Today, Explained - Omicron

Episode Date: November 29, 2021

AA-muh-kraan or OH-muh-kraan Today’s show was produced by Miles Bryan and Will Reid, edited by Matt Collette, engineered by Efim Shapiro, fact-checked by Laura Bullard and hosted by Sean Rameswaram. Transcript at vox.com/todayexplained Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

Get groceries delivered across the GTA from Real Canadian Superstore with PC Express. Shop online for super prices and super savings. Try it today and get up to $75 in PC Optimum Points. Visit superstore.ca to get started. It's Today Explained. I'm Sean Ramos from, and we've got a new variant. It's called the Omicron. Omicron.

The Omicron variant. The face, the Omicron variant. Sorry, Mr. President. It's actually called the Omicron variant, or maybe the Omicron variant, but definitely not the Omnicron variant. Let's go with Omicron. Omicron. Andrew Joseph was reporting on it over the weekend for Stat News.

This new variant is called Omicron. It was designated as such on Friday, on it over the weekend for Stat News. This new variant is called Omicron. It was designated as such on Friday, and it is the fifth variant to be elevated to variant of concern by the World Health Organization. Omicron B.1.1.529 is named as a variant of concern because it has some concerning properties. Well, it has a constellation of mutations, which would be strongly indicative that this will be highly transmissible. This variant is a cause for concern, not a cause for panic. Remind me how they're naming these things. They're going by the Greek alphabet.

Nu, psi, omicron, pi, rho, sigma, tau, epsilon, phi, chi, psi, and omega-2. The World Health Organization started using the Greek alphabet in part because the scientific nomenclature of B.1.1.7 versus B.1.3.5.1 versus P.1. Omicron. It's like officially known as B.1.1.5.2.9. It's just kind of a mess. And they also didn't want variants being named

based on where they were first identified because that's kind of like stigmatizing. If I'm if I'm in Boston right now, and if there was a new variant that emerged here, they wouldn't want it to be known as the Boston variant. They would want to give it sort of more of a neutral, but also easy to use name. So that's why they're using Greek letters. Got it. And there have been many variants. Of course, everyone got to know Delta pretty well. Why is this one particularly worrisome? I feel like I'm going to be annoying to your listeners because I'm going to say like, we don't know in so many different ways throughout this conversation. But basically, there is reason for concern with this variant, but no one really knows

what might actually happen or how big of an impact, if any, it might have on in terms of the course of the pandemic. The virus is constantly evolving. And sometimes even variants that seem really worrisome for a time kind of dissipate. So we're kind of at really early phases with Omicron. I guess there are two main reasons for concern. First, this is like some very limited epidemiological data from South Africa that seems to indicate Omicron is starting to pull ahead even of Delta in terms of transmission. South Africa is likely to see 10,000 new COVID-19 cases daily by the end of the week.

And like the data is very fuzzy and there are possible reasons that could explain why that appears to be the case even without a transmission advantage, but that's one. The second is just the genetics of this virus. The virus acquired just like a huge number of mutations really quickly. More than 30 mutations, say scientists, in the spike protein alone. And that's the protein that our immune systems are trained by vaccines to recognize and target. So the fear is that the more changes in the spike protein, the less well our bodies can sort of recognize the spike. And some of those individual

mutations have been associated with some ability to get around the immune response. So it's kind of a combination of just the genetics of the virus and also some of the early data out of South Africa. Do we know how this thing got so mutated? So when most people get COVID, they clear the virus within a few days. And, you know, that's kind of it. And, you know, the virus kind of picks up mutations as it replicates in your body and as it spreads, but like it's pretty sort of even mutation rate kind of over time. But what can happen is someone with a compromised immune system can get what's known as like a chronic COVID infection. And this is different than long COVID, which is symptoms well after you clear the virus. This is actually a chronic

infection. So the virus is still in your body. And because you have a compromised immune system, you're having trouble clearing it. But what that allows is for the virus to just sort of keep replicating and keep replicating and your body basically incubates the virus. And so that allows it to develop these mutations quite quickly compared to sort of normal transmission. And so it's thought that maybe someone with a compromised immune system contracted COVID, basically allowed the virus to mutate in their body for an extended amount of time, and then passed it on and set this off. And is the theory that this happened somewhere in the South of Africa? So the cases have primarily been identified so far in Botswana and South Africa, but it's really hard to say for sure where it might have come from. Sure,

