In our newsroom this week there was a discussion about what the next month could look like. The holidays are just around the corner, the state re-issued its mask mandate and events — even if out of an abundance of caution — are getting canceled or postponed.
The first local case of Omicron was identified on Dec. 8, and at the time there was speculation that the new variant could spread more rapidly, evade immunity from vaccines and cause more severe illness than the original SARS-CoV-2 virus.
To get some clarity on what we’ve learned since then, Voice of San Diego Editor-in-Chief Scott Lewis sat down with Shane Crotty of the La Jolla Institute of Immunology to discuss all things Omicron. Is it as scary as some anticipated? And exactly how important are booster shots?
Here are some interesting parts of that conversation, edited for clarity.
Scott Lewis: When Omicron first was discovered, I was kind of shocked — and I think a lot of people were — that there was so much alarm around it. But it was all kind of theoretical at that point. Now that we’ve had about a month to learn about it and to see what data comes back about it, is it holding up as a significant new threat from this virus?
Shane Crotty: Yes, Omicron’s a real worry … I would say within three days there was evidence that this was a truly significantly transmissible virus. For me, the first one was the two airplanes that landed in the Netherlands that had 61 cases out of 600 passengers. I’ve never heard of airplanes having anything close to that for COVID-19. So that, to me, was the first thing that suggested this is a virus that’s spreading a lot. And that’s been confirmed essentially every day with news around the world. The test positivity rates are pretty insane for this virus.
To get to the good news, the antibody responses to the vaccine aren’t good with two doses, but three doses of the vaccine look really good against Omicron. So, three doses of Pfizer or three doses of Moderna have really quite impressive neutralizing antibodies against this virus.
SL: That’s fascinating. It’s not like the booster is a different recipe.
SC: It’s exactly the same thing.
SL: Is the ability of the antibodies to adapt because of volume? Why would the second dose not have that characteristic?
SC: No. The antibodies are mutating. It’s a learning process. It’s basically, you go take a class twice and you learn some things. You go to the third class, and you learn some more things. It literally is your immune system learning each time it recognizes it.
SL: I think there was some hope that maybe this does transmit a lot more, but actually isn’t as severe. And there were two explanations for that. One was that because we have so much immunity now built up from previous infections and immunizations, but the other one was that maybe it really isn’t that much more severe. Where are you now on whether it’s less severe but maybe more transmittable, or whether it’s just that we are prepared for it?
SC: That’s the question we all want an answer to. I will say it has been stated way too often in the news in the past week that this is a milder virus or “appears to be milder.” There is no basis for that statement. I feel like I’ve never seen anything stated so often that’s been based on so little. It really is wishful thinking. I hope it turns out to be true, but there’s not data that supports that. It has been the case throughout that the pandemic that the majority of infections are mild.
Something to know about the variant is that we certainly know it’s transmitting quickly in populations that have a significant amount of immunity. So, as you were rightly saying, Scott, one of the possibilities would be that it will turn out to be less virulent in immune populations because people have been vaccinated or they’ve been previously infected. Maybe they don’t have enough antibodies to stop the virus at the front door, but they’ve got enough immunity to keep themselves from getting really sick. As a reminder, this is a virus that transmits very quickly … the virus is going to be passing from person to person even if those people have enough immunity to keep themselves from getting seriously ill. We don’t know for sure what’s going on, but it certainly matches the observations so far.
SL: One of the things we talked about last time was that you and I were both kind of unsure whether we were going to get our booster. We ended up getting it, but I guess the question I have is are we just going to have endless boosters? There’s already a fourth booster discussion.
SC: At this point, our best-case scenario is the third dose does a really good job. Again, with the third dose, you’re getting good neutralizing antibodies against Omicron. So, the question is, are those antibodies durable? And then will the virus change even more? Those are the unknowns. We should know pretty soon if those antibodies are durable or not. If they’re not durable, it looks like more boosters would be on the horizon.
There was a lot of great information from our chat with Crotty that didn’t fit in to this newsletter. Listen to the full conversation here and tell us how you’re feeling about Omicron in the comment section below.
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