New Corona variant: is the Omicron wave coming now?

Status: 16.12.2021 5:41 p.m.

Omikron could soon become the dominant Corona variant in Europe. What does that mean for the vaccinations? What is known about severe gradients? Answers to important questions.

The seven-day incidence in Germany has been falling for days. But it is still at a high level. The Robert Koch Institute (RKI) records several hundred coronavirus-related deaths every day. There can be no talk of relaxation in the clinics.

With Omikron, a corona variant is now spreading, which will lead to even more cases than Delta, says RKI boss Lothar Wieler. It is already widespread in Great Britain and Denmark. In this country there have been a few hundred cases so far, according to Wieler. What is in store for Germany now? Answers to important questions at a glance:

What makes Omikron so special?

The omicron variant (B.1.1.529) was first detected in Botswana at the end of November and initially spread mainly in South Africa. It evidently emerged independently of the currently dominant delta variant. The omicron variant has a noticeably high number of genetic changes at key points: More than 30 mutations affect the so-called spike protein with which the virus enters human cells. For example, some mutations ensure greater transferability, the meaning of many mutations is still unclear, so the Robert Koch Institute.

The problem: The previous vaccines are aimed at the spike protein of the coronavirus from the beginning of the pandemic. If a virus changes in such a way that antibodies from convalescent and vaccinated persons respond less well, experts call this immune escape. In addition, there are indications from genetic analyzes, among other things, that Omikron is per se more contagious than Delta, said modeler Dirk Brockmann from the Humboldt University in Berlin. The immune escape alone cannot explain the growth rates.

How fast will omicron spread?

In the UK, experts believe the number of cases will double every two to three days, possibly even faster. Federal Health Minister Karl Lauterbach called the numbers from Great Britain “very worrying” – also with a view to the relatively high vaccination rate in the country. To Assessment of the EU health authority ECDC Omikron is likely to become the dominant variant in Europe as early as the first two months of 2022.

Brockmann described the situation for Omikron in Germany as follows: In the boosted part of the population – around a quarter – the probability of transmission is reduced, but not permanently. In the other people, the pathogen could be transmitted, also “because the first and second vaccinations are practically ineffective in terms of the spread dynamics”.

How well do vaccinations protect?

The manufacturers BioNTech / Pfizer rated two vaccine doses as insufficient protection against infection. A third vaccination could neutralize Omikron. One Population study from Great Britain found that the effectiveness against symptomatic infection with Omikron drops to 34 percent 15 weeks after the second dose of BioNTech. People who had been vaccinated with two doses of the Astrazeneca preparation were no longer protected from symptomatic infection. Two weeks after a booster vaccination, the effectiveness of both preparations rose to over 70 percent.

A preliminary one Evaluation of the South African health insurance group Discovery According to two doses of BioNTech / Pfizer’s vaccine, 70 percent provides significant protection against serious illness. At Delta it’s 93 percent. The protection against infection drops significantly from 80 percent with Delta to 33 percent with Omikron.

What does a vaccination booster do?

With the booster vaccination, antibody levels can be raised again to protect against infection. According to previous knowledge, however, it is not perfect. Omicron cases are already known in people who have been vaccinated three times. The virologist Sandra Ciesek from the Frankfurt University Hospital therefore warns that concentrating on the booster campaign will not be enough, also because the protection is waning again.

With a view to a study by the Charité Berlin and the University of Cologne, Lauterbach wrote on Twitter that protection against infection can probably only be reliably achieved through booster vaccination. The dates made him hopeful.

How severe are omicron infections?

That cannot be answered with certainty yet, emphasizes RKI boss Wieler. There have been initial observations of relatively mild courses in South Africa, but it is unclear whether this is a property of the virus. The information is based on a relatively small number of cases among rather young people affected. In addition, most people in South Africa are already considered to have recovered from Corona.

The WHO recently stated, “When the clinical profile of patients changes, the way Omikron works may change.” For a relatively old society with many unvaccinated people like in Germany, the picture can therefore turn out differently than in South Africa. British experts also emphasized that many infections only happened recently, but that it takes some time before hospitalization or death.

According to German experts, reports of severe courses in young children are still to be regarded as provisional. The pediatrician Jörg Dötsch from the University of Cologne has not seen any increase in the severe disease courses of a corona infection with a view to the delta and omicron variants of the corona virus.

How widespread is Omikron already?

According to information from the World Health Organization on Tuesday, 77 countries have reported evidence. “Omicron is spreading at a speed that we have not seen in any previous variant,” said WHO chief Tedros Adhanom Ghebreyesus. Omikron is presumably already in most countries, just unrecognized. In South Africa and Great Britain, among others, significant increases in the number of cases are attributed to Omikron.

Does Omikron lead to the endemic state faster?

Because of its high transferability, Omikron could mean a faster transition from pandemic to endemic. The virologist Christian Drosten said in Ed-Podcast: “We are dealing with a perfect post-pandemic virus, a perfect first endemic virus.” Where the mutant originated, Covid-19 could soon become a disease that occurs regularly and frequently, but no longer reaches the proportions of an epidemic. Population immunity is high in southern Africa because many people have already gone through an infection. This does not apply to Germany: “We are not yet ready for a post-infection, we are not yet so far with our immunity.”

The virologist Isabella Eckerle wrote on Twitter that Omikron could become a “ticket” into the endemic situation. However, she also pointed out that the faster transition to the endemic situation comes at a high price. The WHO warns: Even if Omikron should make you less seriously ill, the sheer number of cases could overwhelm unprepared health systems.

What do experts advise against Omikron?

Keeping the wave flat: That is the motto that many scientists and the WHO give. It depends on the combination of measures: “Do it all. Do it consistently. Do it well (do everything. Do it consistently. Do it well),” said WHO chief Ghebreyesus. Vaccination alone will not get a country out of this crisis. It also needs masks, distance, ventilation, hand hygiene.

German experts called on Wednesday for quick, precautionary action. You have to be prepared for all possible scenarios. Even in the worst case, such as increasing hospital occupancy.

Several experts consider vaccines adapted to Omikron to be necessary. BioNTech is already working on an adaptation. The Paul Ehrlich Institute is holding out the prospect of rapid approval of a modified corona vaccine. BioNTech and Moderna have signaled that they can implement a trunk modification within six weeks.

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