Omicron is in NC. Here’s what we know about the new coronavirus variant.
North Carolina has reported its first COVID-19 case caused by omicron, the coronavirus variant recently discovered in South Africa.
A lab that sequences virus at the University of North Carolina in Charlotte reported Friday that the variant was found in the testing sample of a student who traveled outside of North Carolina for Thanksgiving, The Charlotte Observer and The News & Observer reported.
But where did the variant come from? Is it resistant to vaccination or natural infection? And is it more deadly than previous variants?
While data on the new variant is preliminary and conclusions likely will change once new information becomes available, here’s what we know now.
Where did omicron come from?
Omicron was first discovered by doctors in South Africa late in November, but the variant did not necessarily emerge there. Its nation or region of origin is unknown.
The first case of the variant in the U.S. was reported in California on Dec. 1. Since then, it’s been found in 24 other states, now including North Carolina and neighboring Georgia and Virginia.
The UNC-Charlotte student contracted COVID-19, caused by the omicron variant, while traveling out of state for Thanksgiving. There are no known additional cases associated with the student.
Is the new variant causing increasing cases?
Since Thanksgiving, North Carolina has seen an uptick in COVID-19 cases and hospitalizations due to the disease, The News & Observer previously reported.
Infectious disease experts said previously that the arrival of omicron in North Carolina was inevitable despite the United States banning travel by non-citizens from South Africa and seven other countries in southern Africa a few days after the variant was discovered.
But the dominant variant in North Carolina and the rest of the country is delta. Dr. David Wohl, infectious disease specialist at UNC-Chapel Hill, said that the recent uptick is due to the highly transmissible delta variant spreading in ideal conditions.
“This was not a surprise. This was clearly predicted but hoped against,” Wohl said.
He said that we know from previous surges, such as with delta in the summer and the pandemic peak last winter before vaccines were available, that a failure to mask and socially distance, especially at large indoor events and concerts, results in an increase.
“And people gather for holidays. We may very well see the ingredients come together to cause an increase in cases,” Wohl said. “No one is surprised that after Thanksgiving, our numbers are going up.”
Many public health experts expect omicron is more widespread in North Carolina beyond the UNC-Charlotte, just not yet detected.
Wohl said unvaccinated people are the primary concern as they overwhelmingly make up COVID hospitalizations in North Carolina, stressing hospital systems. And those not vaccinated are vulnerable to any variant.
“Health care systems are not built for pandemics. They’re built for usual everyday burdens,” Wohl said. “When our ICUs and emergency departments get full of people with COVID, other things suffer, whether it be usual care for other serious diseases or even elective surgeries, doctor’s visits. You name it. It just has the ripple effects that are quite profound across all of the health care system.”
Hospitalizations statewide due to COVID-19 have increased every day since Thanksgiving, from just over 1,000 to 1,493 on Friday.
Is omicron resistant to vaccines?
Early data from South Africa suggests that those vaccinated, with no booster, may be susceptible to infection. It is unclear if it would result in severe symptoms.
A third dose booster provides a better immune response, early data from Pfizer suggests.
Pfizer announced Wednesday that a third-dose booster of its vaccine was found in laboratory tests to have a significantly better antibody response against omicron compared to just the two doses.
“People who are fully vaccinated and boosted are in a different situation,” Wohl said. “The chances that those people, especially if they’re not very old, especially if they don’t have medical conditions — for most of us who are boosted, we really don’t have to worry too much that we’re going to catch COVID-19 and get deathly ill.”
Despite early data, how the vaccine will work in people is not yet known. Wohl said he’s optimistic.
“When we saw the delta data, we had laboratory studies that said, ‘You know what? Our vaccines may not protect as well. Blood from people who’ve been vaccinated, it may not neutralize the delta variant very well.’ But we found that in real world experience, people who are vaccinated did really well. Some, maybe a little bit more breakthrough with infection, but not severe disease. Same thing seems to be the case for this hyper mutated variant,” Wohl said.
The N.C. Department of Health and Human Services continues to recommend vaccination as the best prevention measure against COVID-19.
