New challenges in the global fight against the epidemic
Before encountering 7 patients with abnormal symptoms of new crown in one day, South African doctor Angelik Kutcher had not been exposed to new crown cases for 8 to 10 weeks. At that time, Coche didn’t know that the abnormal symptoms of these seven people were due to infection with a new mutant strain that had never been seen before and had the characteristics of the “predecessors” of multiple mutant strains-Omi Keron.
Couche’s clinical observations are consistent with South Africa’s epidemic statistics. From the end of October to the beginning of November, there were only 200 to 300 newly diagnosed new crown cases in South Africa in a single day, the lowest value this year. Since late November, this data has started to climb. On December 1, the number of new cases in South Africa reached 8,561; on December 2, there were 11,535 new cases.
The existing detection technology in South Africa is not enough to confirm that the current outbreak is caused by Omi Keron. However, many South African doctors have publicly stated based on clinical observations that most of the new cases in South Africa are currently infected with Omi Keron.
According to the first report from South Africa, the World Health Organization named this new mutant strain after the 15th Greek letter “Omicron” (Omicron). There are still many unknowns in Omi Keron. It is known that Omi Keron has 32 mutations in the spike protein, which is twice that of the Delta mutant strain, and the number of mutations far exceeds any previous new coronavirus variant. Scientists inferred from the mutation and spread of Ome Keron, Ome Keron may have a higher transmission power and a certain immune escape ability, the latter means that it may break through the immune barrier formed by the vaccine or the recovery of the infection.
As of December 3, Omi Keron has spread to more than 30 countries and regions. With the exception of Antarctica, Omi Keron-related cases have been reported on six continents. Dozens of countries have announced travel bans on South Africa and other African countries, and some countries have even “closed their countries” to prevent the spread of Ome Keron.
my country’s epidemic prevention and control department responded quickly to Omi Keron. Just three days after the World Health Organization named Omi Keron, the National Health Commission issued on November 29, my country’s prevention and control of “external defense import, internal defense rebound” The strategy is still valid for Omi Keron mutants.
The South African doctor who “sounds the alarm”
Couche owns a private clinic in South Africa.
On November 18 this year, six days before the South African government reported the discovery of the new mutant strain to the WHO, Couche discovered that her clinic had several patients with unusual symptoms. “At that time, we hadn’t seen patients with COVID-19 for 8 to 10 weeks.” Couche told Reuters.
On the same day, the first patient who caused Couche’s suspicion described himself as having “extreme fatigue” for two consecutive days, accompanied by headaches and general aches. “These symptoms are all related to viral infections. We immediately decided to test the patient for the new crown,” Coucher said. The results showed that the patient and his family all tested positive for the new crown.
Next, within a day, Coetzee’s clinic received a total of 7 patients with positive new crown symptoms with abnormal symptoms. Kutcher said that the clinical manifestations of these patients were very different from Delta infection. They did not experience loss of smell or taste, nor did they experience a significant drop in blood oxygen saturation.
At this time, Couche realized that there might be a mutant strain that he hadn’t seen before. Couche immediately reported the abnormal situation to the South African National Institute of Infectious Diseases (NICD), a research organization that provides the South African government with expertise in infectious diseases.
In the next 10 days, Coetzee’s clinic received about 30 positive cases of the new crown with similar symptoms. During this period, the new variant B.1.1.529 of the Coetzee report quickly attracted global attention.
On November 24, the South African government reported this mutant strain to the WHO; on the 25th, the NICD issued a statement stating that 22 cases of B.1.1.529 infection had been detected in South Africa; on the 26th, the WHO listed it. It is a “variant strain of concern” (VOC) and named “Omicron” (Omicron).
Many media have referred to Couche and other doctors who initially reported the abnormal cases as “wake-up callers.”
How did the Omi Keron mutant appear?
Although the South African government first reported the Omi Keron variant to the WHO, the origin of Omi Keron is still unknown. Some experts believe that the origin of Omi Keron may be even earlier, possibly in early October.
On November 29, just three days after the World Health Organization named Omi Keron, the National Health Commission published an article on its official account to organize experts from the Chinese Center for Disease Control and Prevention to focus on related issues on the Omi Keron variant. Q&A.
