even the milder cases are clogging health-care facilities." "He warned that the debate over the virus's transition from being a pandemic to endemic disease was misguided.

He emphasized the importance of ensuring more equitable and widespread access to vaccines.

The World Health Organization has repeatedly warned that unequal vaccine distribution has resulted in low immunization rates in developing countries, leaving vast populations vulnerable to the emergence of new variants.

The WHO had set a target for all countries to vaccinate 40% of their populations by the end of 2021.

According to the WHO, 92 countries have not met that target.

"This pandemic is far from over," Tedros said. "With the incredible growth of omicron globally, new variants are likely to emerge, which is why tracking and assessment remain critical."

The director of the Africa Centers for Disease Control and Prevention, John Nkengasong, lamented the "total collapse of global cooperation and solidarity" over the last two years during a panel on "The Challenge of Vaccine Equity" at the ongoing Davos Agenda 2022, the online alternative to the annual World Economic Forum gathering, which was postponed due to pandemic health concerns "that only 7% of Africa's population was fully immunized.

He also sought to dispel the widely held belief that vaccine hesitancy is widespread in Africa, citing studies that show that 80 percent of the continent's populations would be willing to receive vaccinations if they were available.

The Davos 22 forum was held in Cologny, Switzerland, near Geneva, and brought together global leaders to shape the principles, policies, and partnerships required during this time.  Many experts have warned that allowing Covid-19 to spread uncontrollably increases the possibility of new variants emerging.

Dr. Tedros also discussed how current Covid vaccines are less effective against Omicron transmission than previous strains. On the other hand, he emphasized the importance of ensuring more equitable access to vaccines.

'Vaccines may be less effective at preventing Omicron infection and transmission than they were for previous variants,' he says, 'but they are still extremely effective at preventing serious disease and death.

In light of the foregoing, Nelly Madegwa has put together this explainer to assist you in understanding Covid-19, its variants and the importance of getting vaccinated.

What is the difference between mutations, variants, and strains?

When the virus infects human cells, their genetic code is copied to make new virus particles, but mistakes happen in the process and these copying errors become mutations. Variants / strains  are subtypes of a microorganism that is genetically distinct from the main strain but not sufficiently different to be termed a distinct strain.

Are variants of viruses more dangerous than the original?

Some of the mutations have made the variants more transmissible and highly infectious, for example the Delta variant was highly infectious with high severity in disease while the Omicron variant even though the severity of infection is low it is very transmissible even causing breakthrough infections.

Is it necessary to be concerned about Covid-19 variants?

Yes , it is , the new variants, for example  Delta (B.1.617.2)  is nearly twice as contagious as earlier variants and cause more severe illness with  greatest risk of transmission among unvaccinated people. Omicron (B.1.1529) spreads more easily than other variants, including delta with cases of breakthrough infections even though  disease severity is low.The virus is mutating very quickly and new strains seem to pop up daily. The best alternative is to slow down the spread of COVID-19 so that the virus has fewer hosts, which in turn limits its ability to mutate into new strains.

Do the current vaccines protect against COVID-19 variants?

Results from recently published studies show that vaccine effectiveness against symptomatic disease is lower for Omicron than for other variants and tends to wane over time. As a result, more vaccinated people are likely to develop breakthrough disease—become infected even after they have been vaccinated— due to the Omicron variant.

However, these studies also show that vaccination continues to provide a high level of protection against severe disease and hospitalization linked to the Omicron variant. The latest evidence, which includes real-world effectiveness data, also suggests that people who have had a booster dose are better protected than those who have only received their primary dose. Data from South Africa indicates that people who have received two doses of a COVID-19 vaccine have up to 70% protection for hospitalization. Similar data from the UK shows that while protection declines a few months after vaccination, protection from hospitalization rises again to 90% after a booster shot. The current vaccines have been found to be effective in preventing severe disease.

How are new variants tracked?

New variants are tracked by continuously analyzing lots of virus samples , looking at how the genetic code of the virus is changing and what mutations are being acquired  through a process referred to as genome sequencing and  genomic surveillance which entails combining data from genome sequencing with epidemiological data(  how the virus is spreading in communities )and this provides insights on how the virus populations are changing and how the virus is evolving.  

Can we avoid the emergence of variants?

Stopping the spread of the virus remains key in preventing the emergence of new variants. Current measures to reduce transmission like wearing masks, handwashing, physical distancing and avoiding crowded places continue to work against new variants by reducing the amount of viral transmission and therefore also reducing opportunities for viruses to mutate.  Mass vaccination is also critical in protecting people before they are exposed to the virus  and the risk of new variants by reducing circulation of the virus which will in turn lead to fewer mutations.

Is the Covid-19 pandemic reaching its endgame? Is it reaching a stage where it can be downgraded to an endemic?

For COVID-19 to be endemic, there needs to be broad immunity against the virus. This can be achieved by enough people being infected or vaccinated against the virus or through a combination of both.

Omicron is rewriting the timeline to get to endemic levels as it is highly transmissible and causes breakthrough infections. Another factor is the low vaccination rates in the majority of the countries such as Kenya which are giving the virus opportunities to spread and mutate to new and possibly dangerous variants. Endemicity does not mean absence of the virus within a population but that the virus will keep circulating in parts of the global population for years, but its prevalence and impact will come down to relatively manageable levels.

“This article was produced by the Africa Women’s Journalism Project (AWJP) in partnership with Article 19, Meedan and the International Center for Journalists (ICFJ).”