The South African scientists tracking the new coronavirus variant believe it probably evolved in a patient with HIV/Aids with a chronic Covid-19 infection.
If so, it will not be the first time a variant has emerged in a patient with a long-running Covid infection, scientists told the The Telegraph. In fact, many experts believe it could be how some of the other variants sprang up, including alpha, the first global "variant of concern", which emerged in Kent last autumn.
Across the world, scientists have traced the virus evolving in immunocompromised patients with months-long Covid infections.
Patients with untreated HIV or other conditions that weaken the immune system - such as cancer, for example - can struggle to see off Covid, leaving their body fighting the virus for prolonged periods. They effectively act as an evolutionary training gym for the virus to mutate to find new ways around their immune responses.
The difference in South Africa is the sheer numbers of people this potentially covers: 8.2 million South Africans are infected with HIV and only around 71 per cent of adults, and 45 per cent of children, are on treatment, leaving a large pool of people vulnerable.
Professor Richard Lessells, an infectious diseases expert at the KwaZulu-Natal Research and Innovation Sequencing Platform (KRISP), part of the team that first alerted the world about the spread of the new B.1.1.529 variant, said it is likely that the new variant was incubated in an untreated HIV/Aids patient.
"It doesn't seem to have emerged from a normal evolutionary process," Prof Lessells told The Telegraph. "There's been an evolutionary jump. This hasn't evolved from the delta variant."
Prof Sharon Peacock, Director of COG-UK Genomics UK Consortium, and Professor of Public Health and Microbiology, University of Cambridge, said this genetic difference was the clue - as it had also been with alpha.
“The genetic difference of B.1.1.529 has led to the hypothesis that this may have evolved in someone who was infected but could then not clear the virus, giving the virus the chance to genetically evolve (the equivalent of an evolutionary gym)," she said.
"The same hypothesis was proposed for the alpha variant, and studies have been done in individual immunocompromised patients that show changes occur in the virus over time, and in response to antibody therapy."
However, she added: "But the index (original) case of alpha was not determined – and trying to pinpoint the index case of a variant of concern does not aid the pandemic response, could be counterproductive by looking back rather than putting all efforts into looking forward, and is to be avoided."
Others said it was "certainly plausible" that this was how B.1.1.529 developed, although some scientists suggested that the gap between the existing virus and the new variant may instead represent a gap in sequencing data in countries lacking surveillance capabilities.
Professor Stuart Neil, a virologist at King's College London, told The Telegraph: "It's speculative, but it's something that has certainly been worrying people for a while, that persistent infection in immunocompromised people could be driving certain levels of viral diversity."
He said this route of viral evolution has been theorised before, for example for influenza.
The concern for many global health experts is that this has not fed into global vaccination strategies for Covid. It also shines a fresh light on the risks of the long-running inequality in HIV prevention, treatment and diagnosis globally.
In South Africa, only 24 per cent of people are fully vaccinated against Covid-19; although the gap seems to be more about hesitancy than supply. However, this is not the case in other African countries which also have high burdens of HIV. Scientists pointed out that it is feasible that B.1.1.529 came from one of these countries and was simply spotted in South Africa, which has strong viral surveillance networks.
"What we're seeing is exactly what we've warned about for the last year," said Prof Lessells in South Africa.
"If we leave parts of the world behind... then the disease will continue to evolve. We could have reduced the risk of this happening and we still can if we deal with the vaccine apartheid."
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Omicron will likely 'dominate and overwhelm' the world in 3-6 months, doctor says
SINGAPORE — The new Covid variant omicron will likely “overwhelm the whole world” in the coming months, according to a Singapore-based infectious disease doctor.
While vaccines against the strain can be developed quickly, they need to be tested over three to six months to prove that they can provide immunity against the variant, Dr. Leong Hoe Nam of Mount Elizabeth Novena Hospital said Wednesday.
“But frankly, omicron will dominate and overwhelm the whole world in three to six months,” he told CNBC’s “Street Signs Asia.”
Delta, the strain that is currently accounts for 99% of Covid infections, started becoming more common in the Indian state of Maharashtra in March 2021, and was dominant globally by July, according to Reuters.
Moderna CEO Stephane Bancel on Monday said it will take months to develop and ship a vaccine that specifically targets the omicron variant.
Pfizer CEO Albert Bourla also said shots could be ready in less than 100 days, or slightly over three months.
“Nice idea, but honestly, it is not practical,” Leong said of a vaccine that specifically targets omicron. “We won’t be able to rush out the vaccines in time and by the time the vaccines come, practically everyone will be infected omicron given this high infectious and transmissibility.”
Experts don’t know exactly how contagious the highly mutated omicron variant is, but the virus’ spike protein — which binds to human cells — has mutations associated with higher transmission and a decrease in antibody protection.
“The profile of the mutations strongly suggest that it’s going to have an advantage in transmissibility and that it might evade immune protection that you would get,” U.S. infectious disease expert Dr. Anthony Fauci told NBC’s “Meet the Press” on Sunday.
Protection from current vaccines
That said, some doctors believe that the existing vaccines will be able to provide some protection against the new variant.
Our bodies generate a “whole host of different antibodies” in response to vaccines, said Dr. Syra Madad, a fellow at the Belfer Center for Science and International Affairs.
“I do think that our current vaccines will hold up to a certain extent, with this new variant,” she told CNBC’s “Capital Connection” on Wednesday, noting that the vaccines were able to provide protection against delta.
“It may reduce vaccine effectiveness by a couple of notches, but that is yet to be seen,” she said. Current vaccines, along with boosters should still provide a “good level of protection,” she added. Leong agreed that a three-dose vaccine regimen would likely protect against severe disease, but pointed out that many countries still have low vaccination rates.
He said omicron is “threatening the whole world” with a sudden surge in cases, and health-care systems could be overwhelmed, even if only 1% or 2% of the cases end up in hospital.
Omicron was first detected in South Africa and was designated a variant of concern by the WHO last week. It has since been reported in several other places, including Hong Kong, the Netherlands and Portugal.
For now, however, Leong said we should continue to roll out vaccinations, keep our distance, wear masks, and not be overly concerned.
Madad echoed the same sentiment. “We continue to do the Covid-19 prevention measures on an ongoing basis,” she said. “Layering it up is really the best approach here.”
https://www.cnbc.com/2021/12/02/omicron-to-dominate-and-overwhelm-the-world-in-3-6-months-doctor-says.html
ZHUN BO???!!!!! Don't anyhow fearmonger leh