Talking about the reasons for the emergence of Omi Keron, the article mentioned that there may be the following three situations: after immunodeficiency patients are infected with the new coronavirus, they have undergone a long period of evolution in the body to accumulate a large number of mutations, which are spread by chance; Animal populations are infected with the new coronavirus, and the virus undergoes adaptive evolution during the spread of the animal population. The mutation rate is higher than that of humans, and then spilled into humans; this mutant strain has continued to circulate for a long time in countries or regions where the mutation monitoring of the new coronavirus genome is lagging. , Due to insufficient monitoring capabilities, the intermediate generation viruses of its evolution could not be detected in time.
In two days, Omi Keron became a “mutant strain that needs attention”
While attracting global attention, this new strain spread rapidly. On November 29, the WHO assessed that the overall global transmission risk of Omi Keron was “very high”, which could lead to a surge in cases and “serious consequences.”
According to the WHO report, as of December 3, 38 countries and regions have reported Omi Keron cases.
In Africa, where the first reported cases of related infections, South Africa is the country with the largest number of Ome Keron infections, most of which occur in Gauteng. At the same time, the epidemic in South Africa is growing exponentially, entering the fourth round of the epidemic. Related cases have also appeared in other African countries such as Botswana, Nigeria, and Ghana.
In North America, except Canada, the United States reported its first case of Ome Keron infection on December 1. On December 2, there were 5 new cases of Omi Keron infection in New York State. In South America, the number of Omi Keron infections in Brazil rose to five.
In Asia, Singapore and India respectively reported 2 cases of Ome Keron infection on December 2. This is the first time that the two countries have experienced Ome Keron infection. Prior to this, Japan, South Korea, Hong Kong, etc. have all reported relevant cases of infection. Israel, the United Arab Emirates, and Saudi Arabia in the Middle East have also reported related cases.
In Europe, where the current epidemic is the most severe, more and more countries have reported cases of Ome Keron infection, and related cases have appeared for the first time in Norway, Iceland, Greece, Ireland, and France. Prior to this, the United Kingdom, Germany, Italy, the Netherlands, Austria, Belgium, Spain, Portugal, Sweden, Switzerland, Denmark and other countries have reported cases of Ome Keron infection. Australia, located in Oceania, was not immune.
Since the outbreak of the new crown virus, the world has repeatedly witnessed the impact of mutant strains of the new crown virus. But the emergence of Omi Keron still aroused global vigilance. In fact, Omi Keron is the fastest new strain of the new coronavirus to be listed as a “mutant strain of concern” by the WHO.
On November 24 this year, the South African government reported the new crown variant strain B.1.1.529 to WHO for the first time. Two days later, the World Health Organization listed it as a “variant strain of concern” (VOC) and named it “Omi Keron.”
Omi Keron has become the fifth “variant strain of concern” identified by the WHO since the outbreak of the new crown epidemic, and it is also the fastest variant of the new crown virus to be identified as a VOC.
Among the four previous “variants to watch”, the alpha variant was first discovered in the UK in September 2020 and was listed as a VOC on December 18; the beta variant was first discovered in South Africa in May 2020 and was first discovered on December 18 Listed as a VOC; the gamma variant was first discovered in Brazil in November 2020, and was listed as a VOC on January 11, 2021; the delta variant was first discovered in India in October 2020 and was not until May 11, 2021 Listed as VOC.
Omi Keron is very different from previous strains
Why did the WHO quickly list Omi Keron as a VOC?
On November 28, Zhang Wenhong, the leader of the Shanghai New Coronary Pneumonia Clinical Treatment Expert Team, posted on his personal social account that Omi Keron carries many mutation points of the virus and seems to have defeated other South African virus strains in a short period of time in terms of transmission, including Delta strain. Therefore, out of caution, the WHO has included it as a “mutant strain requiring attention”, which means that it will cause great concern.
So far studies have shown that there are 32 mutations in Omi Keron’s spike protein-twice as many as Delta; Omi Keron is also the new coronavirus variant with the largest number of mutation sites so far.
Among the many mutations in Ome Keron, mutations related to infectiousness and immune escape have caused concerns among experts from all over the world. Omi Keron has 10 mutations in the Receptor Binding Domain, which means Omi Keron may be more infectious than Delta. The rapid spread of Omi Keron strain in South Africa also preliminarily proves that Omi Keron is more infectious.
In addition, although the majority of Omi Keron infections occur in unvaccinated and only partially vaccinated people, there is evidence that it can infect those who have been vaccinated. In addition, Omi Keron and Beta and Gamma have similar spike protein mutations, which means Omi Keron may have stronger immune escape.
