COVID-19: Omicron raises questions of pandemic's origins - analysis

HEALTH AFFAIRS: The world faces diminishing returns in its policy options as it struggles to confront a new variant.

 A nurse prepares a dose of the Soberana 02 vaccine during its clinical trials at a hospital amid concerns about the spread of the coronavirus disease (COVID-19) in Havana, Cuba, June 29, 2021. (photo credit: REUTERS/ALEXANDRE MENEGHINI/FILE PHOTO)
A nurse prepares a dose of the Soberana 02 vaccine during its clinical trials at a hospital amid concerns about the spread of the coronavirus disease (COVID-19) in Havana, Cuba, June 29, 2021.
(photo credit: REUTERS/ALEXANDRE MENEGHINI/FILE PHOTO)

In the last week the world has once again entered a cycle that feels familiar. Governments are threatening to suspend travel from more countries due to the emergence of a new COVID variant. News coverage is obsessively counting every new case as if we are back to square one. Reentering this déjà vu cycle brings up key questions about how this all began.

It’s hard to remember that there was a time before COVID. Who would have believed, two years ago in December 2019, if you had told them that a dangerous virus was spreading among people in a city in China, and that within a few months international travel would come to a halt and people would be “locked down” all over the world. Despite all those movies like Contagion and books like Spillover that had predicted a similar pandemic, governments were woefully unprepared

‘Woefully’ might be a kind word for this. Criminally unprepared is probably better. Two years into the pandemic, we are not closer to knowing how it actually began. An independent investigation is impossible and key information is lacking. Leading publications are still debating the “lab leak theory” that posits that the virus actually came from a nearby lab.

The Atlantic recently noted: “What are the odds… that a global outbreak of the bat-derived SARS-CoV-2 coronavirus would just happen to begin a few miles from the Wuhan Institute of Virology – the world’s largest BSL-4 facility and the research home of the world’s leading bat-coronavirus researcher?” Similarly, other researchers are still questioning whether it is possible it was a natural spillover at a market. 

How can we live in a world where there is ostensibly so much information at our fingertips, so many “open source” sleuths online, so much crowdsourcing and “artificial intelligence” – and yet a pandemic that has killed some 5 million people and infected more than 264 million, still lacks basic historical facts? It happened right before our eyes in one of the most technologically advanced countries. 

 COVID-19 (illustrative) (credit: TORANGE) COVID-19 (illustrative) (credit: TORANGE)

And then that very technology, like social media big-tech giants, was put into action to stop us asking questions about the “lab,” and doors were shut to us. Major organizations that were supposed to help stop a pandemic, like the World Health Organization, were telling people as late as January 14, 2020 that “preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCoV) identified in Wuhan.” 

We’re still expected to believe, two years later, that we weren’t criminally misled regarding a preventable pandemic, and that basic information wasn’t denied the world in those key weeks in December 2019 and January 2020. Leading Western coronavirus researchers had been studying this exact threat in China in the years before the outbreak and yet, in January 2020, didn’t rush to warn the world or help provide insights into how to prevent a worse pandemic.

INSTEAD, TODAY we are still grasping at straws. With the emergence of the new Omicron variant, the talking point in the US revolves around a few basic manifestos. Prof. Peter Hotez, a vaccine scientist, told NBC on December 1 that “we have too many unvaccinated kids that are eligible. If we are ultimately going to end this pandemic, we are going to have to vaccinate our way out of it. But the bar is high. When you have a highly transmissible variant like Delta and Omicron, it means 85 percent of the entire population needs to be vaccinated.” 

He says that includes those who are eligible for three immunizations, meaning that what we once called “boosters” are required everywhere. As he points out, society has achieved this for measles, polio and other threats. Alexander Nazaryan, senior White House correspondent for Yahoo news, reminds us: “How do we get through Delta? Rapid testing. What about Omicron? Rapid testing.” 

In America, there is always an easy answer behind every stage of the pandemic. In March 2020, CNN reported that the “US Surgeon General Dr. Jerome Adams not only wants people to stop buying face masks to prevent the novel coronavirus, but warns that you actually might increase your risk of infection if face masks are not worn properly.” 

As late as the end of March 2020, US media reported that the “WHO stands by recommendation to not wear masks if you are not sick or not caring for someone who is sick.” The same WHO had written in its “Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)” on February 24, 2020 regarding China’s approach that “the strategy that underpinned this containment effort was initially a national approach that promoted universal temperature monitoring, masking, and hand washing.”

While the West was initially told not to wear masks, the WHO reported that in China “every citizen has to wear a mask in public.” In fact the WHO had already detailed in February 2020 the measures that most countries would undertake a month or two later: “Restriction of movement, social distancing, school and workplace closures, wearing a mask in general public, mandatory quarantine, voluntary quarantine with active surveillance.”

