[music]

Brian Lehrer: Brian Lehrer on WNYC, and yes a new COVID variant was identified over Thanksgiving weekend and given the name Omicron. The public health analysts said not to panic, but nobody told the financial analysts. The Dow dropped 900 points on Friday before the variant even got its name, the Dow is up a little so far today as cooler heads prevail. There are no identified cases in New York at least as of when we went on the air, but Governor Kathy Hochul declared a state of emergency that would allow her to order hospital staffing and treatment priorities if necessary.

The US and the EU banned most travelers from Southern Africa where the first clusters were identified, but it's already in Europe and probably here. Israel and Morocco have each banned all foreigners from anywhere entering their country. Let's talk about the science and the policy responses with New York Times Science and Global Health correspondent, Apoorva Mandavilli.

The wording of the headlines in her two articles this weekend say a lot, Scientists Are Studying Whether Omicron Leads To Severe Illness, and the other one, Will the Vaccines Stop Omicron? Scientists Are Racing to Find Out. In other words, there's a lot we don't know, and better that we acknowledge that. Apoorva, we always appreciate when you come on. Welcome back to WNYC.

Apoorva Mandavilli: Thank you, Bryan, always a pleasure.

Brian Lehrer: Omicron is a Greek letter, for people wondering, like delta. What makes the World Health Organization decide a COVID variant that we don't know the severity of yet is worthy of a Greek letter?

Apoorva Mandavilli: Well, in this case, Omicron has a lot of mutations that make scientists worry. It has about 50 new mutations. That's many more than we've seen in any other variant, and about 30 of those are on the spike protein, which is the most important protein in the virus really. When scientists see that, and then they see that cases seem to be popping up fairly quickly, that really rings their alarm bells.

Brian Lehrer: Could the mutations make it less threatening rather than more? I saw one reference in one article to that, that sometimes viruses change over time and mutate toward more weakness?

Apoorva Mandavilli: Absolutely. It's a phenomenon called epistasis where mutations can work together to make things worse, or they can work together to-- or work against each other and mitigate some of the effects. We don't really know yet what these mutations do. We know what some of them do and in modeling, some of these mutations have popped up as not very good ones to have, but we don't know what they do in combination, and we certainly still don't know what some of the unique mutations that have just popped up will do in this context. One thing I keep hearing from scientists, as you pointed out, is, we just don't know. This is one of those very frustrating moments when we want a lot of answers and we just don't have them.

Brian Lehrer: What do we know about the potential severity? I see the theory so far as likely to suggest, again, that it might produce less severe disease than Delta as that it might be worse.

Apoorva Mandavilli: The less severe disease is based on some reports from South Africa saying that the early cases seemed to be mild and people don't seem to have some of the trademark symptoms of COVID like the loss of sense or smell, but the doctors I've spoken to have pointed out that it's actually a little too early to conclude that because the variant really hasn't even been long enough to send people to the hospital.

We know that there's usually a delay. People first get infected, and then it's a few weeks later that they may end up in the hospital in big numbers, so we don't know that. We also have been hearing that a lot of the early cases are in young people who would have mild symptoms anyway. We don't know if it's mild because it's young people getting them or it's because this variant really does cause just mild illness.

Brian Lehrer: What about the transmissibility? I saw one doctor on TV say four times more transmissible than Delta. Even for all that I've covered COVID, I don't really know what that means. How do they know and what does that really measure when they say four times more transmissible?

Apoorva Mandavilli: They're measuring something called R0, which is really a measure of how many people each infected person can spread the virus to. We know we learned very quickly with Delta, that it was incredibly contagious, much more than Alpha, which was the first variant we worried about, and we could see that it was spreading pretty quickly. The numbers you're hearing now for Omicron are really just estimates. I think it's way too early to say what we know about its transmissibility. It certainly seems to be somewhat transmissible because it has popped up in several countries now, but I don't know that we can really put a firm number on exactly how contagious it is quite yet.

Brian Lehrer: Listeners, your science or policy response questions about the Omicron variant welcome here for New York Times Science and Global Health Correspondent, Apoorva Mandavilli, 212-433-WNYC, 212-433-9692, or tweet @BrianLehrer. I do want to get to the policy responses here. Different countries are reacting differently to the fact that this was discovered in Southern Africa. Some like the US are banning travel from there, that takes effect today. Two that I know of, Israel and Morocco are banning travel from everywhere outside their countries, except I guess for citizens of their country returning home. What's the science behind travel bans? If that's not too big a question.