it might have come from some country in Southern Africa, but Botswana and South Africa have relatively strong sequencing networks. They're just sequencing more infections than a lot of countries there. But as we've seen really quickly, this virus moves. So it's really hard to say with any sort of sense of certainty where it came from. That being said, though, there have been all these travel restrictions placed on a number of nations in Southern Africa, right? Yes. On Friday, the U.S. announced that actually effective today, Monday, it would be restricting travel from South Africa, Botswana and six other countries with some exemptions for U.S. citizens and residents. The White House said this is being done out of an abundance of caution

in light of the new COVID variant and on the advice of the CDC. Obviously, like a lot of other countries in Europe and Asia and Australia have also imposed travel restrictions. And some countries, like I think the list was growing, but I think Japan and Israel and maybe Morocco have kind of shut off all travel for some amount of time. Travel restrictions are tricky because the evidence throughout the pandemic has sort of shifted how experts view travel restrictions. And it's thought that they can slow the arrival of new variants, for example, but not block them forever. And like, as we've seen, like the number of countries reporting Omicron is growing like by the hour. But there is like kind of a

sense out there among scientists and public health advocates. You know, South African scientists did what an incredible job of recognizing this early, characterizing this virus and sort of getting it onto like the world's radar. But even as countries are praising what South Africa did, they're then penalizing them by sort of cutting them off economically without providing any extra support or even vaccine supplies necessarily. There's always the fear that like if countries that report new variants then get penalized economically, like maybe that provides a disincentive to be transparent, which is what South Africa was here. Do we know how dangerous Omicron is going to be?

Based on what some doctors have said, people appear to have mild infections. This morning, I already saw three cases, all three children, mild cases, easily treated at home. But it seems like that's mostly in younger people who generally have milder infections to begin with. Who knows that maybe they had a prior infection and so there's some amount of protection with them. But so it's like, no one knows what's going to happen when this virus gets into older people. And so I think that's one of the many open questions. It would be great if the virus had changed in a way

that makes it less virulent, but it's too early to say. And is it also too early to know whether the vaccines we have will be effective against the Omicron variant? So vaccines can lose basically some ability to protect people from infection without losing much of a step at protecting people from severe disease, hospitalization, and death. And we've already seen that to an extent with other variants, including Delta. People know there are breakthrough infections that are happening. But with Omicron, it's just not really clear what

level of immune escape there might be. And just like to remind people, it's not like vaccines aren't 100% protective or 0% protective. Like there's a huge range in the middle. So it's possible that maybe in the face of Omicron, we're all more vulnerable to getting infected, but we're still protected from those serious outcomes. But it's also possible that, you know, maybe more breakthrough infections lead to serious outcomes. You know, it's possible that there's that level of immune escape. Again, that is truly speculative. The studies that can

help answer that question are being launched right now, and they involve growing the virus in the lab and testing them against antibodies pulled from people's blood who've been vaccinated or had a prior infection. So those studies will take a few weeks to come through, unfortunately. Well, maybe we'll have you back when we have some answers, Andrew. Thank you so much. I'm sorry I don't have more firm answers, but we just kind of have to wait and see. And we also have to see what Omicron does, like continuing in South Africa, to see if it really does seem to see what Omicron does, like continuing in South Africa to see if it really does seem to be out competing Delta there. And what will help answer the question

of whether it's more transmissible is also what it does in other countries. If it's able to establish toeholds and spread in other countries over Delta, that would show that really maybe is more transmissible. The second this variant dropped, people were saying, of course there's a new big bad variant in Africa now. This is what happens when the West hoards vaccines. We're going to ask our guy Umair Irfan if vaccine hoarding is to blame for Omicron in a minute. Support for Today Explained comes from Ramp. Ramp is the corporate card and spend management software designed to help you save time and put money back in your pocket.

Ramp says they give finance teams unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join RAMP. You can go to ramp.com slash explained, ramp.com slash explained, R-A-M-P dot com slash explained, cards issued by Sutton Bank,

member FDIC, terms and conditions apply. BetMGM, authorized gaming partner of the NBA, has your back all season long. From tip-off to the final buzzer, you're always taken care of with a sportsbook born in Vegas. That's a feeling you can only get with BetMGM.com This year with BetMGM, a sports book worth a slam dunk, an authorized gaming partner of the NBA. BetMGM.com for terms and conditions. Must be 19 years of age or older to wager. Ontario only. Please play responsibly.

