Is Omicron the end of the Covid-19 pandemic?

Dr Bijon Shil, the developer of the first Bangladeshi rapid Covid-19 antigen kit from the Gonoshasthaya Kendra, strongly believes that from August onward the Covid-19 can be treated as an endemic.

On 1 February, Bangladeshi-Singaporean scientist Dr Shil spoke to The Business Standard in a virtual interview to share his insights on the highly transmissible variant Omicron, "NeoCOV," and how long the Covid-19 pandemic will persist.

He also stressed on, in moving forward, paying heed to the lessons the pandemic has taught the world. While we discuss the possibilities of when and how we can 'return to normal,' Dr Shil said, "for people who lost their loved ones, the situation will never return to normal and we have to remember how the pandemic affected us."

In the last few weeks, we have seen a lot of reports of a new Coronavirus 'NeoCov," which, it has been said, can kill 1 out of 3 people and has a high infection rate. How accurate are these reports and should we be worried?

The research is still not peer-reviewed and we have to remember that people worldwide already have had vaccines and there is a high percentage of herd immunity.

There are a lot of factors to consider, one of them is how the body's immune system can fight against the new virus.

At the moment, the virus has been detected only among bats. The "NeoCov" is unlikely to cause another pandemic soon. We should rather focus on current vaccinations and boosters against the Covid-19.

We have seen a lot of reports that say that the Omicron variant is more transmissible/contagious but less deadly than the Delta. After almost three months of its detection, do you think that still holds?

The Omicron variant is more transmissible and in fact, it is 500% more infectious than the Delta variant. Still, in terms of hospitalisation, there had been 64% fewer and it caused 54 % fewer fatalities.

The actual positive cases of Omicron is three times more than the [reported] positive cases. If we look at the total number of infections per day and compare that with the Delta variant, it's evident that the hospitalisation and fatalities rates are much lower.

Because of several mutations, the Omicron variant is less capable of infecting the lung tissue, the heart and the kidney, whereas the Delta variant proved to be more deadly. But even if there is less risk of lung infection, the virus is very contagious.

The symptoms of Omicron are different from the other variants.

The most common symptoms are a runny nose and a sore throat. The runny nose contains a considerable amount of the virus and the virus can spread upto eight metres when a person sneezes.

Because of the seasonal cold or people not knowing they have Covid-19 due to mild to no symptoms, this variant spreads faster.

Another point is that the nasal discharge that people spit out on the streets actually dries up to form dust. We have to remember that this variant is transmissible by air.

Illustration: TBS

Will vaccines still protect us from this variant? Many people with three shots of the vaccine are testing positive for Covid-19.

I believe that the vaccines will protect people from the virus, it may not be 100% protection, but vaccinations can reduce the hospitalisation rate and fatalities.

Simply put, the vaccine works by neutralising the virus and destroying the virus multiplying in the body. The body also has its own immune system, which also fights the virus and the vaccine can support the body to tackle the infections.

The vaccines will work, perhaps not 90 % or 70 %, but may be up to 40%. This 40% is still enough for the infected person not to go to the hospital and not experience anything severe.

In regards to the Omicron variant, what is your recommendation for people to stay safe? Do the previous rules of social distancing and wearing masks still hold, and is there something more we can do?

To stay protected from the Omicron variant is very difficult. However, wearing masks is still essential; nasal discharge is a common reason for its transmission. Masks can protect uninfected people from infection. But this only works if everyone wears masks.

I have also seen people wear two masks, which can help, but I go for cotton masks. A three to five layered cotton mask is good because cotton absorbs moisture and retains viruses. It's also non-allergic and comfortable to wear.

The Omicron variant also causes itchy and dry throats. A good home remedy is tea, which can benefit people by increasing the body's immunity and help with bacterial infection, which will fight the virus. I also advise people, especially infected people, not to drink cold water, which aggravates their coughs and transmits the virus more.

Also, Vitamin C is very important to counter respiratory problems, which are common in winter. Additionally, I always advise seeing a doctor if someone is experiencing symptoms to receive the correct treatment.

Many people in Bangladesh are receiving a third dose of the vaccine (booster shots), while the EU is considering a fourth. Do you think we will also need a fourth booster?

One of the studies from Israel said that three doses of the vaccine might be better than having a fourth one because when the body has a high level of immunity, a fourth vaccination will not have any effect. It might even weaken the immune system of the body.

It is better to receive the fourth vaccination  six months after the third dose.

The symptoms of the Omicron variant are very mild and at this moment, many scientists believe that almost 50% of the world has been exposed to the Omicron variant. So all these people have developed antibodies. It's important to remember that someone who has been infected with Omicron will already be immune to other variants like Delta.

We see many reports that say Omicron is endemic and marks the end of the pandemic. What are your thoughts on this?

With Omicron's high transmissibility rate, I think it will affect 80% of the uninfected population by June, but the symptoms will most likely be mild. I believe it will become endemic by September, with small pockets of  outbreaks that can be controlled. We will then have to treat it like the flu. 

So I believe the pandemic will reach its peak with the Omicron variant by February and then cases will start dropping from March to August, when it can be treated as an endemic.

What are the lessons we should learn from these last two years of the Covid-19 pandemic?

I think authorities, especially the World Health Organisation (WHO), should not ignore any viruses observed in different parts of the world. The world is a global village; if any virus emerges in one part of the world, it won't take long to travel to other countries, so if any virus comes under the scrutiny of the WHO, they must take action immediately.

The lessons learned by the WHO and the world from SARS-CoV-1, which spread in 2003 and was contained within six months, and lessons from the 2012 outbreak of Middle East respiratory syndrome — these two situations made the WHO confident that the same thing would happen this time, but that's why almost every country was unprepared for Covid-19.

The Covid-19 is much deadlier than the two earlier cases. And unfortunately, the data on the transmissibility of Covid-19 was gathered much later, and when the health authorities realised it, it was already too late.

Simply put, the WHO and the world health authorities have to be vigilant and observe any new virus when it emerges. It's not the job of only one country but every one of them.

What are your thoughts on the Bangladesh government's overall response to Covid-19 and what can we do from a healthcare perspective so that people can be prepared for the future?

Bangladesh is doing quite well; from the reports, the cases are not high like in Europe or the United States and fatality rates  are still lower than that of the Delta variant.

Bangladesh will still have to research to develop diagnostic tests and manufacture vaccines. We learned from the western countries that each country will vaccinate its people first. So in the future, Bangladesh needs to be equipped with research and the ability to manufacture its own vaccine for its people.

After two years, do you think the world can return to a pre-pandemic situation and if so, what would you say the time frame is for that?

The question is tricky; I believe that the Covid-19 will stay on for a longer time. Post Covid-19 symptoms like lung problems, memory loss, blood pressure and other symptoms might persist.

We cannot say what long-term health effects Covid-19 will have.

Even after recovery, some symptoms might stay for a long time and only after we have crossed the pandemic stage, can we be sure how long these symptoms will last.

I hope we can return to a pre-pandemic situation in five years with  regards to the economy and also in some other aspects of what we know of pre-pandemic life. But for people who lost their loved ones, the situation will never return to normal and we have to remember how the pandemic affected us.