Thursday, August 11th, 2022 10:38:26

”Stealth Omicron” victims: The boiling frogs in slow cooker

By Sarat C. Das
Updated: March 7, 2022 11:08 am

Omicron is the most benevolent of all the apostles of death! Your chances of dying of Omicron is far less than the diarrheal diseases, listed as number 8 cause of global death by World Health Organization (WHO). Further, WHO reveals, among the communicable deaths the respiratory infections and tuberculosis account for 6.85 percent of all deaths. Hence, Omicron death pales into insignificance.

The anti-vaxxers or Covid-death deniers claim the chances of dying from Omicron is far less than falling prey to a snakebite in a supermarket or getting choked eating jelly beans while watching cinema. Unlike the second wave last year, which was fueled by the Delta variant and killed over two million people in just a few weeks, according to The Economist’s estimates, the Omicron outbreak passed without enormous loss of life. We accepted Omicron as innocuous as cough or sneeze. However, all these statistics are going to change very quickly, as we are falling into the quicksand of the Russia-Ukraine war. Further, the possibilities of new variants of Coronavirus or Omicron seem to be imminent.

In a war situation, there are more people dying from contagious diseases than the blitzkrieg of the war. An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in World War I. Of the U.S. soldiers who died in Europe, half of them fell to the influenza virus and not to the enemy. An estimated 43,000 servicemen mobilized for WWI died of influenza. Now, we know where we are heading for as the aggressor Russia invaded Ukraine. The world is bracing for an Armageddon. The mobilization of Russian and Ukrainian troops will mean more soldiers in the billets, makeshift caserns and trenches, living in cheek-by-jowl proximity, without any regard for social distancing.

May be Omicron is not as fatal as other variants of SARS 2 Covid-19 for many countries.  However, the USA experience would sit at a sharp contrast to this popular myth. Well, Omicron infections are 91 percent less fatal than the delta variant, with 51 percent less risk of hospitalization, according to a research study jointly published by Cold Spring Harbor Laboratory (CSHL), Yale University and BMJ, a global healthcare knowledge provider. Further, the researchers from Hong Kong University (HKU) found Omicron replication was less efficient in deeper lung tissue — more than ten times lower than the original virus. But it is all about reading between lines. Dr Michael Chan Chi-wai, the study’s principal investigator, says that virus replication is not the only driver of disease severity and that host immune response can also play a role, such as the immune system dysregulation that leads to cytokine storm.

Omicron multiplies around 70 times faster than the Delta variant in the bronchi (lung airways) but evidence suggests it is less severe than previous strains, especially compared to the Delta variant. However, the estimated difference in intrinsic hospitalization risk largely decreases to 0–30 percent when reinfections are discounted, according to a research study published by Imperial College London. Overall, the extremely high rate of spread, combined with its ability to escape both double vaccination and the body’s immune system, means the total number of patients requiring hospital care at any given time is still of nightmarish concern.

As amply evident in case of Omicron, the coronavirus is highly susceptible to genetic changes that are predicted or known to affect virus characteristics such as transmissibility, disease severity, and immune escape, diagnostic or therapeutic escape. Thus, the virus will continue to cause significant community transmission or multiple COVID-19 clusters, in multiple countries with increasing relative prevalence alongside increasing number of cases over time, or other apparent epidemiological impacts to suggest an emerging risk to global public health.

Many countries including the USA have experienced a brutal winter wave of COVID-19, driven by the highly transmissible Omicron variant. Daily deaths are higher today than they were during the peak of last fall’s Delta wave, and have plateaued at about 2,500 per day. Many hospitals are still under huge strain and are postponing elective surgeries to free up beds for patients with COVID-19. Daily cases have been higher than during the Delta surge, despite multiple eager predictions in the past that we had reached herd immunity and that the pandemic was over.

WHO director general Tedros Adhanom Ghebreyesus said the record numbers of people catching the new variant — which is rapidly out-competing the previously-dominant Delta variant in many countries — meant hospitals were being overwhelmed. “While Omicron does appear to be less severe compared to Delta, especially in those vaccinated, it does not mean it should be categorised as mild,” Tedros told a press conference.

“In fact, the tsunami of cases is so huge and quick, that it is overwhelming health systems around the world.”

“Hospitals are becoming overcrowded and understaffed, which further results in preventable deaths from not only COVID-19 but other diseases and injuries where patients cannot receive timely care,” he added.

The Omicron variant is causing record numbers of new Covid infections in Russia and Ukraine, threatening to impact military calculations over Russia’s continued assault over Ukraine. Covid is emerging as another element that may complicate plans for the Russian and Ukrainian armies, as record case numbers in both societies are replicated among the troops.