As of Dec. 1, the latest available data from DHHS, those unvaccinated are more than five times as likely to contract COVID-19 and over 25 times as likely to die from the disease, compared to those who are vaccinated.
As of Friday, 69% of adults in North Carolina are fully vaccinated. Among those eligible, ages 5 and up, 61% have received their shots.
When omicron was first reported by South African officials, the Centers for Disease Control and Prevention strengthened its call for booster shots, recommending that everyone 18 or older get an additional shot of either Pfizer or Moderna six months after their last. For the Johnson & Johnson, the recommendation is two months after the first shot.
“That vaccination platform has protected us through alpha, through beta, to delta, and can protect us against omicron. We just need higher levels of antibodies,” Wohl said. “High levels of antibodies protect us.”
All three manufacturers are working to adjust their vaccines to combat omicron, in the case that it is vaccine resistant, but that process could last a few months.
Resistant to natural immunization?
Early data suggests that natural immunization, in those unvaccinated, is not as effective against omicron.
“Natural infection alone, unfortunately, doesn’t seem to protect against omicron. Data from South Africa show us that people who’ve had COVID-19 before were more susceptible to omicron than they were to delta,” Wohl said. “I would love for us to catch COVID-19 and never catch it again. That, you know, one and done. That’s not the way that this works.”
He said vaccination, on top of natural immunity, provides the best protection. Getting COVID-19 intentionally though is dangerous due to the risks associated with contracting the disease.
“Even if you’ve had COVID before you should get vaccinated,” Wohl said. “Having a natural infection and being vaccinated on top of it, you’re going to be some of the most protected people on the planet.”
Unvaccinated people with no prior infection remain the greatest at risk of developing severe symptoms of COVID-19.
Is omicron more deadly?
Some experts believe the new variant may induce less severe symptoms, but others attribute this to more younger people being infected in South Africa where omicron has spread.
Wohl said omicron being less severe than delta is a possibility.
“Omicron may turn out to be similar in its ability to spread, but may not cause any more severe illness than delta,” he said.
Wohl said the primary concern is omicron’s ability to evade immunity.
“Can it evade our immune system’s ability to protect ourselves, either from natural infection or vaccination? Seems like it can. So that’s what we care about,” he said. “To the extent that it can do that, though, is unclear. It does look very reassuring that if you are boosted, that you are relatively well protected against omicron, which may or may not cause a severe risk of severe illness as delta.”
Will omicron out-compete delta?
Delta is still the dominant variant in both North Carolina and the rest of the country, making up nearly all of new cases reported.
Omicron would in theory be more transmissible, but Wohl said human immune systems are complicated and go beyond antibody tests performed in the lab.
He suspects delta, given how quickly it overtook previous variants over the summer, may remain the dominant variant.
“My suspicion is delta would remain dominant, given its ability to spread as quickly as it has,” Wohl said.
Vaccines are needed to prevent future variants
“My real concern is there’s the wild west of the unvaccinated and things can circulate in them,” Wohl said. “We really need to decrease that pool.”
He said more needs to be done, even if it requires more mandates, to get people vaccinated.
“There’s a role for government to protect us. And so I feel that mandates can be a very important tool,” Wohl said. “We sometimes take measures to protect the public and protect each of us. I have a right not to get infected. I have a right to get on a plane and not have the person next to me unmasked.”
He also said that more needs to be done to get vaccines to lower-income countries that don’t have the funds or the infrastructure to distribute vaccines.
“We can have our cake and eat it, too, here. I think we can have boosters here, and vaccination, including boosters elsewhere. I think there’s the capacity. It just takes people getting together. It takes political will,” Wohl said.
He said omicron should serve as a call to action to get more people vaccinated, both in the United States and abroad.
“Omicron was a shot across the bow that has indicated to us if there’s a lot of folks unvaccinated out there, we can see variants pop up, and they can impact us,” Wohl said. “We’re seeing with omicron markets fell. For a while because of omicron, your supply chain issues may be stifled further, adding to inflation, because of omicron. So this is not some far distant concern or worry that doesn’t have anything to do with us. It has everything to do with us.”
This story was originally published December 10, 2021 at 6:30 PM.