- The Washington Times - Tuesday, December 7, 2021

The answer to the world’s biggest question right now rests in a series of petri dishes at Duke University.

Dr. David Montefiori and his team are growing a pseudovirus batch of the omicron strain that is harmless to humans but can be tested against blood samples from people vaccinated against COVID-19. Their experiments, which focus on the Moderna vaccine, will help the drugmaker and the Biden administration learn whether the shots can fend off the alarming variant of the coronavirus first detected in South Africa.

They should reach a verdict by next week. After that, the drugmaker and public officials must decide whether they are satisfied with the vaccine or need a plan B, such as a variant-specific booster.

“We’re very anxious to learn how susceptible omicron is to being neutralized by the antibodies that the vaccines induce,” Dr. Montefiori, a professor who focuses on vaccine research, told The Washington Times. “To be doing such important work right now is very exciting. It’s also a lot of pressure. A lot of things can go wrong and delay an answer.”

The Duke team is among more than a dozen across the country examining ways to neutralize omicron.

“Starting next week, we’ll hear reports coming out of these labs,” Dr. Montefiori said. The results will probably be announced in a press release instead of a peer-reviewed journal. “I want these data to get out to people as soon as we feel they are reliable enough.”

The results will be pivotal. U.S. and other global leaders say they are alarmed by omicron, which is causing South African cases of COVID-19 to skyrocket. Early reports suggest the variant is causing mild symptoms. Still, hospitals are preparing for an influx of patients and officials are calling for broader vaccination to suppress the virus as much as possible.

Omicron feels like the latest insult from an incorrigible and crafty pathogen. But a virus is simply a piece of RNA, tucked into a protein sleeve, that is trying to replicate inside a host and pass down its genetic code to descendants.

“Sometimes it just doesn’t get it right. Because of that, you end up with mutations. Most of the time, those mutations are unhelpful, making the virus less able to do its virusy things,” said Stephen Kissler, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health. “Once in a while, these ‘mistakes’ actually turn out to be advantageous and get around the immune system.”

The result is a long trail of warnings from the White House, cable news networks and others about the latest variant threatening to set back efforts to end the pandemic.

These variants are mutations that got “selected through evolutionary forces and become fixed in the virus,” Dr. Montefiori said. “What I mean is it spreads. It keeps that mutation and amplifies itself by having an advantage, so it becomes more prevalent over time. It’s what we’ve seen with all of these variants.”

Scientists have not outlined a base minimum of efficacy, but they hope the vaccines will beat back omicron at similar levels as the ancestral strain found in Wuhan, China, the alpha variant first detected in the United Kingdom last year or the fast-moving delta variant that was found in India and ravaged the U.S. this summer.

Omicron could be a problem if it overtakes the vaccines to an even greater degree than beta, a variant detected in South Africa that blunted vaccines to a notable degree in clinical trials.

Moderna’s CEO lowered expectations by warning of a “material drop” in vaccine effectiveness from omicron, given its host of mutations. Administration officials, however, are betting the vaccines will hold up well against the variant.

White House COVID-19 response coordinator Jeff Zients said Tuesday that vaccines remain the best line of defense against the virus in any of its forms. He said the U.S. delivered 12.5 million shots into arms last week as boosters or initial vaccinations.

“That’s the highest weekly total of shots since May,” Mr. Zients said.

He said 7 million of the shots were boosters for those previously vaccinated.

Some leaders aren’t waiting for people to come forward willingly. New York Mayor Bill de Blasio announced a sweeping mandate that requires all private-sector employees who report to workplaces to get vaccinated. He is also mandating proof of at least one dose of a vaccine for children ages 5-11 to enter social venues such as indoor restaurants and performance halls.

“This kind of triple threat — omicron, winter and holiday gatherings — this is coming on fast,” the Democrat told the “Inside City Hall” program on Spectrum News NY1. “So we want to get those youth vaccination numbers up. We want to get seniors especially, but everyone with those boosters. And we want to extend to anyone who has gotten the first dose. And we think the mandates really help us on that level.”

The omicron variant has been detected in 50 countries and 19 U.S. states.

“We expect that number to increase,” Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said Tuesday.

Dr. Anthony Fauci said anecdotal evidence, mainly from South Africa, suggests omicron causes mild COVID-19 symptoms.

“It appears with the cases that are seen, we are not seeing a very severe profile of disease. In fact, it might be, and I underscore, might be, less severe as shown by the ratio of hospitalizations per number of new cases,” said Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases.

“This could be influenced by the fact that many in this particular cohort are young individuals, [but] the hospital stay seems to be less and the use of supplemental oxygen seems to be less,” he said. “Again, I caution you, these are still preliminary.”

Cases reported in the U.S. have tended to affect vaccinated people, who also reported mild symptoms.

The bad news is that omicron is producing an evident surge in cases in South Africa, from 266 reported infections on Nov. 6 to 10,628 on Monday.

“The almost vertical inflection of this clearly argues toward a high degree of transmissibility,” said Dr. Fauci, using a chart to underscore the rise.

GlaxoSmithKline, meanwhile, reported good news on the treatment front. The monoclonal antibody drug it created with American drugmaker Vir Biotechnology, sotrovimab, was able to combat the omicron spike protein in lab studies.

“These data add to the growing body of preclinical evidence demonstrating that sotrovimab retains activity against all tested variants of concern,” the company said Tuesday.

On vaccines, Dr. Montefiori’s team of eight scientists at Duke is coordinating with scientists at the National Institutes of Health and another team at Emory University.

NIH and Moderna are sponsoring the work from the individual teams, which allows for independent confirmation of results from each lab. They are testing multiple dilutions of the vaccine on a device with dozens of small petri dishes, known as a 96-well plate, that allows them to study the presence and level, or titer, of antibodies produced in the blood samples.

Part of the reason the coronavirus is spreading so many variants around the world is that the crisis is sweeping. Many countries are collecting samples for sequencing, so mutations are spotted sooner and elevated to the public discourse.

The number of mutations is also tied to the nature of viruses.

“Bacteria use DNA, viruses use RNA. It’s a slightly different chemical, but basically, RNA is less chemically stable. It allows viruses to go through evolution a lot more quickly,” Mr. Kissler said. “That gives it a lot of opportunities for those rare, advantageous changes to occur.”

One leading hypothesis, which hasn’t been proved, is that the virus mutates swiftly in immunocompromised patients. They hold on to the virus for a long time, exposing the pathogen to immune responses that allow viruses to develop workarounds.

“It’s right in that sweet spot where [the virus is] challenged but not so much it disappears,” Mr. Kissler said.

Omicron is the second significant variant first detected in South Africa, which has a high prevalence of HIV/AIDs. Scientists, however, caution that it is unclear where these variants originated.

Members of Congress and others have debated whether the first strain of the coronavirus came from China. A lack of cooperation from Beijing has muddled that picture. A live-animal market in Wuhan was blamed at first, though others suspect a lab leak from a virology institute in the central Chinese city, perhaps with man-made engineering.

Scientists say the virus probably originated in bats and may have passed through an intermediary species before reaching humans.

“When it jumps to a new species, those adaption features that are optimal for surviving in bats need to adjust to survive in people. What this virus has been doing is evolving to adapt to its new human host,” Dr. Montefiori said.

The virus will reach optimal transmission before it stabilizes, meaning mutations won’t make it any fitter, the doctor said.

“We don’t know when that is going to happen,” he said. “There’s always the next variant. I think we just have to come to expect that.”

For more information, visit The Washington Times COVID-19 resource page.

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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