Apoorva Mandavilli: There actually isn't any so that's a very quick answer. Public health experts are actually really upset about these travel bans because from what we know, the bans accomplish almost nothing and they do send economies into a tailspin, as you were mentioning earlier on. The number of countries that are starting to ban all foreigners is also rising. Japan has just joined that list that you mentioned, Israel and Morocco.

It's not really clear what that does, because if they're still letting citizens in, they're probably still letting some people in, maybe it slows it down by a very little bit, but in the meantime, the real attention needs to be on testing and contact tracing and making sure that everybody's wearing masks. Things that we know actually work rather than what seemed like really these big political gestures that probably don't accomplish anything.

Brian Lehrer: Let me play devil's advocate on that a little bit, maybe the Morocco and Israel, and did you just say Japan now also banning travel from everywhere?

Apoorva Mandavilli: Yes, that's right.

Brian Lehrer: Maybe it makes sense if we assume the variant is everywhere, not just in South Africa and Botswana, and around there. Let's go back to our corners in terms of international travel. The US and Europe, for example, as you know, only lifted travel restrictions against each other recently. Canada just started letting in people from the US again after we had so many infections. Why go scattershot or why let people just go from place to place to place to place, rather than this is one of the forms of isolating the virus?

Apoorva Mandavilli: It would be if Canada had completely shut its borders and had stayed shut, for example, but it didn't, and that's true for almost all of these countries. They may have shut their borders before, but in the past few weeks, there has been record numbers of travel again in the United States and also to other countries. If a variant was going to be jumping borders, it's already done that. The fact that we've seen the variant now in Canada, and in all of these European countries, including in some places where there isn't a link to travel to South Africa, tells us that the horse has left the barn.

Brian Lehrer: Let's take a phone call. Marilyn in Manhattan, you're on WNYC with Apoorva Mandavilli from the New York Times. Hello, Marilyn.

Marilyn: Yes. Hi. Thank you. My question is about the incredibly low rate of genomic sequencing with COVID all over the world, but in the United States, I believe we're only sequencing 3.6% of cases that comes from a recent Washington Post article-

Brian Lehrer: When you talk about, just for everybody's context, when you talk about genomic sequencing, that's basically testing a positive COVID sample from a person to see which variant it is, right?

Marilyn: Right. Right, and it's almost never done. The point is if we're doing so little genomic sequencing, how do we even know that this particular variant isn't here already? I should mention that South Africa made the point that they should be lauded for discovering it because they are doing not a lot. They're doing enough genomic sequencing that they discovered it, but we don't know where else in the world, including the United States, this variant might be because we're not genome sequencing and what is being done to increase genomic sequencing?

Brian Lehrer: Great question. Thank you very much. Apoorva, first of all, to the specific point that she made there near the end, is it possible that this is being seen as originating in Southern Africa because they do more genomic sequencing? They're looking for which variant it is more than we are? Is that a possible reality?

Apoorva Mandavilli: That's actually very likely, in fact, because South African researchers have been really on top of this, not just now, but even earlier they detected the Beta variant quite early also. They have been sequencing very actively, much more than European countries because I would point out the South African countries knew that they had Omicron before the European countries really caught onto it and had not caught it yet in their sequencing.

I would also if I were a betting woman that it's already in the US too and we have not detected it because as Marylin said, we're not really sequencing enough cases here. We did ramp it up quite a bit after last year's debacles, but we're still nowhere near where we need to be. The fact that we haven't found it doesn't mean anything beyond that we just haven't found it yet. It does not mean it's not here yet.

Brian Lehrer: If I'm sick and I go to the doctor to get a PCR test, the real nasal swab collected by a medical professional, what do they do with it, and what determines whether that gets sequenced for what kind of variant?

Apoorva Mandavilli: In most cases, nothing happens with your test. In fact, you may not even know which variant you have and your doctor may not even know which variant you have. That's been the case throughout most of this pandemic and it's been one of the most frustrating things. We do not in this country have a public health infrastructure that makes it easy for us to know which tests are coming up positive, which variant they're testing for, what the prevalence is, none of that. We don't actually have a good system for that. We are building it up, but at the moment, any samples that you may give to a private lab or any commercial lab, or even some hospital labs, are not actually making it to the CDC or to any organization that can sequence it.

