Is Omicron really more dangerous? Will the vaccine still protect me?
And where CAN I get my booster? All your questions on the new mutation – answered by our team of top experts
IT HAS been a little over a week since scientists in Botswana and South Africa alerted the world about the emergence of a rapidly spreading new Covid variant – casting a shadow over the forthcoming festive season. Despite gloom from some quarters about the potential risks it poses, which has seen companies scrambling to cancel Christmas parties, the Prime Minister and Health Secretary were adamant last week that the public should carry on as they have been recently.
Meanwhile, some of our European neighbours have reacted by imposing
stringent travel bans, nationwide restrictions and even mandatory vaccination. Amid all this, it’s difficult to know what to make of the risks and how we should respond.
To provide some clarity, The Mail on Sunday spoke to the experts – and the prevailing attitude was that, while Omicron must be taken seriously, its emergence was not unexpected.
Of what little is known, some is concerning and some reassuring. Importantly, based on current evidence, there is no cause for panic.
Here is what you need to know.
Some people seem very worried about the new variant. Should I be, too?
Intense research into Omicron has only just begun, so it’s too soon to know much for certain.
So far there has been a lot of speculation ‘which isn’t helpful’, said Dr Julian Tang, a virus expert at the University of Leicester. ‘Relatively little is known about Omicron, even among scientists,’ added Professor Mark Woolhouse, an epidemiologist at the University of Edinburgh.
The facts so far are as follows. On November 25, South African health officials announced an uptick in Covid cases linked to a new variant. Due to the large number and type of mutations, or changes, to the variant, it could be more transmissible, the scientists said – meaning it could spread faster than previous iterations.
The next day, the World Health Organisation (WHO) declared it a variant of concern, and named it Omicron – the 15th letter in the Greek alphabet – following its variant naming system.
Since then it has been identified in more than 20 countries worldwide, including Britain.
On Thursday, Dr Michelle Groome of South Africa’s National Institute For Communicable Diseases said there had been an ‘exponential increase’ in infections over the past two weeks. In mid-November, the country – where just a quarter of the population have been jabbed – was seeing roughly 300 new cases per day.
Last Monday they recorded 2,858 cases. By Wednesday it was 8,561, and on Friday it was 16,055.
Based on what’s being seen there, experts say the South African scientists’ initial assessment seems correct – Omicron is likely more infectious than the currently dominant Delta variant, which itself was 60 per cent more infectious than the Alpha variant which overtook the original Wuhan virus in late 2020.
And it is this, primarily, that has caused concern. How much more infectious is Omicron?
However, due to South Africa’s low vaccination rate it’s not possible to make direct comparisons with European countries.
‘We’d need to see more numbers before putting a figure on it,’ said Prof Woolhouse.
I have read ominous things about ‘vaccine escape’. Does this mean our jabs won’t protect us against Omicron?
The swift spread of Omicron in South Africa hints that it has some capacity to overcome existing immunity, but there is no suggestion that the vaccines will no longer be effective.
Indeed, scientists we spoke to believe the jabs will still provide an ‘incredibly strong’ protection against serious illness, which is key. And this is why the booster programme, which aims to have every adult offered a third dose by the end of January, is still vital.
What we know for certain is that a South African study published last week examined medical reports of roughly three million people with lab-confirmed Covid. It found 35,670 suspected reinfections – people who’d caught Covid a second time after having tested positive three months or more before. Based on this data, the scientists estimated Omicron was three times as likely to cause reinfection as the Delta or Alpha variants.
‘This is not overly surprising,’ said Professor Francois Balloux, director of the Genetics Institute at University College London.
‘The large number of mutations in the spike protein [is likely to] increase the Omicron variant’s ability to bypass immunity.’