If you have any questions or concerns about your gambling or someone close to you, please contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Omicron. Umair Irfan, Vox, the second we heard about Omicron, people were saying this was inevitable because the West was hoarding all the vaccines. Is that true? Is that what happened here? That's not entirely true.

We do expect that in general, as long as the virus spreads, there is a greater chance of mutation. And the more spread there is, the greater those odds. But, you know, South Africa is one of the more vaccinated countries on the continent. About 41 percent of adults in South Africa have received at least one jab. That goes down to 35 percent for people who are fully vaccinated. Mobile vaccination sites are being set up next to welfare offices and supermarkets all over the country. The idea, take the vaccine to the people. You know, they've been a bit ahead of the curve there. But if you look across the rest of the continent, we're looking at roughly 10% of the population is being vaccinated. And that leaves a huge swath of vulnerable people where this virus

can continue spreading. The vaccination rates in Africa are ridiculously low. I mean, it's not just a problem that's limited to Africa, of course. You know, some of the poorest countries in the world in general are suffering from low vaccination rates. There are more than 50 countries that have about less than a quarter of their population vaccinated. Whereas, you know, wealthy countries that have about twice the population of low-income countries have about 50 times as many doses available to them. So way out of proportion with their population in terms of what they have available to them. And that huge resource inequity is a problem not just for humanitarian reasons, but it creates situations where we can end up perpetuating the pandemic. Let's talk more in detail about why the global vaccine rollout has been slow and uneven,

especially for poorer countries, starting with this idea that the West is hoarding. Is that true? I know we've talked on the show before about this COVAX initiative to get the vaccine out to poor countries. Well, COVAX was this idea where countries would pool resources and help distribute the vaccines more evenly across the board. The World Health Organization program is aiming to deliver 2 billion doses to people in 190 countries by the end of the year. And it started with a lot of promise and there was a lot of good intentions behind it, but it struggled to get funding to actually purchase the vaccines to begin with.

And so by the time they actually had the money lined up, a lot of the first batches of vaccines that were being manufactured by manufacturers were already spoken for. By bilateral deals that were made by the U.S., by the U.K., also the European Union, and they basically bought up the vaccine market. So there was little left over for COVAX to actually distribute to poorer countries. And so a lot of COVAX administrators are saying that they would like wealthier countries to kind of give up some of their spots earlier in line to help them actually get the doses that they already paid for. You know, these are not all donations. These are things that they've already bought. And they're saying that, you know, we don't want to end up competing with governments that are already looking at, you know, giving people third doses

or expanding the eligibility pool to younger and younger children. And they're saying that, you know, we still have frontline health workers that are being exposed to this virus in very high risk scenarios. And we really need to be able to bolster them in order to help contain the spread of this virus around the world, which is something that is in everyone's interest. Sounds like you're talking about the United States when you mentioned third doses and kids getting the vaccine. What is President Biden doing about this? Well, certainly the United States has expanded its exports of vaccines and is donating to other countries. You know, President Biden has set a target of helping every country vaccinate about 70 percent of its population by fall of 2022. Put another way, for every one shot we've administered to date in America, we have now committed to do three shots to the rest of the world.

But if you're looking at the current vaccination rates in some countries, you know, if we continue on the same path, some of the poorest countries may not get to, you know, that level of vaccination until 2023. You know, the U.S. has pledged about 1.1 billion doses. And, you know, other countries have pledged millions more. And, you know, some of the manufacturers are doing tiered pricing schemes to help make it cheaper for countries to buy them. But a lot of this is ad hoc and piecemeal. And that makes it really hard for countries to actually anticipate when they'll be able to receive vaccines. And then, of course, you run into other hurdles that we see around the world, misinformation, hesitancy, just all sorts of pushback on vaccines for various reasons. That isn't just an American thing. That's not just an American thing. It's a problem that's, you know, around the world and it manifests in different ways for different reasons. But it's certainly a problem, you know.

