Omicron BA.2 variant to become dominant worldwide - WHO regional director

Dr. Dorit Nitzan explains the difference between Omicron and the new sub-variant, and why there may be bigger issues at hand.

 People pose with syringe with needle in front of displayed words "OMICRON SARS-COV-2" in this illustration taken, December 11, 2021 (photo credit: REUTERS/DADO RUVIC/ILLUSTRATION/FILE PHOTO)
People pose with syringe with needle in front of displayed words "OMICRON SARS-COV-2" in this illustration taken, December 11, 2021

While the original Omicron variant first detected in South Africa in late November is still the dominant virus strain in most countries, others are starting to worry about a new sub-variant that has been halting the downward trend in infections – the BA.2 sub-variant.

One of three Omicron sub-variants, BA.2 has become the main strain circulating in several countries including Denmark, the UK, India and South Africa. According to a February 3 Financial Times report on the sub-variant, it has as many as 27 mutations that are not found in the original Omicron variant, BA.1.

But is this enough to make it a real threat to countries still struggling to recover from the Omicron wave and the unprecedented rate of infections it caused? 

Public health bodies in both Denmark and the UK have determined the variant to be between 30%-34% more infectious than BA.1, according to the Times, and the UK designated BA.2 to be a variant under investigation back in mid-January. The World Health Organization is also currently investigating it as a Variant of Concern, as they are with all Omicron sub-lineages.

Speaking to The Jerusalem Post, Dr. Dorit Nitzan, the WHO's regional emergency director, explained the expected trajectory of the sub-variant, and what it could mean for the future of the pandemic.

“The expected trajectory is that it will become the new dominant variant, as once it crosses past a certain threshold it becomes dominant – like we’re seeing in Denmark and the UK,” she said in answer to whether or not other countries can expect to see a similar rise in sub-variant cases in the coming weeks. 

However, she said, there does not seem to be a risk of reinfection for those who have already contracted the original Omicron variant, as the two variants are not different enough, although there is not yet enough research to be certain.

A logo is pictured on the World Health Organization (WHO) headquarters in Geneva, Switzerland.  (credit: REUTERS/ DENIS BALIBOUSE)A logo is pictured on the World Health Organization (WHO) headquarters in Geneva, Switzerland. (credit: REUTERS/ DENIS BALIBOUSE)

In terms of the similarities and differences between BA.1 and BA.2, Nitzan explained that the most prominent difference right now is the transmissibility of the sub-variant.

“It moves from person to person much faster,” she explained. “If you’re with someone in a room who has the virus, you will get it. The moment you take your mask off to drink and eat – you never know when you’ll get it. We can see this in Denmark – it moves so quickly.”

Regarding the incubation period – the time between contracting the virus and becoming sick – some people have reported a shorter incubation period of just two to three days after exposure. Others have reported unusually long incubation periods, sometimes taking up to two weeks for symptoms to show after exposure.

Nitzan said it’s hard to get an accurate reading of the incubation period in places like the UK and Denmark because so many people are carrying the virus, and a positive case can often not be traced to one specific point of infection.

Other than the increased transmissibility of BA.2, she said there are not many significant differences that have been found during initial research into the variant.

“There are three main sub-types of Omicron: the original, BA.2 and BA.3, and we are following them and need to be aware of them and to learn more about them,” Nitzan said, before explaining why there are bigger concerns than just one or two Omicron sub-variants.

“What we will probably see in Europe is that most of the mutations and changes in the virus will occur now within the Omicron tree, but in the meantime, under our noses in Africa and other places that have no access to vaccines, we might have totally different variants developing right now," she said. 

"I think that Omicron right now is not the mega-issue. We have to focus on allowing and ensuring vaccine access in other parts of the world.”

IN SOME places, 80% of the most vulnerable population have yet to receive even one vaccine, the WHO regional director explained, adding that it would be impossible to say what variants are developing in these areas of the world and to know whether they could be similar to Delta or even worse.

“Virus mutations occur in the immunodeficient, and these countries have a lot of malnutrition and chronic or communicable diseases like HIV/AIDS," she said. "And these are the people that the virus likes to stay with for a longer time – their body gives fertile ground to the variants. That’s why we need to focus on them.”

Does this mean countries trying to get the variant under control are wasting their time?

“It’s good to focus on other variants [like BA.2],” she stressed. “We still need to save lives here and now and we need to do whatever we can to protect ourselves and allow the health services to take care of all who need them, not just those with coronavirus.” At the same time, however, she added, “We need to lend a shoulder to the rest of the world, and that will protect us too.”

Asked if the vaccine shortages in developing countries means that Omicron and the subsequent BA.2 variant will not mean the “end of the pandemic” as many have been suggesting, Nitzan was skeptical, saying it could be, but only if the rest of the world is provided with the vaccines they are currently lacking.

“Omicron gives us hope [for the end of the pandemic] but this is a window of opportunity for us to take care of the rest of the world," she said. "If we do it quickly and in the right way, Omicron could lead us to the end of the pandemic, but if we keep focusing on ourselves and not on the rest of the world, we will not be able to call it the endgame yet.”

In conclusion, she said that countries are correct to be vigilant when it comes to the Omicron sub-variants, but there is no use hoping that they signal the end of the pandemic while vulnerable people still lack access to vaccines.

“It’s very important that we do everything we need to do locally, but we also have to care globally," Nitzan said. "I don’t think we should stop what we’re doing, but it’s not enough – and we can’t defend ourselves without protecting the rest of the world.”