The spike protein is part of the Covid virus that allows it to bind to healthy cells – much like a key entering a lock. The outer shell of the roughly spherical viral particle is covered in them. Most Covid vaccines, including the Pfizer, Moderna and AstraZeneca jabs, are designed to mimic the coronavirus spike protein. They work, in part, by teaching the immune system to create defensive cells called antibodies which recognise and attach to this part of the virus – stopping the key from ever entering the lock.
Scientists have long known that the more changes there are to the spike protein, the more likely it is that Covid antibodies, even in a fully vaccinated individual, will not recognise the virus, allowing it to slip past the body’s defences. In Omicron, the spike protein has 32 mutations differentiating it from previous variants, which is what has led experts to suspect that existing antibodies will be less effective in fighting it off.
How much this is the case isn’t known. This is partly because antibodies are not the only cells that the immune system develops to fight off viruses.
The Covid vaccines also trigger the creation of T-cells and B-cells – fighter cells that attack foreign invaders – and experts believe that these cells will still be able to identify the Omicron variant, neutralising it before the majority of fully vaccinated people become seriously unwell.
A similar pattern was seen with the Delta variant which arrived in the UK in March. Early lab studies suggested mutations to the spike protein would allow it to slip past many of our antibodies, and scientists estimated the jabs would be only 67 per cent effective – a massive fall from the initial 90 per cent touted by the manufacturers.
However, half a year on, experts believe protection against Delta provided by the vaccines only fell by roughly three per cent.
‘We have our T-cells and B-cells to thank for this,’ said virologist Dr Tang, ‘and I expect we’ll see the same with Omicron.
‘The majority of the vaccinated population will still be protected from the worst of the disease.’
Is it true that Omicron is causing a milder illness than previous variants?
Early signs, again from South Africa, suggest that many people who catch Omicron are experiencing only mild symptoms. However, experts have warned against making too many comparisons or forecasts at this stage.
Based on the current evidence, little is known about the severity of infection – with or without vaccination – caused by Omicron. Prof Balloux said: ‘South Africa has a low vaccination rate but a large proportion of the population has been infected during previous Covid-19 waves. The population of South Africa also tends to be fairly young, with a median age of 27.6 years
[compared with 40 in the UK]. More data will be needed before we can make robust predictions about the potential threat posed by a global spread of Omicron.’
Speaking at a press conference on Wednesday, the WHO’s Dr Maria Van Kerkhove said: ‘We have seen reports of cases with Omicron that go from mild all the way to severe. There is some indication that some the patients are presenting with mild disease, but it is early days.’
The severity of Covid illness depends on a multitude of factors, which is what makes this a particularly difficult question to untangle – and a proper answer may not come for many months.
The main concern is that, even if it’s not causing severe illness in general, Omicron could spread rapidly through the vaccinated population, increasing the chances that it will reach vulnerable people whose immune systems have not been sufficiently trained by the vaccines, or the unvaccinated. Professor Penny Ward, a pharmaceutical expert at King’s College London, said: ‘It may be a while before we know the effect on older, more vulnerable people.’
How quickly is Omicron spreading in the UK?
At the time of going to press, there have been more than 150 cases of the Omicron variant detected in the UK, but scientists believe there are already many more that haven’t been picked up.
A cluster of cases was identified in Scotland, while individual cases have been seen in Liverpool, Norfolk and Nottingham.
However, the majority have been seen in London, including an Israeli doctor who attended a medical conference before travelling back to Tel Aviv, where he was diagnosed. Experts say these will just be ‘the tip of the iceberg’ because roughly only one in seven PCR tests are analysed for variants.
‘We know from experience of Alpha and Delta that by the time you’ve learnt it’s here, the horse has already bolted,’ said Dr Tang. ‘Considering we have so few restrictions in place, it’s likely this virus will propagate at speed.’ However, it will likely take some time before it outpaces Delta, which is still causing nearly 50,000 new cases each day.
Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, said: ‘It’s unlikely we’ll see big Omicron numbers before January.’
Will we see more restrictions?
On Monday, Health Secretary Sajid Javid confirmed that hospitalisations would be ‘what matters more than anything’ when considering further measures.