According to Mr. Hao, a native of Nantong, Jiangsu, who was sent to work in South Africa, the escape of immunity that scientists speculated may have caused his secondary infection. In an interview with the Beijing News, Mr. Hao said that he had been infected with the Delta mutant in South Africa and recovered. He did not expect to be infected with Omi Keron this time. A few days ago, Mr. Hao felt a sore throat, itching, listlessness, and particularly dry thirst. On December 1, Mr. Hao tested positive for the new crown, and the doctor informed him that he was infected with Omi Keron. Currently, Mr. Hao is recuperating at home according to the instructions of a South African doctor.
Doctors from Gauteng Province in South Africa also pointed out that most of the infected patients in the fourth wave of South Africa had only mild illnesses. The European Centers for Disease Control and Prevention and the World Health Organization have also stated that most of the current patients with Omi Keron infection show mild symptoms. As of now, there have been no deaths related to Omi Keron.
Consistent with the statements of many South African doctors, Mr. Hao also felt that Omi Keron’s infection symptoms were milder than those of Delta. He did not have a high fever, but he had headaches, sore throat, low-grade fever, cough and other symptoms. “I can definitely survive the last time (infection with Delta), the fever was so severe.” Mr. Hao said.
In an interview with a reporter from the Beijing News, Andrew Pecosz, a professor of the Department of Molecular Microbiology and Immunology at the School of Public Health at Hopkins University, also talked about the characteristics of Ome Keron related to infectivity and immune escape ability. . Pekosz said that the Omi Keron mutation may make the virus bind more firmly to the cell, and may make the virus self-replicate faster, and may allow the virus to escape certain immunity gained through vaccination or infection.
However, Pekosz pointed out that the current concerns mainly focus on the characteristics of the Omi Keron variant itself. What is the actual community epidemic, pathogenicity, and immune escape of this variant, and it needs to be provided by South Africa and other countries. With more data and evidence, it is expected that there will be more answers in the next one to two weeks.
Travel bans, “close the country”, a more vigilant world
The whole world responded quickly to the prevention and control pressure brought by Omi Keron.
On November 29, Xu Wenbo, director of the Viral Disease Prevention and Control Institute of the Chinese Center for Disease Control and Prevention, pointed out in an interview with a CCTV reporter that my country’s prevention and control strategy of “preventing foreign imports and preventing internal rebounds” is still effective for the Omi Keron mutant. The Institute for Viral Disease Prevention and Control of the Chinese Center for Disease Control and Prevention has established a specific nucleic acid detection method for the Omi Keron mutant strain, and continues to carry out viral genome monitoring for possible imported cases.
At a press conference held by the Joint Prevention and Control Mechanism of the State Council on November 30, Xu Wenbo further pointed out that the mutation sites of the Omi Keron mutant strain are mainly concentrated on the spike protein of the new coronavirus. The main primers and probes of nucleic acid detection reagents in my country The targets are in ORF1ab gene and N gene, these two target regions are relatively stable. Therefore, the sensitivity and specificity of the mainstream nucleic acid detection reagents in my country have not changed, and they can cope with the input of Omi Keron mutant strains.
In response to Omi Keron’s possible stronger immune escape, many countries have begun to develop vaccines against Omi Keron strain. Zheng Zhongwei, the leader of the Vaccine Research and Development Special Team of the Joint Prevention and Control Mechanism Research Team of the State Council, revealed in an interview with CCTV reporters on December 2 that my country is rapidly advancing the research and development of the Omi Keron strain vaccine.
“In fact, since the emergence of the first virus mutant strain, our technical reserves for vaccines against mutant virus strains have already begun. When new mutant strains appear, research and development of vaccines against new mutant strains can be carried out soon. We are just one purpose, “prepared” but not necessarily used. We are prepared only when we need it.” Zheng Zhongwei said.
For the newly discovered Omi Keron variant, many countries have adopted more rapid and prudent prevention and control measures than ever before.
On November 25, local time, the WHO had not yet identified Omi Keron as a “mutant strain of concern”. The UK took the lead in announcing the ban on flights from six African countries including South Africa and Botswana.
In the following days, dozens of countries and regions in Europe, America, Asia, and Oceania announced restrictions on flights and passengers from South Africa and other countries. Even African countries such as Rwanda and Angola also announced travel bans against South Africa.
Among them, Israel announced on November 27 that it would close its borders and ban all foreign travelers from entering, becoming the first country in the world to “close the country” in order to prevent Omi Keron. Israel discovered its first confirmed case of Ome Keron on November 26.
