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expert reaction to six cases of the Omicron variant being detected in Scotland

Scottish health officials have confirmed that six cases of the Omicron variant have been detected in the Scotland.

 

Prof Cath Noakes, Professor of Environmental Engineering for Buildings, University of Leeds, said: 

“Over the past 20 months, scientists have been developing a detailed picture of how the variants of the virus that cause COVID-19 are transmitted, and how simple steps can help keep people safe. Although data is still emerging, it is highly likely that the Omicron variant transmits in the same way and the same mitigation measures are likely to reduce risks.  

“The biggest risk comes from people spending extended periods in crowded indoor spaces that are poorly ventilated, particularly if people are interacting closely or are shouting, singing or exercising.

“When a person is infectious, they exhale viral particles while breathing, talking or coughing. Some of the larger droplets can only be inhaled by people who are close-by. Other, smaller droplets form an aerosol which can pose a risk to people close-by and can be carried by the airflow in the room, presenting an infection risk to people who are further away. 

“Droplets also end up on surfaces like door handles and other frequent-touch points. This poses a lower risk than inhaling the virus, but if someone gets the virus on their hands and then touches their nose or eyes, they risk infection.  

“Vaccination is the most important mitigation measure as it can reduce the transmission of the virus and it has a very significant effect on reducing the likelihood of severe illness.

“Even with good vaccination coverage, we still need other precautions to reduce the risk of exposure to the virus. The easiest ways to reduce the chance of infection are to use a face covering in busy settings, socially distance, make sure a space is well ventilated – so the air changes frequently – and ensure that people wash or sanitise their hands frequently.”  

“Ventilation can be more difficult in cold weather, but if you are spending time indoors with people you do not normally live with, then it is important to reduce the risk of virus transmission through the air. Even just opening windows a small amount or opening them for a few minutes every hour can help to ventilate a room and reduce the risk of infection.”

 

Dr Moritz Kraemer, Lead Researcher on the Oxford Martin Programme on Pandemic Genomics at the University of Oxford said,

“It is not surprising that we see cases of Omicron that are acquired in the community especially as local restrictions have been relaxed over the last few months. That makes it much easier for novel clusters to arise and spread in the community. With enhanced surveillance and testing, it is likely that we will find more cases. There have also been imported cases in other nations which had no travel history to South Africa so it is likely that the virus has spread to many more countries where it has yet to be detected. We also don’t know the origin yet. However, I don’t think we can draw the conclusion that Omicron is more transmissible than other variants from this observation alone.

“In the areas that have already identified Omicron cases, ideally contact tracing can take place and teams should also identify whether those infected had previous exposure to SARS-CoV-2 and/or are vaccinated. UKHSA has done a fantastic job in the past collating information from clusters and estimating vaccine efficacy, disease severity and secondary attack rates. Having that infrastructure in place will help us greatly learn more about Omicron as it continues to spread.”

 

Prof Rowland Kao, the Sir Timothy O’Shea Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:

“It is now clear that the omicron variant has been spreading around the world for some days, if not weeks prior to the alarms being raised, and this is only to be expected for a virus which transmits as easily as SARS-CoV-2, and with international travel now substantial (even though not quite at the level pre-pandemic). Evidence of community spread in two locations in Scotland (i.e. cases with no obvious risks other than community spread) and no obvious source yet, are strong indicators that we shall see more cases in Scotland arise over the next few days and weeks. The usual measures (contact tracing, testing, isolation) in combination with vaccination may be sufficient to contain this variant and most importantly, ensure that it’s as yet unknown capacity to cause severe disease is well mitigated – if so and there is no threat of increased hospitalisation and death rates, spread of the omicron variant may need no further measures. As always, anything individuals can do to mitigate spread (physical distancing, taking lateral flow tests when appropriate and being aware of covid symptoms and testing) will be beneficial. However it is important to remember that the omicron variant may not pose an increased health risk – it may in fact cause milder infections. However we shall only know for sure in the next few weeks, once there are enough cases and enough time for statistically reliable estimates of severe illness to be made.

“More broadly, the omicron variant highlights the fact that variants are likely to arise again in the future so long as SARS-CoV-2 continues to circulate. Long term, it is likely that COVID will become more benign and we will be able to live with it as yet another endemic disease. For now however, reducing the rate at which this occurs and therefore the probability of more variants of concern, should be a priority. This will require better distribution of vaccines to countries with low uptake. This may also therefore imply that countries that already have had good uptake thus far, should consider at least some continued measures outside of vaccination for longer, especially where these have lesser societal or economic repercussions, rather than relying on vaccination alone to allow us to ‘get back to normal’.”