And based on what we know so far, these are unlikely to rise for some time.
The variant would have to significantly reduce the effectiveness of the vaccines before major social restrictions such as lockdowns were necessary in the UK, experts told us.
Studies show the booster jabs, which have now been given to nearly 90 per cent of Britons over the age of 70, provide an unprecedented level of protection against the virus – and even if Omicron ‘dents’ this, we’re starting from an ideal position to fight it off, said Dr David Strain, clinical Covid lead at the Royal Devon and Exeter NHS Foundation Trust.
According to an Israeli study published in November, a third dose of the Pfizer jab increased protection against symptomatic infection to as much as 94 per cent.
The effect of this is already being seen in the UK, where hospitalisations are now falling – particularly in older age groups – even as Covid cases rise.
Dr Strain explained: ‘The boosters put us in a wonderful position before this new variant arrived. Omicron has dented that campaign somewhat, but if you are fully boosted you are still in an ideal position to defend against it.’
Disease modellers believe that the strength of the boosters is such that the NHS could ‘tolerate’ even a large wave of Omicron.
Prof Woolhouse said: ‘Healthcare settings could probably bear some fall-off in protection, given just how effective the boosters appear to be.
‘However, I’d like to see some numbers before I say that with certainty. Studies looking at how effective the boosters are against this variant are a priority right now.’
On November 25, the Government announced that it would temporarily ban travellers from six southern African countries, and reintroduce PCR tests for all passengers on arrival, no matter where from, to combat the spread of the variant.
And last week masks once again became mandatory in indoor public spaces, including shops and public transport.
These measures will buy the UK some time while scientists race to analyse the variant, Ministers have said.
We’ve been told that boosters are vital – but the rules keep changing. How will I know when and where to get mine?
Last week the Government announced that all adults would be offered a booster Covid vaccine three months after their second dose. It means the entire adult population will have at least been given the opportunity to have a third dose by the end of January.
On Friday, NHS England issued an update, saying the rollout would begin on December 13.
Until then, those eligible to book a booster remains as it was: only those aged 40 and over; those aged 16 and over with a health condition that puts them at high risk from Covid; and frontline health and social care workers who had their second dose more than six months ago.
These groups should already have received an invitation, via text message or email or both.
After December 13, as with the initial vaccine campaign, people will be invited in descending age order. Again, this will be in the form of text or email.
At present, if you look at the NHS Covid vaccine booking website, it states in a yellow box at the top of the page: ‘The NHS is working on plans to offer a booster dose to everyone aged 18 years old and over... Please wait to be contacted by the NHS.’
The Government recommends that people book a jab appointment or locate a walk-in service through the NHS website (go to nhs.uk, scroll down and click ‘Find out about Covid-19 vaccination’ – or Google ‘book a Covid jab’, and click on the top result, titled: Book or manage a coronavirus (COVID-19) vaccination).
The process is relatively straightforward and requires people to enter their name, age, and address (the nhs. uk booking form asks if you know your NHS number, however it’s not a problem if you don’t have this to hand).
Once this is done, you will be given a list of nearby clinics where you can access the booster. These might be a GP surgery, a pharmacist, a hub at a community centre, hospital or a walk-in service.
Anyone who has trouble accessing the internet can book their booster jab through their GP, but family doctors have asked that this is done as a last resort.
Dr Dean Eggitt, a Doncasterbased GP, said: ‘If you ring up your surgery for help with a booster jab, they should be able to organise it for you, but you could be waiting on the phone for quite some time so it is far speedier to do it online.’
Eligible people who are housebound will be prioritised under the new system, and should already be known to their GP, who will organise a booster to be done in the home. If you are housebound and are not sure if your GP is aware, you should contact them. Patients in hospital who have not yet had their booster will also be able to receive their shot in hospital.
In some areas, such as the Isle of Wight and Hampshire, special ‘booster buses’ have been deployed,
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