Augmenting the public health response to ensure effective containment of the Omicron variant :Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Environmental Disease

REVIEW ARTICLE
Year : 2022 | Volume : 7 | Issue : 1 | Page : 12--15

Augmenting the public health response to ensure effective containment of the Omicron variant

Saurabh RamBihariLal Shrivastava¹, Prateek Saurabh Shrivastava²,
¹ Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
² Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Correspondence Address:
Saurabh RamBihariLal Shrivastava
MD, FAIMER, PGDHHM, DHRM, FCS, ACME, Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India

Abstract

The ongoing coronavirus disease–2019 (COVID-19) pandemic continues to disrupt human lives and almost all sectors and industries. The purpose of the current review was to explore the Omicron variant, the associated global risk, and the public health measures that need to be taken to contain the new variant. An extensive search of all materials related to the topic was carried out in the PubMed search engine and the World Health Organization website. A total of 13 articles were selected based upon their suitability with the current review objectives. Keywords used in the search include COVID-19 and Omicron in the title alone only. The World Health Organization identified a new variant of concern – Omicron on November 26, 2021, which has been reported in more than 170 nations. Depending on the evidence that has surfaced till now, the overall global risk associated with Omicron has been identified as very high. However, the variant has not been linked with serious forms of illness and complications; nevertheless, the large number of cases resulting due to high transmissibility has definitely accounted for a proportional rise in the number of hospital admissions and thus overwhelming the health-care delivery systems. To conclude, the Omicron variant of the causative virus has been associated with high transmissibility but low rates of development of serious infections. This call for the need to raise to the occasion, and all of us should adhere to the standard prevention and control measures and get immunized with the vaccine at the earliest.

How to cite this article:
Shrivastava SR, Shrivastava PS. Augmenting the public health response to ensure effective containment of the Omicron variant.Environ Dis 2022;7:12-15

How to cite this URL:
Shrivastava SR, Shrivastava PS. Augmenting the public health response to ensure effective containment of the Omicron variant. Environ Dis [serial online] 2022 [cited 2023 Jun 5 ];7:12-15
Available from: http://www.environmentmed.org/text.asp?2022/7/1/12/341191

Full Text

Introduction

The ongoing coronavirus disease–2019 (COVID-19) pandemic continues to disrupt human lives and almost all sectors and industries. Since the detection of the causative virus 2 years back, the virus has undergone various mutations and has resulted in the emergence of variants of concern (such as Alpha, Beta, Gamma, Delta, and Omicron) and variants of interest (viz. Lambda and Mu).[1],[2],[3] The emergence of these variants has continued the pandemic and has accounted for the rising incidence of the disease even after the completion of 2 years.[4] In fact, as of January 30, 2022, a cumulative total of more than 370 million cases and in excess of 5.6 million deaths have been attributed to the infection, with the European and the American region being the most affected.[4] The purpose of the current review was to explore the Omicron variant, the associated global risk, and the public health measures that need to be taken to contain the new variant.

Methods

An extensive search of all materials related to the topic was carried out in the PubMed search engine and the World Health Organization website. Relevant research articles focusing on Omicron variant and COVID-19 pandemic published in the period November 2021 to January 2022 were included in the review. A total of 16 studies similar to current study objectives was identified initially, of which three were excluded due to the unavailability of the complete version of the articles. Overall, 13 articles were selected based upon their suitability with the current review objectives and analyzed. Keywords used in the search include COVID-19 and Omicron in the title alone only (viz. COVID-19 [ti] AND Omicron [ti]; COVID vaccines [ti] AND Omicron [ti]; Omicron [ti]). The articles published in only the English language were included in the review [Figure 1]. The collected information is presented under the following subheadings, namely Omicron variant, Omicron and global risk, Omicron and its impact on diagnosis, immunity, and treatment, vaccines and Omicron, and strengthening public health and social measures.{Figure 1}