We need to get as many people vaccinated as possible. And if we hit a stubborn plateau, that means there will still be a population of people that can get infected and make other people sick and also create the risk of coming up with new variants that will undermine what little progress we've already made. And it's not just a matter of vaccine hoarding. It's also like a matter of vaccine shipping, right? And vaccine infrastructure. Right. Well, at the outset, no country was really doing a great job of vaccinating. Like the U.S.

struggled to get vaccines out to a lot of people. We had doses getting spoiled. We had people getting vaccines out of turn, and we had a lot of misinformation floating around. And so it's difficult even in the best of circumstances, even with the most resources. Now, if you're in a country with a poor healthcare system, with poor information and limited access to supplies, all those things just get more difficult and more problematic. So that's one factor to keep in mind. The U.S., of course, produces vaccines. The rest of the world does not. And so they're counting on imports of vaccines from other countries like the U.S., like Western Europe, like India, these countries that do manufacture vaccines at scale. But that leaves them vulnerable to supply chain shocks,

things like problems at shipping ports where they have a hard time getting supplies in. And it's not just the vaccines themselves, but the raw materials used to make them. Those are also bottlenecks. So like, while some countries are now lifting export restrictions on the vaccines themselves, they still have restrictions on things like the glass that's used to make the vaccine vials, the rubber stoppers, the syringes. So a lot of the ingredients that go into making an effective vaccine supply chain are also being constrained in other ways. And that ends up manifesting with very limited vaccine rollout in some of the poorest countries in the world. I mean, talking about getting these vaccines to people in 2022 or even 2023, it just feels like

we're going to be seeing so many more variants and mutations, and we're just not going to put an end to this thing anytime soon. Can the so-called international community do more to speed this up? I mean, one big thing countries can be doing is, of course, you know, lifting the restrictions and export bans on many of the materials and the vaccines themselves, you know, make them more freely available to other countries so they can purchase them, make more donations available. But it's not just the vaccines themselves. You need to have people on the ground trained to administer the vaccines. You need to have better infrastructure

to identify people who are at risk and get them the vaccines first, and also information about correcting the misinformation that's out there as well. So there's no one lever that's going to solve this problem. You need to have multiple approaches to actually getting the vaccination rate up. Even countries with the most resources struggle with this, and the struggle is just going to get worse in countries that have less resources. So we're all kind of in this together. We're facing the problem, but certainly some countries are going to be afflicted worse than others. Could vaccine manufacturers be doing more to help share access to the vaccine,

to help get shipments to countries that need them. There's been some talk about lifting intellectual property restrictions on vaccines and licensing it to other countries. India and South Africa have led the campaign, arguing it will help poorer nations vaccinate quicker. But Pfizer and BioNTech, who developed a COVID vaccine together, say a waiver won't boost global stocks anytime soon. But again, the manufacturer is not the only limitation here. vaccine together say a waiver won't boost global stocks anytime soon.

But again, the manufacturer is not the only limitation here. If people refuse to get vaccinated, you know, if they are misinformed or if they have some degree of hesitancy that isn't addressed, then having all the doses available really doesn't solve the problem either. You know, we've been leaning really hard on this technology-focused approach that, you know, if we get the vaccine that's highly effective out there, we can ultimately solve the problem. But clearly, that's not the case. You know, we still need to be able to address people's social concerns. We still need to address a lot of underlying inequities in our healthcare system. And also just allaying people's concerns. Some of it's well-founded, some of it is not. And just being able to parse that, it's all very difficult. And it shows that, you know, relying on technology alone doesn't

solve the problem. Do you think the arrival of Omicron might galvanize countries to kind of be more vigilant about the spread of mutations or even about COVID in the first place, especially countries that are sort of ready to put this in the rear view? Yeah. I mean, it shows that, you know, we can't turn our backs on the virus, that, you know, we cannot allow it to be spreading unchecked. We cannot take our eyes off the ball here. You know, surveillance is important. Vigilance is important. You know, this is the only way we're going to stay ahead of this.

And it also shows that, you know, we can't lean on any one particular approach. You know, a single focus on just vaccinations means that we're going to be missing dangerous changes that could be out there. So, yeah, you want to keep your eye out for any potential threats and be able to adapt to them before they become too dangerous. Umair Irfan, thank you. My pleasure. Umair Irfan, you can find his reporting at Vox.com. Earlier in the show, you heard from Andrew Joseph at Stat News.

You can find his reporting at StatNews.com. Our show today was produced by Miles Bryan, with help from Will Reed, engineered by Afim Shapiro, edited by Matthew Collette, and fact-checked by Laura Bullard. Special thanks to Stephen Sondheim. Somebody crowd me with love Somebody force me to care Somebody make me come through

I'll always be there as frightened as you to help us survive being alive being alive being alive