Over 20 months into the COVID-19 pandemic, the world is set to face another hurdle in moving past the virus: the omicron variant.
Doctors in South Africa last week discovered omicron, but the mutation did not necessarily emerge there. Its nation or region of origin is unknown.
Cases have been reported in South Africa and surrounding countries.
Since then, the World Health Organization has designated omicron a “variant of concern,” its most severe categorization of variants.
President Joe Biden said Monday that omicron is a “cause for concern, not a cause for panic.” A few days prior, the United States banned travel for non-citizens from South Africa and seven other sub-Saharan African countries, starting Monday.
The variant has been detected in recent international travelers in Hong Kong, Australia, Germany, Italy and the United Kingdom, among others. Closer to home, Canada has reported the variant in a traveler as well.
Gov. Roy Cooper spoke at a press conference Tuesday to address omicron. He was joined by N.C. Department of Health and Human Services secretary Dr. Mandy Cohen, whose resignation, effective Jan. 1, was announced hours earlier.
But is omicron coming to North Carolina? And why is the variant so concerning to many public health officials?
Here’s what we know.
Why is the variant so concerning?
Dr. David Wohl, infectious disease specialist at UNC-Chapel Hill, told The News & Observer the high number of mutations found in omicron show a potential for higher transmission and evading immunity derived from either natural infection or vaccination.
“These mutations create a signature that suggests that this could be a more dangerous variant than we’ve seen previously,” Wohl said. “That’s why there’s been all this concern.”
He did say preliminary data show the handful of vaccinated people with reported omicron infection have had no symptoms.
Cohen said at the press conference that there is concern among public health officials as well.
“We are all concerned looking at some of the early data from other countries, seeing that it could potentially be more contagious,” she said. “It does show significant mutations or changes at the spot in the virus that we anchored our vaccines to.”
But reports are preliminary and there is little known about the variant currently. Wohl said we’ll know more in the coming weeks.
“Laboratory data is going to start emerging where blood from people who’ve had natural infection or been vaccinated is going to be put to a test against the omicron virus to see what kind of neutralization occurs,” he said.
Symptoms will also be studied more closely in vaccinated and unvaccinated people, he added.
“Both of those pieces of information, I think, will help us understand the threat,” Wohl said.
But even tests and what happens in actual people can differ, Wohl said. Human immune systems are complicated.
“While there’s mutations that may make it harder for cells to respond and gobble up this virus, we don’t know for sure what will happen in people,” he said. “I’m cautiously optimistic that people who are vaccinated make a broad enough response that they should be able to avoid severe illness with this new variant.”
The Biden administration is planning to brief state and local governments this week to prepare them to detect and monitor omicron, anticipating that it may show up inside the United States within a matter of days, McClatchy DC reported.
Cooper said they hadn’t been briefed as of Tuesday, but he is pleased with the federal response from the Biden administration.
“Our federal partners are going to continue to be important to us as we work to get us through the other side of this pandemic,” Cooper said.
Is omicron coming to NC?
Despite travel bans, Wohl said North Carolina and the rest of the country will start seeing cases of omicron.
“All these travel bans do is delay the inevitable. There’s no way to keep this out. This is going to get in no matter what,” he said.
There haven’t been any reported cases of omicron in North Carolina or the rest of the country, as of Tuesday afternoon, but that is expected to change soon.
“Many experts believe it is likely already here,” Cohen said.
Currently, the dominant variant is delta, which makes up nearly all new cases of COVID-19 in North Carolina.
The delta variant surged during late summer, infecting and killing thousands in the state.
UNC Health keeps close track of variants detected through COVID-19 testing. But they haven’t found any cases of omicron, though the latest data is only through Nov. 6.
Wohl said that through the molecular testing, UNC and others that sequence the virus will be able to detect omicron once it arrives in North Carolina.
In an emailed statement, UNC Health said: “COVID testing teams are keeping close watch for the omicron variant. Our research teams are working with various partners to determine implications for vaccines and treatments, and our clinical teams remain ready for any increase in cases and hospitalizations.”
Wohl said the key question is whether omicron will be able to out-compete and overtake delta.
“How do you out-compete delta? Which has really already filled this niche,” he said. “Right now, we know that the vaccine is protecting us really well against delta. If this is able to have an advantage over delta, especially among people who are vaccinated or had natural infection, that would be a concern.”
Will there be more restrictions?
“We don’t anticipate any additional restrictions at this point, but we know that there are questions to answer,” Cooper said.
Vaccinations started about a year ago, first available in North Carolina for health care workers who had direct contact with COVID-19 patients. Within a few months, vaccination eligibility was widespread.
Since then restrictions have lessened significantly.
There hasn’t been a statewide mask mandate in North Carolina since July. The Centers for Disease Control and Prevention guidance recommends mask-wearing indoors in areas of high “community spread.”
In North Carolina, that includes every county in the Triangle except Orange County.
Triangle governments who still have indoor mask mandates in place include Raleigh, Wake County, Durham and Chapel Hill.
Cary, which is in Wake County, lifted its mandate earlier this fall.
Local school boards must also vote on mask mandates for schools once a month. The provision was part of a legislative bill.
There haven’t been any statewide mandates since the end of July, when final restrictions lifted, only recommendations which closely follow CDC guidelines.
“We’ve encouraged local governments to look at those recommendations and to make decisions that are best for their communities,” Cooper said.
What should I do now?
Wohl urged caution.
“This is something more akin to a cloud on the horizon. It’s coming our way. We don’t know if it’s carrying a lot of rain or a little rain or if it’s going to rain at all. We just don’t know,” he said. “We really won’t know until we get a little bit better forecast and a little bit better information.”
Wohl urged people to continue masking and to get vaccinated if they’re not already.
Cooper continued to urge vaccination.
“My level of confidence is strong that vaccinations are going to continue to be the way out of this pandemic,” he said.
As of Nov. 24, the latest available data from DHHS, those unvaccinated are more than five times as likely to contract COVID-19 and over 25 times as likely to die from the disease compared to those who are vaccinated.
As of Monday, 72% of the state’s adults had at least one vaccination dose, with 68% total who are fully vaccinated.
The CDC strengthened its call for booster shots Monday, recommending that everyone 18 or older get an additional shot of either Pfizer or Moderna six months after their last. For the Johnson & Johnson, the recommendation is two months past the first shot.
“With the holidays, colder weather and this potential of a new variant approaching, you should not put off getting your booster,” Cohen said.
Omicron? What happened to nu and xi?
WHO has normally followed the Greek alphabet in order, but skipped two letters when naming this variant.
The most recent variant before omicron was “mu.” After that in the Greek alphabet is “nu,” but a WHO spokesperson told the The News York Times that the letter “nu” is too easily confounded with “new.”
As for xi, it was explained to the Times that it was not used because it is a common last name.
The WHO spokesperson told the Times that naming of the variants requires “avoiding causing offense to any cultural, social, national, regional, professional or ethnic groups.”
The Times reported that some speculate that it’s because it shares the name — though pronounced differently — of China’s president, Xi Jinping.
How do you pronounce omicron?
Google says it’s aah-muh-kraan, not oh-muh-cron.