Omicron Variant

The World Health Organization identified a new variant of concern – Omicron on November 26, 2021, which has 26–32 mutations in the spike protein, making it a potential candidate to escape immune response and with higher rates of transmission.[1],[3] Since its detection, it has been reported in more than 170 nations, and clearly, the number of cases reported across different regions has gone beyond the Delta variant.[5] The available findings have revealed that Omicron has remarkable growth potential and a more secondary attack rate in comparison with the Delta.[5]

With regard to its severity, as the trends have started to emerge, it has been identified that the novel strain has been linked to a lower incidence of hospital admission, considering the extent of community transmission attributed to the same.[5],[6] These kinds of contrasting results (viz. more incidence versus less hospitalization) could be due to the low intrinsic severity of the variant. That vaccine is more effective in preserving the development of severe forms of illness.[5],[6],[7] Moreover, it has been identified that the novel variant has more affinity to the upper respiratory tract when compared with the Delta variant, which had more affinity to attack the lower respiratory tract.

Omicron and Global Risk

The risk to any variant is ascertained depending on the transmissibility and the extent of protection offered by the vaccines in terms of preventing acquisition of infection, transmissibility, development of disease, and fatal consequences.[5],[8] In addition, the virulence of the strain, the level of awareness about the strain amongst the population, and adherence to the standard infection prevention and control measures also determine the overall risk attributed to any strain of the virus.[5],[8] Depending on the evidence that has surfaced till now, the overall global risk associated with Omicron has been identified as very high.[5],[9]

This can be acknowledged based on the rapid spread of the strain in the community that has accounted for the higher incidence of the COVID-19 cases.[1],[6] We do agree that the variant has not been linked with serious forms of illness and complications; nevertheless, the large number of cases resulting due to high transmissibility has definitely accounted for a proportional rise in the number of hospital admissions and thus overwhelming the health-care delivery systems.[10],[11]

Omicron and its Impact on Diagnosis, Immunity, and Treatment

With reference to the diagnosis, the utility of routinely employed rapid antigen test or reverse transcriptase–polymerase chain reaction (PCR) test remains the same, and not much has changed with the Omicron variant.[5],[8] In terms of immunity acquired because of prior infection or due to the vaccine, the available evidence depicts a decline in the titers of protective antibodies against the novel variant, and thus increased risk of reinfection has been reported in some of the nations.[5],[8],[9],[12] The treatment protocol for the severe forms of Omicron-induced infection is expected to remain the same, but questions have been raised about the effectiveness of monoclonal antibodies.[5],[13]

Vaccines and Omicron

A number of COVID-19 vaccines manufactured by different companies have been administered in different nations. The available evidence suggests that people who have received vaccines not only have less risk to acquire infection but also tend to have a mild form of the illness and usually do not land up with complications.[3],[5] Considering that a sudden increase in the number of Omicron cases has been reported in different parts of the world, it becomes quite essential that all people should be immunized with vaccines.[5],[12] Mere receiving a vaccine will not alone bring about a reduction in the incidence of the Omicron disease, but it will definitely aid in reducing the probability of severe forms of the disease and thereby minimize the burden on the health system.[3],[5],[12] Vaccine mandate refers to the necessity that if a person wants to do some specific things (viz. entering a mall, traveling abroad, participating in a public event, etc.), they must be vaccinated. From a human rights perspective, we cannot force a person to get vaccinated, but considering the fact that such an action will be better for the overall well-being of the society and people at large, it should be envisaged, and people should be motivated to get immunized at their turn.[14] In fact, some of the governments have introduced vaccine mandates in their settings keeping in mind the interests of the general population.[14]

Strengthening Public Health and Social Measures

Considering the sudden rise in the number of COVID-19 cases, there is an urgent need to raise our guard and strengthen the implementation of the standard infection prevention control measures.[15],[16] This has to begin with the strengthening of the surveillance activities and should be supported by an increase in the network of laboratories entitled to carryout testing.[13],[15],[16] Depending on the resources available, we can definitely adopt PCR-based screening activities in different geographical locations.[5] It is also important that all the omicron cases are reported to the WHO periodically. It is quite essential that targeted efforts are taken to expedite and augment the COVID-19 vaccination coverage in all nations among high-risk population groups to begin with.[17]

