By Prof. Lam Sai Kit

KUALA LUMPUR, Malaysia--The announcement of a new COVID-19 virus in South Africa has raised global concern of the potential of another deadly wave of COVID-19 pandemic, especially in the northern hemisphere where winter is about to set in.

This new variant, B.1.1.529, was first confirmed from a specimen collected on 9 November 2021 in South Africa where, in recent weeks, infections have increased steeply.

What has sparked global concern is that this variant, now given the name Omicron by WHO, has over 50 mutations, with more than 30 in the spike protein alone.

“Any mutation on the spike protein is of concern since it is responsible for the entry of the virus into human cells and is the target of most COVID-19 vaccines.

Thus, this new variant has the potential to escape immunity and have increased infectivity.” (WHO defines a virus to be a variant of concern in a category for dangerous variants that may spread quickly, cause severe disease, or decrease the effectiveness of vaccines or treatments).

To date, 77 cases have been confirmed to be due to Omicron in South Africa, but the fact that cases have also been detected in Botswana, Belgium, Hong Kong, and Israel, is worrying.

The two cases reported in Hong Kong were in travelers arriving from parts of southern Africa and had been quarantined upon arrival.

“So far, there is no proof that this variant is more contagious or lethal than the Delta variant, but the fact that so many mutations have been found associated with the virus spike protein give rise to the fear that Omicron may prove to be equally transmissible and deadly”.

Countries around the world have reacted to the emergence of this new variant by banning flights and restricting travelers arriving from countries in southern Africa.

Malaysia has also announced a travel ban on seven African nations, and foreigners who have visited these countries in the last 14 days will be barred entry.

However, Malaysians and permanent residents returning from these countries will be allowed to enter but must undergo a mandatory 14-day quarantine.

“The appearance of Omicron could not have come at a worse time because of the expected surge in global travel during the forthcoming holiday season.

In Malaysia, the additional concern is the possible introduction of this variant into the country with the Sarawak election due next month.

The Health Minister, Khairy Jamaluddin, has also advised against the holding of GE15 any time soon.

Like other countries, Malaysia must enhance its surveillance and sequencing efforts at its borders, especially foreign tourists from affected countries.

Malaysia must join the global effort in sharing complete genome sequences of any new variants to a public database such as GISAID and report any variants of interest and concern to WHO through the International Health regulation (IHR) mechanism.

“We do not know the disease severity of Omicron, and whether the present diagnostic procedures using the PCR and the rapid antigen test will still work well.

In addition, will the present vaccines in use, which is prepared against the origin SARS-CoV-2, still be effective in protecting us against Omicron.

Another concern is whether the present antiviral regime in treating severe COVID-19 will continue to be effective.

“Although there is much we need to know about Omicron, I believe that the public health and social measures that are already in place, namely wearing of face masks, physical distancing, hand hygiene, avoiding crowded spaces, improving ventilation of indoor spaces, will still work.

"Getting vaccinated as well as getting the booster dose is still highly recommended irrespective of the variants causing COVID-19”.

To reimpose travel restrictions of any kind is not a popular move and will certainly further damage the global economy.

The stock market tumbled around the world on Friday, reacting negatively to the news of Omicron.

The Foreign Minister of South Africa has hit out against imposing restrictions to his country.

“But what else can we do to prevent or at least slow down the variant from spreading outside of South Africa?

We have to be proactive to protect our borders, and one way is to impose travel restrictions, no matter how unpopular this is.

In the next few weeks, much more will be known about the Omicron variant, and we can then adjust our response accordingly.

In the meantime, Malaysia and the world must be prepared for a worst-case scenario.”
*Professor S.K. Lam has been one of the most influential figures in Medical Virology in Southeast Asia. His research in dengue is recognized worldwide as well as by the World Health Organization. In recent years, his involvement in emerging diseases has led to the discovery of new viruses in the region, and the isolation of Nipah virus and Tioman virus has made his team internationally recognized.*