Japan is the second country to declare a “close state” after Israel. On November 29, Japanese Prime Minister Fumio Kishida announced that all foreign tourists will be prohibited from entering the country from 0:00 on November 30. At that time, Japan had not reported any confirmed cases related to Omi Keron.
Regarding the country’s closure policy, some Japanese citizens have quite criticized it. Two Japanese interviewed by reporters from the Beijing News believed that Japan’s policy of “closing the country” was too strict. “Because foreigners can’t vote, the Japanese government doesn’t need to worry about a drop in the approval rate,” said a Japanese.
There are also Japanese people who support “closing the country.” “The easing of the epidemic in Japan is the result of the joint efforts of Japanese people. If we don’t respond well now, our efforts so far will be in vain.” Supporters said.
However, regarding the announcement of travel bans by many countries, South African President Ramaphosa stated in a televised speech on November 28 that these restrictions are not supported by any scientific basis and are “discrimination” against South Africa and other southern African countries. Ramaphosa called on these countries to lift the travel ban, emphasizing that vaccination is the “powerful weapon” to deal with the epidemic.
To end the pandemic, increasing vaccination rates remains the key
In fact, Omi Keron happened at a critical moment when the global epidemic was again on the rise.
In the past month or so, the number of new confirmed cases and new deaths around the world have been on the rise, especially in the European region. The European Center for Disease Control and Prevention issued a report on December 2 stating that the possibility of the Omi Keron strain’s community spread in Europe is high risk, and the possible harm to Europe is “extremely high.”
As of December 2, there have been more than 260 million confirmed cases of COVID-19 worldwide and more than 5.22 million deaths.
The rising period of the epidemic will collide with new variants that may be more threatening, and the global anti-epidemic results may also disappear. “Our most urgent task is to end this pandemic.” Tedros said. However, the ongoing unfair distribution of vaccines around the world is hindering the pace of humankind to end the epidemic. He said that the new crown epidemic will not end until the “vaccine crisis” is over.
Since the start of the global vaccination campaign, the “vaccine gap” between rich countries and low- and middle-income countries has been widening. Currently, low-income countries receive only about 0.6% of the world’s vaccines, while developed Group of Twenty (G20) countries have received more than 80%.
The continued expansion of the “vaccine gap” will not only increase the possibility of new mutations, but will also prolong the pandemic that has lasted for nearly two years. Seth Berkeley, CEO of the Global Alliance for Vaccines and Immunization (GAVI), also stated in a statement on December 1 that although humans still need to learn more about Omi Keron, “as long as most people in the world are not vaccinated , Mutations will continue to appear, and the pandemic will continue to extend.”
Edwin Michael, an epidemiologist at the Center for Global Health and Infectious Diseases at the University of South Florida, believes that the emergence of the new crown variant is related to the low vaccination rate and the unhindered spread of the epidemic among a large number of susceptible populations. Correlation, the previous beta, gamma, and delta variants initially appeared in susceptible populations in countries with relatively low vaccination rates.
Thierno Balde, the head of the COVID-19 emergency response project at the WHO Africa Regional Office, said, “We are currently in a situation that we have tried to avoid before-that is, the emergence of potentially infectious and pathogenic New variants that are both stronger”. He pointed out that efforts must be made to stop the spread of the epidemic in order to prevent similar new variants from appearing again and bring new variables to the global epidemic. It is critical to increase the vaccination rate, especially in countries and regions with low vaccination rates.
Regarding whether the existing vaccines are still effective against Omi Keron, Maria Van Khov, the technical director of WHO’s health emergency project, said on December 1 that there is currently no evidence that existing vaccines have no protective effect on Omi Keron. Vaccines can still greatly reduce severe cases and deaths.
Michael pointed out that from the fact that the majority of people infected with Omi Keron in South Africa are not vaccinated, it can be seen that vaccination is still effective. Therefore, it is very important to continue to promote global vaccination, including booster vaccination, in the fight against the epidemic.
In the face of Omi Keron, which has triggered global vigilance, WHO also once again calls on member states to accelerate vaccination of high-risk populations, at the same time strengthen surveillance and genetic sequencing, report relevant cases to WHO, and promote field investigations and experiments. Laboratory test to further assess the risk of Omi Keron.
It remains to be seen what impact Omi Keron will have on the global fight against the epidemic, but its emergence has already issued a warning. Tedros said on November 29 that “although many people may think that the new crown is over, the new crown does not Never let us go”, “We are in a cycle of panic and neglect.”
Beijing News reporter Xie Lian, Chen Yikai, Hou Wu Ting, intern Liu Yanshuang, Jiang Yue
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