Omicron reaction makes no sense

We saw that at the end of November 2021, when A new SARS-CoV-2 variant, B.1.1.1.529, Was Designated as a type of concern (VOC) and designated Omicron, by the World Health Organisation, the response of many countries had a close resemblance to the initial pandemic response around February–March 2020. The countries that had reported the new version were unilaterally withheld. Some countries jumped into action to expand or introduce COVID-19 booster dose vaccinations for their populations. The virus was often referred to as the South African and Botswana versions.

an irrational return

It seemed as if the world had hardly learned anything, while the reality is that the world of December 2021 is very different from the world of March 2020. At that time, SARS-CoV-2 was a new virus and everything was unknown. In contrast, Omicron is another form of a virus that we have known for almost two years. At the time, almost everyone was susceptible and now, with natural infection and/or vaccination, the pool of susceptible populations has been reduced.

Currently, more than half the world’s population has received at least one shot. In addition, there is appropriate testing and genome sequencing capability, including the availability of some new drugs with greater evidence of effectiveness, which are widely used.

In response to all this, some nuances and nuances should have come. Scientific development should have reassured everyone that the response should be calm, composed and evidence-informed. However, it seems to be missing, mostly if not always and the entire time. This is not understood enough.

South Africa, instead of appreciating the work of its medical doctors, researchers and scientists in identifying and reporting the new variant in real time, has ended up as a nation punished by a travel ban that has even That also threatened essential COVID-19 lab supplies. Compare this to the Netherlands, which detected and did not report omicron earlier than South Africa.

overreaction and why

It is true that many mutations occur in the oomicron and that some of the spike proteins may have an effect on transmission efficiency, immune evasion and sub-optimal response to treatment. Apparently, it is enough to designate it as a VOC, as it were. Subsequent response, however, should be measured, evidence-based, derived from experience acquired over the past months and consistent with knowledge and understanding. However, it has certainly been excessive, in most if not all cases.

The problem is not only with the governments. Some researchers and scientists, oblivious to ground reality in South Africa and often not in contact with anyone at ground zero, should also take some of the blame for the exaggerations and exaggerations that have been used to describe the version.

It would not be an exaggeration to say that so-called ‘experts’ on social media and prime time television practice what might be termed ‘borderline public health misconduct’; with most of his information from sources on the Internet, yet always speaking as though he has definite and final words; And as if this is the only true science – that may be an unfortunate reality of the social media age.

Then, there are debates on television where invited guests – often influential voices, though not necessarily experts on the subject – readily take a position that echoes popular sentiment, and where that sense of rationality sinks in. The impact of such misinformation is widely known to the people of India, where the baseless claim that ‘children will be affected in the third wave of COVID-19’ cannot be dispelled for long, and those continues to affect children’s education where parents are still wary of sending children to individual schooling.

Ground

Both countries, from which we are the authors, have responded to the emergence of Omicron with largely balanced, evidence-informed and measured responses, with occasional exceptions, such as on all international flights of a few chief ministers to Indian states. demanding a ban. The last part raises serious doubts about his advisors on the COVID-19 pandemic, as well as the continued need for science to guide pandemic response, not just political wisdom.

With the emergence of new forms, the next natural step should be for countries to become more vigilant about the need to tackle vaccine disparities; In fact, some high-income countries have started to look inward and are focusing on administering boosters. Another reality is that many ‘experts’ have taken a tough stand on how the new variant is more permeable, evades immunity, and has a higher chance of re-infection.

Then, as an example, even when ground reports from South Africa indicate that most cases are mild, some experts are unwilling to back down from their position.

Similarly, the point that the majority of cases were detected in a vaccinated person who traveled is being argued as evidence of immune avoidance or re-infection, while missing the point of confusion or detection bias. going, because international travelers are essentially required to be vaccinated and tested. Therefore, it is not sufficient to argue that these cases are being reported more commonly among vaccinated individuals, thus leading to higher vaccine success infections than previous variants.

editorial | Limited Benefit: At Omicron Risk

Most importantly, the role of current COVID-19 vaccines in preventing infection is limited. Therefore, as the global pool of vaccinated individuals continues to grow, the absolute number of infections in this subgroup is likely to increase proportionally, especially when the practice of wearing masks is anything but universal and is declining.

‘specialist’

The world seems to be divided into two groups of ‘experts’. One who is in a flamboyant rush to reach a certain conclusion before anyone else and is in competition. Here’s a subsection that argues that even though it may take weeks or months for anything to be known for certain, ‘let’s assume that everything is worse with diversity’. This is not the right way. However, this first group gets more public attention than the second group talking about rationality and evidence-guided response. The approach of this group (the second group) is to look at the entire set of cumulative evidence, not isolated, which is best suited to the argument it seeks to make.

One needs to remember that the effect of the Omicron version, no matter what new features it has, will depend on the context and settings. A highly transmissible variant in a well-vaccinated population is unlikely to change the scenario, while it could pose a real threat to a less vaccinated population. Avoidance of immunity alone may have limited relevance if not accompanied by high transmission and severity. Re-infection or breakthrough infections are common with all vaccines and all types. Therefore, the solution is not a booster dose (which is not helpful in reducing transmission as is the case with most vaccines); The approach should be to increase coverage with the first two shots of vaccines and focus on improving adherence to COVID-19 appropriate practices.

lost voices

However, the easiest thing that political leaders can resort to is to do something that resonates with the sentiments of the people. The flight ban and booster shot are reflections of that challenge. This is where the voices of technical advisors, independent experts providing data on COVID-19 and epidemiologists trained to draw conclusions based on limited information should be heard more often.

Rich countries have mostly disappointed the rest of the world in terms of global solidarity in their response to the pandemic, including vaccine disparity. There seems to be no end to this sad story. Now, take the lead on India, South Africa and many other countries in the global South, and let rationality and science determine the course of the pandemic response. Simultaneously, this is a time for a dynamic pandemic response and not a worst-case scenario. It’s all very much worth doing.

Dr. Chandrakant Laharia is a physician based in New Delhi, India, with advanced training in epidemiology and public health. Dr. Angelique Coetzee is a physician in general practice and President of the South African Medical Association based in Pretoria, South Africa.