Omicron can lead to 64 times more cases in the third phase

A new variant may be more contagious, more lethal, warns Dr Raj Karnatak stressing the urgency for world wide vaccination

As the Covid-19 pandemic enters its third year, the new Omicron variant has managed to upend any hope of life returning to normal – at least for some more time.

With the US recording over 800,000 cases a day – setting a new record since the pandemic broke, there is also a growing worry as the hospitalizations saw an unexpected surge.

On Sunday, the US Surgeon General, Vivek Murthy warned that the somewhat declining trend in some parts is not indicative of the national Covid-19 portrait.

Read: Everything you need to know about Covid-19 Delta variant (August 10, 2021)

With an average of 1,776 deaths per day reported last week, there is every reason for Americans to be both warned and wary of what lies ahead,

The American Bazaar caught up with Dr Raj Karnatak, an infectious and critical care physician practicing in Milwaukee, Wisconsin.

A fellow of infectious disease and critical care at the University of Nebraska Medical Center 2017-2020, he has worked as an assistant professor of medicine at the Pennsylvania State University. He received his medical training in India and medical residency training in Brooklyn, New York.

We spoke to Dr Karnatak on the new Omicron variant about what we need to know and what we need not be scared of.

AB: The Covid-19 pandemic has been quite unsettling for everyone, after we saw the Alpha, Beta, Gamma, Delta now it is the Omicron variant. Can you tell us the reasons behind the emergence of these new variants?

RK: Alpha, Beta, Gamma, Delta, and several other SARS-CoV-2 variants emerged around the world in the last two years. The reason behind the emergence of new variants is very simple.

SARS-CoV-2 is a RNA virus and every time the virus replicates it creates random mistakes in its genetic sequence leading to mutations.

When we look at a new variant, we want to know how infectious it is? How lethal it is? And its potential to escape immunity. We also want to know if the current testing and therapeutics are still useful?

With the current Omicron variant (B.1.1.529) initially identified in Botswana and soon after reported in South Africa, we are seeing the virus is likely 3-4 times more infectious than Delta variant which was twice as infectious as the original SARS-CoV-2 virus.

Due to being highly infectious, Omicron has replaced other variants around the world. During this surge we are seeing exponential increase in cases.

Omicron being four times more infectious than the earlier Delta variant, if we do the math, we are going to have four times more cases in the first cycle, 16 times more cases in 2nd cycle, and 64 times more cases in 3rd cycle. During a surge, viruses can go through many cycles depending on the immunity of the population.

AB: Can one differentiate among people depending on their symptoms if they are infected with Omicron or another variant?

RK: It is very difficult to differentiate Omicron from any other SARS-CoV-2 variant or another respiratory virus.

We are learning the loss of taste and smell that was described with earlier variants is less common with Omicron. If you have respiratory symptoms just go and get yourself tested.

Omicron being four times more infectious than the earlier Delta variant, if we do the math, we are going to have four times more cases in the first cycle, 16 times more cases in 2nd cycle, and 64 times more cases in 3rd cycle — Dr Raj Karnatak, Infectious disease and critical care expert

AB: With cases around the world seeing an upward trajectory, how lethal the new variant looks to be?

RK: Even if we consider Omicron is slightly less lethal than Delta we are still going to have a huge number of patients requiring hospitalizations, ICU admissions or a significantly greater number of people dying. It’s just simple math.

Part of the reason we are seeing Omicron causing slightly milder symptoms, is that in many cases people had Covid in the past or had a vaccine breakthrough. The Omicron variant is likely as bad as any other SARS-CoV-2 variant in the immunologically naïve population.

That is why in the United States unfortunately Covid-19 deaths are still going up every day. How a new variant will behave in a community depends on what percentage of the population is fully vaccinated.

Vaccines are the most effective way to get yourself and your community protected against this variant and variants coming.

Read: Covid-19 vaccination: What India can learn from the U.S. experience (July 13, 2021)

The problem with natural immunity is if you were previously infected with SARS-CoV-2 variant your immunity is probably very good against that variant for at least a few months and then it starts to fade away. But your cross immunity for other variants such as Delta or Omicron is very very poor.

One should get fully vaccinated to get better protection even if you had a previous infection. The good news is Covid-19 vaccine still gives you great protection against all the variants.

Vaccines are safe and have many advantages, provide excellent immunity, prevent huge community surges that can cause paralysis in the healthcare system. Vaccines also prevent the widespread replication of the virus thus reducing chances for future variants.

It’s tragic, viruses are killing people and filling our hospitals and people aren’t getting treatment for other diseases that they need to get treated for and some people still choose not to get the vaccine.

AB: And finally the question that is on top of everyone’s mind, with three years and counting living with the pandemic, where is all this going?

RK: We know the new variants are created while the virus is replicating, the more this virus replicates the more we provide this virus opportunity to replicate and mutate.

With the ongoing pandemic, the virus has evolutionary pressure to replicate itself as much as possible. Until we have a large percentage of the world’s population fully vaccinated or immune, we are going to see new variants keep emerging.

Time is running out, if you look at the SARS-CoV-2 viruses’ ability to spread, the Delta variant was two times more infectious than the original strain, the worst being the new Omicron variant.

Read: Covid-19 delta wave in US is ‘exhausting’: Vivek Murthy (August 5, 2021)

If we continue to let the virus replicate in communities with no immunity, the virus may end up becoming much more lethal and even more infectious.

A future variant may be more contagious, more lethal, and may also have the ability to escape the immunity or even may escape our testing ability for the virus. We must vaccinate a large proportion of the world’s population as soon as possible.

Unfortunately, it appears we haven’t learned lessons from what has been happening in the past two years. If a large part of the world remains unvaccinated that means we are letting viruses freely divide and mutate. The new variant will soon arrive in highly vaccinated countries in no time.

The good news is we are starting to see the surge coming down in some parts of the US, but this is just temporary good news until and unless we vaccinate the rest of the world new variants will keep emerging and will arrive at our doors in no time.

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