Gen Oleksandr Syrskyi, the commander of the Ukrainian land forces, told the Guardian that from about 150,000 soldiers in his ranks, 2,400 were infected by Covid. Before the Russian invasion the Ukrainian military bases had been closed to visitors to help prevent the spread. Ukrainian officials believe Covid has swept through the Russian soldiers placed close to the border and participating in exercises in neighbouring Belarus.

Gen Oleksandr Syrskyi said 99.3 percent of the Ukrainian army had received two doses of a vaccine, and that booster shots were being rolled out. As of November, 95 percent of Russia’s army personnel has been vaccinated and 25 percent received boosters, according to the defence minister, Sergei Shoigu. The stealth Omicron is likely to escape through many of these vaccinated soldiers, even Russia claimed to have fortified them with Sputnik or Ukraine’s use of a medley of vaccines from AstraZeneca, Pfizer and Moderna.

After Omicron was identified in South Africa the WHO assigned it to the B.1.1.529 variant of concern. Unlike the second wave last year, which was fueled by the Delta variant and killed over two million people in just a few weeks, according to The Economist’s estimates, the Omicron outbreak passed without enormous loss of life. However, the truth is stark and bitter. Omicron is still mutating, like a shape-shifting creature.

So far, the Omicron variant has a total of 60 mutations compared to the reference / ancestral variant: 50 nonsynonymous mutations, 8 synonymous mutations, and 2 non-coding mutations. Thirty-two mutations affect the spike protein, the main antigenic target of antibodies generated by infections and of many vaccines widely administered. Many of those mutations had not been observed in other strains. It is believed that one of these many mutations, comprising a 9-nucleotide sequence, may have been acquired from another coronavirus (known as HCoV-229E), responsible for the common cold. This is not entirely unexpected  —  at times, viruses within the body acquire and swap segments of genetic material from each other, and this is one common means of mutation.

In the case of Omicron, the victim’s death may just seem to be compounded by a long Covid or comorbidities. The Long Covid is as enigmatic as Covid fatigue. You never know when it starts and how it will end. There is also what the New York Times calls a “pandemic of the forgotten.” Around seven million Americans have weakened immune systems from transplants, cancer treatment, rheumatoid arthritis medications, or other medical conditions, and the Omicron may be enough to snuff them out like eating barbiturates.

The omicron, because it is the most contagious type identified so far, is likely to be fatal to more vulnerable people in nursing homes, prisons, and other high-risk congregate settings.

During the 2009 swine flu pandemic, an estimated 3 in 10 people with symptoms in the U.S. went to work, infecting up to 7 million others. The U.S. is the only high-income nation without mandatory federal sick pay, and this will continue to be a huge barrier to controlling COVID-19. Hence, more people risking their lives and limbs during Omicron can be apparent, and more appallingly their chances of infecting and killing their colleagues.

The long Covid and comorbidities deaths are appallingly underreported in India. The death of a person with comorbidities in Rajasthan in the month of January was contentious. The 73-year-old, who was found infected with Omicron in genome sequencing, had tested negative for the infection twice. He died in a Udaipur hospital on December 31, due to post-COVID-19 pneumonia coupled with comorbidities—diabetes mellitus, hypertension and hypothyroidism. The second Omicron death was from Odisha, such an occurrence confirmed by CDMO, Balangir, Dr Snehalata Sahu. The deceased, a 50 year old woman, was suffering from a brain stroke. She was admitted to Burla Medical College where she tested COVID positive. She died on December 27, 2021. Then the floodgates of the deaths opened. Many of these are underreported or ignored.

WHO’s Dr Abdi Mahamud meant to create a template of Omicron deaths to raise public concern over the same. She referred to a span of 24 hours in the Omicron timeline, and found 3,400 people had died. This is almost ten times the number of the victims of the Boeing 737 Max, two of which crashed in 2018-19, killing 346 passengers. ‘’So, if you take the number of just 24 hours in the US, that’s 18 Boeing 737s crashing every day,’’ he noted. ‘’Should not that concern us?’’

‘’So, while everyone was saying Omicron is milder, I think we missed the point that half a million people have died since this was detected,” he said and further added, “And, in the age of effective vaccines, half a million people dying is really something.”

Many countries have not passed their peak of Omicron as yet. While some countries are seeing a decline in cases in Omicron, others have not yet reached that peak.  Hence, we will continue to see a surge in cases. Thus, any prediction of the fatality of Omicron must be put on hold till Omicron completes its cycle across geographies.

 


By Sarat C. Das

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