 

Prof Lawrence Young, Virologist and Professor of Molecular Oncology, Warwick Medical School, University of Warwick, said:

“We will see increasing numbers of cases infected with the Omicron variant over the coming days. Once a variant is identified, particularly one that is likely to be more infectious, it will have spread far beyond the few original cases and countries. That’s the nature of infectious disease in a world where international travel is so common.

“Some of the cases in Scotland have no history of travel indicating that their infection was caught by community spread. This highlights the importance of doing everything to slow and limit the spread of Omicron. That means restricting travel from countries where this variant is prevalent and operating a robust test and trace regime to identify infected individuals and their contacts and then ensure that they are isolating. We have no idea whether the Omicron variant is more transmissible than Delta – only time will tell.

“We don’t know whether infection with Omicron will result in more severe or mild disease, although early indications from South Africa suggest that fully vaccinated individuals can get infected but develop mild symptoms. Hospitals in South Africa are seeing a rise in young people admitted with moderate to severe disease, many of whom are either unvaccinated or have received only one dose. This might suggest, as we hope, that full and boosted vaccination is able to protect from disease caused by the Omicron variant as it does for all the other variants. It will take a couple of weeks for laboratory studies to determine whether the antibodies induced by current vaccines are able to block infection with omicron.

“We do need to get this situation with omicron into perspective. We currently have very high daily case numbers infected with delta variant – around 10 fold higher in the UK than the current cases infected with omicron in South Africa and delta is responsible for around 600,000 new confirmed cases per day globally. It is just as important to continue to control the spread of infection with delta as it is to contain the new omicron variant.”

 

Prof Jim Naismith, Director of the Rosalind Franklin Institute, and Professor of Structural Biology, University of Oxford, said:

“The discovery of six cases in Scotland, some with no travel to South Africa or other “red” list countries is to be expected.

“Travel is in reality all or nothing with respect to Covid19 variants. Rapidly spreading variants will move faster than surveillance systems.

“Stopping travel to one country, whilst allowing it from others has not been particularly effective because the virus is able to take multiple transit routes.

“Similarly discriminating between who is allowed to travel into a country the on citizenship grounds has not worked well, since the virus is not interested in passports.

“Local zoning in the UK failed for the same reason and has little scientific basis.

“It seems likely the omicron variant of the virus has a foothold here.

“We still do not know

(1) What is the rate of the spread of omicron versus Delta ?

(2) Does it cause more or less or the same disease as Delta ?

(3) To what extent is omicron able to evade immunity?

“All three questions are crucial.

“We have a clue about (1), some early data suggests the virus can spread rapidly. However, I would caution this may change.

“It is too early to know about (2).

“Based on scientific studies of various changes to Spike and our understanding of the structural biology of neutralisation, we would expect this variant to be less susceptible to immunity either from vaccine or previous infection.

“However, to use a football analogy, in playing in the cup final winning 5 – 0 is just as good as winning on penalties by one goal after extra time.

“The vaccines we have are safe and effective, they have massively reduced serious disease and death.

“They will be still be effective to some extent and I would urge everyone to get theirs.

“Further, new medicines are coming online, these will not be affected by the omicron changes.

“Beyond vaccination, ventilation is an effective measure as is universal masking.

“However, the ONS survey results on prevalence shows that the Scottish and English approach to masking although formally different since July has made no meaningful difference to Delta.

“In both countries very high levels of prevalence have continued for months.

“Thus the new changes announced are unlikely to have much of impact if Omicron does indeed spread rapidly.”

 

Dr Shaun Fitzgerald, Royal Academy of Engineering Visiting Professor, University of Cambridge, said:

“The news of more cases of Omicron in the UK is not surprising. And if some of those identified have no travel history it means that transmission here in the UK is happening. This means that we need to be even more fastidious in our behaviours to help look after ourselves and others. One of the things which is still not widely applied in all sectors is ensuring an adequate level of ventilation. It is of course harder in the cold weather, like today. In warmer times it is not just easy to throw open all the windows, it is the natural thing to do to create a pleasant environment. But in cold weather we still have to ventilate our spaces and limit the build up of virus in the indoor air. It means cracking open windows if you aren’t in a space with automatic ventilation control. If we go to places for a meal etc. and there are no windows open, then this should not be on the menu – get the windows slightly open.

“We have been better at getting vaccinated and boosted, but even so there is more we can do – more people getting jabbed. And of course testing regularly, wearing face coverings and washing hands. We also need to remember to keep our distance when we can and if we can opt to travel at less busy times then this is a sensible thing.”

 

 

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

 

 

Declared interests

None received.

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