It is unclear why the organization was telling the world not to wear masks for months after this, and like the investigation into the origins, we probably won’t know why the leading health authorities released these misleading statements.

ONE OF THE trends during the pandemic has been a tendency of social media to drive obsessive hot-takes around each new crisis. This has led to an avalanche of self-assured COVID experts, most of whom have no expertise, lecturing each other online about the pandemic. Journalist Mehdi Hasan asked a reasonable question about how Omicron cases arrived in San Francisco reportedly aboard a flight from South Africa on November 22. 

“If this person got COVID in South Africa, didn’t they have to present a negative COVID test before being allowed to board the flight back?” The replies all present plausible expertise: “rapid tests are only 50-70% accurate”; “it takes a few days for COVID to show up on a pcr test after exposure”; “incubation period is anywhere from 2-14 days. Most airlines will accept a negative test within 72 hours”; “there is a difference between infected (having the virus) and infectious (able to transmit to someone else).”

The answers go on and on; endless theories and faux-expertise, without basic knowledge of the facts.

This is the experience of living in COVID times – few answers to key questions. Let’s take examples from the past two years, beyond the questions about the origins of the virus and the misleading statements by the WHO in January and February 2020 that may have contributed to the crisis.

First, vaccines. One of the controversial issues in the West is the use of vaccine mandates. Two courts in the US blocked aspects of vaccine mandates that the Biden administration wants to put in place for millions of US workers. Republicans want a government shutdown over this issue. In Europe there is talk of a continent-wide push for mandates.

 “It is time for the European Union to ‘think about mandatory vaccination’ against COVID-19, European Commission chief Ursula von der Leyen said Wednesday, while stressing member state governments would decide,” reports said this week.

When vaccination programs began, people were offered a carrot: In May 2021 “US health officials announced that vaccinated Americans no longer need to wear masks or social distance in most indoor settings,” the BBC reported. Then came the stick: Travelers to the US have to show proof of vaccination and a negative COVID test no more than three days before travel, according to rules released in early November. The “unvaccinated,” which is increasingly a term of abuse, must have a negative test result no more than one day before travel. 

 US and European officials over the summer and fall began to blame the pandemic on the “unvaccinated,” calling it a “pandemic of the unvaccinated.” The Lancet warned on November 20 against stigmatizing the unvaccinated and that “this view is far too simple. There is increasing evidence that vaccinated individuals continue to have a relevant role in transmission.” 

The problem facing those who believed a campaign of vaccination would lead to a light at the end of the tunnel of the pandemic was that vaccines tended to have waning immunity. By the winter of 2021 there were high numbers of cases in countries with high vaccination levels. A bit of nuance in the discussion of vaccines would have been better. 

The Atlantic’s Katherine Wu wrote about the quest for durable vaccines on December 1. “Several experts I spoke with described it as one of the most elusive concepts in vaccinology, an immunological white whale that researchers frequently chase but almost never catch. ‘We don’t have one right answer’ for what makes a vaccine’s protection stick,’ Padmini Pillai, an immunologist at MIT, told me. ‘It’s always it depends.’” 

IT INCREASINGLY looks like a lot of the messaging about vaccines has been simplistic. Vaccines work, but much remains to be known about how effective they will be in the long run. During the pandemic no one likes this uncertainty. 

Faced with uncertainty over the new variant, the US is now weighing new travel restrictions that would force everyone entering the country to be tested one day before boarding flights, regardless of their vaccination status or country of departure. In essence that means the benefit vaccinated people received in travel could now vanish, a policy admission that implies concern over the variant spreading among vaccinated people.

This leads to other troubling questions as the world enters year three of the pandemic. Hospitals are still overwhelmed with COVID patients. Travel restrictions are back. There is waning immunity for vaccines and proof of being “boostered,” or having your third shot will likely be part of the definition “fully vaccinated.” 

Major media has also come to the conclusion that unvaccinated areas of the world are responsible for variants. Time magazine said this week “at this stage in the pandemic, COVID-19 has effectively become a disease of the unvaccinated… had access [to vaccines] been made more equitably available across the globe… it’s quite possible that variants like Omicron would not have been given the opportunity to emerge.” 

The argument is that vaccine inequality heightens the risk of further mutations and that unvaccinated areas are “breeding grounds” for COVID to mutate. Had this pandemic emerged several decades ago, before the technology was available for current vaccines, would we have even more mutations?

Although reports say all viruses mutate, COVID has been uniquely pernicious. “Unlike SARS-CoV-2, which mutated into new strains in its first year as a human disease-causing virus, measles virus does not mutate in a comparable way. A person who is fully vaccinated against the measles virus will usually be protected for life,” the Mayo Clinic noted in a news brief. 

It remains to be seen about why COVID’s mutations are so effective and worrisome. If we knew more about the origins of the pandemic, we might have been better prepared.