The Delta variant of the coronavirus got it’s start in India. Over a billion densely populated humans was good fodder for a SARS-CoV2 mutation that made it more transmissible. We should recall the dark days before vaccination when funeral pyres were burning 24/7 in the Subcontinent. Delta spread quickly and was soon the predominant strain of COVID infections worldwide. I am not convinced it caused any more severe illness than it’s predecessor as the 2% mortality rate didn’t seem to nudge up. Happily, the vaccines were still effective against this variant. Personally, I know this as of all the patients in the hospital less than 10% were vaccinated, the others unvaccinated. Of the hospitalized vaccinated patients, nearly all were immunocompromised or elderly.
Even as we watched Delta take over the world, we had our eyes on the B.1.1.529 variant that we called the South African Variant. It was causing a cluster of infections in Botswana, but remained largely confined to sub-Saharan Africa. Now exactly why and how this variant accumulated the many more mutations needed to take on and contend with Delta as the predominant strain of the pandemic is theoretical. I’ve just read a headline saying it evolved in rats. I find more plausible a Harvard epidemiologist who suggests it’s the combination of HIV and low vaccination rates that have led to its success. Well, of course, vaccination rates. It will be in a large population of unvaccinated humans that any variant can hone it’s mutations and select for traits that make it more transmissible. Then the HIV. The immunocompromised host is so hospitable to a virus trying to evade the human immune system. Sub-Saharan Africa proffered the perfect combination for the new variant, we now call it Omicron.
Omicron is already everywhere. We’re just starting to find it. While it’s true that it will take a few weeks to know if it is any more severe than Delta or any more vaccine resistant than Delta, the timing couldn’t be worse. “Do they know it’s Christmas time at all?” (Band Aid). Movement of people certainly is important in the spread of COVID, but it’s the logarithmic movement that really impacts. For example, when the last surge was plummeting, here in Austin, TX we had over 50,000 people a day for two weekends at ACL Fest. There were 140,000 people at Circuit of the Americas for the Formula 1 Race. There was no uptick in the surge, it kept going down. But that movement was just in our neck of the woods. In the coming weeks there will be tens of millions not tens of thousands humans moving all about the planet. Trying to squeeze some human contact out of their loved ones. And rightly so. With them, they are going to carry a little bit of Omicron from here to there to everywhere.
We can only implement what we’ve learned over the past nearly two years: 1) Get vaccinated and get the booster 2) Risk stratify who you choose to spend time with indoors without a mask 3) If in doubt of who you’re hanging with indoors, wear a mask.