Regarding health-care institutions, it is a must that all infection prevention and control measures (such as engineering measures, environmental modifications, triage facility, training of health-care professionals, provision of personal protective equipment, and awareness activities.) are systematically implemented.[6],[8],[18] In addition, other measures such as physical distancing, adequate ventilation, promotion of hand hygiene, and adherence to cough etiquettes should also be strictly envisaged.[8],[9] Further, we cannot ignore the significance of contact tracing, isolation of the cases, and quarantine of the known contacts in this regard, as it will play an important role in interrupting the chain of transmission.[15],[17] Moreover, people should be advised to avoid unnecessary travel and not to visit crowded public places to minimize the risk of acquisition of infection.[18]

Conclusion

The Omicron variant of the causative virus has been associated with high transmissibility but low rates of development of serious infections. This call for the need to raise to the occasion, and all of us should adhere to the standard prevention and control measures and get immunized with the vaccine at the earliest.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1	World Health Organization. Tracking SARS-CoV-2 Variants; 2021. Available from: https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/. [Last accessed on 2022 Jan 25].
2	Hageman JR, Alcocer Alkureishi L. Omicron: A variant of concern? Pediatr Ann 2022;51:e1.
3	World Health Organization. Classification of Omicron (B.1.1.529): SARS-CoV-2 Variant of Concern; 2021. Available from: https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b. 1.1.529)-sars-cov-2-variant-of-concern. [Last accessed on 2022 Jan 25].
4	World Health Organization. Weekly Epidemiological Update on COVID-19 – 1 February 2022; 2022. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---1-february-2022. [Last accessed on 2022 Feb 03].
5	World Health Organization. Enhancing response to Omicron SARS-CoV-2 Variant: Technical Brief and Priority Actions for Member States. Geneva: WHO Press; 2022. p. 1-18.
6	Le Page M. Understanding omicron. New Sci 2022;253:8-9.
7	Meo SA, Meo AS, Al-Jassir FF, Klonoff DC. Omicron SARS-CoV-2 new variant: Global prevalence and biological and clinical characteristics. Eur Rev Med Pharmacol Sci 2021;25:8012-8.
8	Poudel S, Ishak A, Perez-Fernandez J, Garcia E, León-Figueroa DA, Romaní L, et al. Highly mutated SARS-CoV-2 Omicron variant sparks significant concern among global experts – What is known so far? Travel Med Infect Dis 2022;45:102234.
9	Ferré VM, Peiffer-Smadja N, Visseaux B, Descamps D, Ghosn J, Charpentier C. Omicron SARS-CoV-2 variant: What we know and what we don't. Anaesth Crit Care Pain Med 2022;41:100998.
10	Abdullah F, Myers J, Basu D, Tintinger G, Ueckermann V, Mathebula M, et al. Decreased severity of disease during the first global omicron variant COVID-19 outbreak in a large hospital in Tshwane, South Africa. Int J Infect Dis 2021;116:38-42.
11	Ledford H. How severe are Omicron infections? Nature 2021;600:577-8.
12	Chen J, Wang R, Gilby NB, Wei GW. Omicron variant (B.1.1.529): Infectivity, vaccine breakthrough, and antibody resistance. J Chem Inf Model 2022;62:412-22.
13	Mohiuddin M, Kasahara K. Investigating the aggressiveness of the COVID-19 Omicron variant and suggestions for possible treatment options. Respir Med 2022;191:106716.
14	WebMD. Vaccine Mandates: What to Know; 2022. Available from: https://www.webmd.com/vaccines/covid-19-vaccine/vaccine-mandates#1. [Last accessed on 2022 Feb 09].
15	Kutscher E. Preparing for omicron as a COVID veteran. BMJ 2021;375:n3021.
16	Health professionals and researchers from across Europe. Europe must come together to confront omicron. BMJ 2022;376:o90.
17	Dolgin E. Omicron thwarts some of the world's most-used COVID vaccines. Nature 2022;601:311.
18	Wang X, Powell CA. How to translate the knowledge of COVID-19 into the prevention of Omicron variants. Clin Transl Med 2021;11:e680.