Omicron will be hard to contain. Sri Lanka should be testing all passengers entering the country: Prof. Malik Peiris

Hong Kong based virologist Professor Malik Peiris recognized for his research on the pathogenesis and ecology of viral infections, particularly influenza says the newest variant (Omicron) is very transmissible and may be evading prior immunity elicited by the Delta variant. Professor Peiris received the 2021 John Dirks Canada Gairdner Global 
Health Award.

Professor what do we know so far about the Omicron variant?
It is just about a week since this new SARS-CoV-2 variant was reported from Botswana and South Africa. Thus, our knowledge on this variant is limited and still early days.

One thing we can clearly see immediately, from looking at the virus sequence, is that the virus has acquired a large number of mutations, including in the spike protein, which is the target for immunity including vaccine 
elicited immunity. 

Some of the mutations we can see have been seen separately, in other variants and we know that they have capacity to reduce the efficiency of our immunity including immunity elicited by vaccines. But direct evidence for this is still pending and many laboratories including our own are working on this question. We should have results in a few weeks.    

This variant seems to be rapidly increasing in many provinces in South Africa, a country where the Delta variant had subsided, likely due to high infection and immunity 
in the population. 

This gives us cause for concern, that the virus is very transmissible and may be evading prior immunity elicited by the Delta variant. 

What are the aspects of this variant that are cause for concern?
Even if this variant is able to partially evade prior immunity from vaccines, it is very unlikely it will be able to completely evade vaccine immunity. It is very likely that vaccines will still protect, at least from severe disease. So this is why Sri Lanka needs to accelerate its booster vaccine programme.

Are there deadly characteristics found in this variant more fatal than before?
We do not have any good information on disease severity as yet. The initial reports from one South African doctor saying that the cases seem mild are premature. 
Most of the cases they saw were you healthy adults, and we know that COVID-19 is mild in young adults. So we need more systematic information on this question.  
At the moment, we do not know if the Omicron variant is similar to Delta variant, more or less severe. We expect to have better information in the next few weeks from South Africa.

How does a country like Sri Lanka deal with this early?
Given the uncertainties I have outlined above, and the worrying signals we get from the mutation virus sequence and the current pattern of transmission of the virus in South Africa, it is sensible to act with caution. 
The primary aim should be to avoid this virus getting into the country. Detecting it after it has got into Sri Lanka will be too late, as we saw with Delta.

 So we have to stop it at the entry points to the country, at least till we know more about this virus. This will also give us a chance increase vaccine coverage and booster coverage in 
the population. 

Although the initial focus in regard to travel was the six or seven countries in Southern Africa, the virus has been detected in travellers from other countries, such as Nigeria and Egypt. 

So while the highest risk is likely to be from the Southern African region, we cannot assume that travellers coming from other parts of the world are safe. Sri Lanka should be testing all passengers coming into to the country at the point of entry, at least until the situation becomes clearer. As I said, once the virus is in the country, it will be very difficult to contain it. 

Are elderly people more prone as before to this latest variant?
There is no direct data on this. But we know that all previous variants have been more severe in the elderly and those with other underlying diseases, such as diabetes, hypertension.  

Where have they found people infected with this variant in large numbers?
Although the highest risk is likely to be from the Southern African region, we cannot assume that travellers coming from other parts of the world are safe.

How effective are vaccines to contain the spread and deaths?
This is still under investigation as mentioned above. But it is very likely that existing vaccines will reduce disease severity.  

How long do you think this virus will go on mutating?
It is not likely that SARS-CoV-2 will stop mutating. SO we have to learn to live with this virus. But we need to make sure we have got the population well immunized, so we reduce the extent of severe disease. 
We also need to be aware that our social activities do promote virus transmission. I do not think we can throw caution to the winds with regard to social distancing and public health measures. We should reduce large gatherings of people where large transmission events may take place.