From alpha to omicron: How COVID-19 variants affect you

Variants matter in the larger community, but we don’t treat for variants yet, experts say

A COVID-19 virus model.

ORLANDO, Fla. – The latest data on the omicron variant of COVID-19 is promising, scientists say, because it doesn’t appear to be as severe as previous strains of the virus.

The omicron variant, first identified by scientists in South Africa, has spread quickly through the country and other countries in the southern part of the continent.

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The South African Medical Research Council said a report of early experiences in the hospitals where omicron was first spotted showed few patients required high-level or intensive care.

President Biden’s chief medical adviser, Dr. Anthony Fauci, still was cautious.

“We have really got to be careful before we make any determinations that it is less severe or it really doesn’t cause any severe illness, comparable to (the delta variant),” Fauci said.

It’s not uncommon for a virus to evolve a less severe strain of itself. That’s what the swine flu eventually did, for instance.

Nevertheless, news of the variant caused the stock market to drop and several countries, including the United States, to impose new travel restrictions.

A gap in vaccination rates in parts of the United States and across the world means any new variant is going to be a cause for concern in terms of public health. For the individual, however, it may not mean much.

What exactly is a variant?

Alpha, beta, delta, omicron; COVID-19 has had several variants and those four are not even all of them.

A variant is when a virus’ genome contains one or more mutations.

How and why does a virus mutate? Chad Neilsen, director of infection prevention at the University of Florida Health in Jacksonville, said any number of factors can cause viruses to evolve.

One thing viruses definitely need though; a host to breed.

“You have to empty the pool of people who are susceptible to cut off the virus’ ability to change,” Neilsen said.

That’s the whole point of vaccines. Neilsen said the COVID-19 vaccine interrupts the spike protein, which is the part of the virus that invades a person’s cells. The fewer hosts amenable to being infected there are, the lower the chances for the virus to spread and change.

There are around a dozen COVID-19 variants, all named after Greek letters, according to the Centers for Disease Control and Prevention. You probably haven’t heard of many of them. Most have not shown to be dangerous enough to rise above just being monitored by public health officials.

Why do new variants scare public health officials?

A variant only needs one or more mutations to the viral genome to be classified as a variant. In the case of omicron, it has more than 30 mutations. That’s more than the Delta variant of COVID-19 has.

The more mutations, the more chances that the virus can change enough to blunt the effectiveness of vaccines or treatments.

“When you have enough mutations, it can cause the spike protein to evade the vaccine,” Neilsen said.

This means researchers and companies producing those treatments now must test against the new variant to see if they need to adjust or create new treatments and vaccines.

The World Health Organization classifies COVID-19 variants into three levels, based on evidence of transmissibility; its severity, prevalence in the community and how it responds to available treatment.

There are variants of concern, variants of interest and variants under monitoring.

“Why the WHO has called it a variant of concern is that it has risen to become a dominant variant very fast (in South Africa),” Neilsen said.

Omicron has been found in 38 countries and 17 U.S. states, including Florida, since it was first identified Nov. 24.

Neilsen said because of unknowns in new variants, sometimes governments need to hit the pause button until they have more information. That’s what travel restrictions are, he says.

“We know that the cases (of omicron) in the United States are tied to people who either had contact with someone who was in South Africa, or traveled there,” Neilsen said.

How do you know if you have a variant? Does it even matter?

Neilsen said the only way to know what variation of COVID-19 a person has is to have a sample genomically sequenced.

“Any given person who gets a COVID test in the United States does not know what variant they are testing positive for,” Neilsen said.

Does it really matter for the individual? Not really at this point, Neilsen said.

“From a hospital perspective, there’s not much utility. COVID is COVID, it doesn’t change the treatment,” he said. “We don’t have therapeutics targeting the delta variant vs. alpha.”

Where it can matter is in the public health world.

Health departments will take a set of tests to be genomically sequenced to learn what the dominant strain is in a community.

Consider the delta variant.

“Look at the damage that delta caused,” Neilsen said. “Being more transmissible than the previous variant, it was able to move with such speed.”

Delta is the dominant variant in the United States for months now. It doesn’t mean a person can’t catch a previous variant, but they are much more likely to catch delta.

“Delta is a little more severe and much more transmissible than alpha and beta strains,” Neilsen said.

That speed caused a delta wave of severe cases and deaths that lasted for months in the United States. Understanding what the dominant variant is in a region or community allows agencies to tailor their responses.

It’s also why vaccination rates are important, Neilsen said.

In the case of South Africa, vaccination rates are not as high there as they are in other countries.

“We have to look at the data in total to look at what is really going on, but if you have a low vaccination rate, a variant is going to go through faster, but we haven’t seen significant rise in hospitalization rates,” Neilsen said.

Neilsen also said that it is possible a new variant may someday change what we use for treatments against COVID-19.

He pointed out that there is a new flu vaccine every year based on dominant strains.

“Virology is a very imperfect science, and when you look at a worldwide pandemic, any variant that could spread potential danger, it blows up,” Neilsen said.

For now, Neilsen and other scientists hope the news on omicron is good — that the virus might be moving fast, but it’s weakening.

“Our hope is that more people get vaccinated, COVID will mutate into a less virulent form. And will weaken into something closer to the common cold,” Neilsen said.

Until then, Neilsen said the best advice is coming from U.S. public health officials right now: omicron is cause for concern, not panic.

About the Author:

Christie joined the ClickOrlando team in November 2021.