Brian Lehrer: Elliot in Manhattanville, you're on WNYC. Hi, Elliot.

Elliot: Good morning. Hi. I know I'm getting a little bit ahead of where the research is but I'm curious to know there is a type of variant that is a level more serious than variant of concern, and we have not had anything more serious than a variant of concern yet for COVID. I'm just wondering based on the bits and pieces that you've seen in studying Omicron, does it seem to be one that might go up there, go over variant of concern and go up to more serious?

Brian Lehrer: Elliot, thank you. That's an official World Health Organization designation, right, Apoorva?

Apoorva Mandavilli: Yes.

Brian Lehrer: Variant of concern, and that's what the label is for Delta, and that's what the label is now Omicron. Do I have that right?

Apoorva Mandavilli: You do. When we first start hearing about a variant, the WHO might call it a variant of interest. Then when it looks like it's a troublesome enough variant, we see enough signs of transmissibility or immune escape or something that makes them worry, that's when it gets elevated to variant of concern.

Brian Lehrer: The caller is at asking, what's above level of concern. For a disease, COVID, that has killed so many hundreds of thousands of people, [chuckles] is there really a higher level of concern than what we've already been calling it?

Apoorva Mandavilli: I agree with you. I think these labels don't really make a lot of difference. Variant of concern, perhaps just to alert the world, but now that we know it is of concern, I don't think the exact name or classification means very much. We do know that this scene seems to have more unique mutations than anything we've seen before, including Delta, so if there is a next level, this is a good candidate but I really don't want to speculate because we don't know. We don't know that all of these mutations are bad, and we also don't know that the vaccines won't work. I think it's not quite time to panic or even really worry. I think it's time for scientists to be concerned and do all of these tests, but I think the rest of us should wait for some answers.

Brian Lehrer: Bernice in Pleasant, Philly, you're on WNYC. Hi, Bernice?

Bernice: Hi, thanks for taking my call. Our daughter lives in London and we had tried to go last year, and obviously weren't able to. We're scheduled to go on December 16th and with this new variant and now new restrictions being put in place in London, we're wondering if it's advisable to go?

Brian Lehrer: Do you give this kind of advice, Apoorva?

Apoorva Mandavilli: [chuckles] I wish I had a crystal ball and in fact, I'm supposed to go to India next week to see my parents whom I have not seen in two years-

Brian Lehrer: Wow.

Apoorva Mandavilli: -and to report on tuberculosis, and I don't know if that's still going to happen. I hope so but things are changing day by day so all we can do is hope for the best.

Brian Lehrer: Right. Well, she's asking a judgment question I think. Maybe India will block you from coming in, but then there's the question of is it safe for her based on I guess she'll determine her risk tolerance, but even if the UK lets her come in, I guess people are going to start asking themselves those questions in a new way again.

Apoorva Mandavilli: Yes, and I think a lot will depend on what we find out about the vaccine, so if the caller is vaccinated and has had a booster dose, probably has very high levels of antibodies and will probably be okay, at least from getting severe disease or being hospitalized. Again, in a couple of weeks, we'll know more of that and so she might know that before she actually has to get on a plane, but at the moment, we don't know if it's 100% safe.

Brian Lehrer: You just said a couple of weeks, Dr. Fauci, and just about everyone else I've seen seem to be saying it'll take two weeks to get most of the big questions answered, like the severity and how effective the vaccines we've already gotten are against it. What two weeks? Why can't they look at this variant in a lab against the vaccines, for example, and answer that question?

Apoorva Mandavilli: There's some steps that we just can't skip. In terms of severity, we have to wait to see what happens with hospitalizations. Who is coming into the hospital? Is it only unvaccinated people? What does the age distribution look like? We can't really draw those conclusions till we see enough numbers. In terms of the vaccine efficacy, again, we need to be able to build that particular variant from scratch. What the researchers are doing is starting with the backbone and then they have to add all of the mutations that this variant has before they can test it against the vaccines, and that takes time. That process of building the variant in an artificial setting in a lab does take time.

It also takes time to grow enough of the virus to test live virus, which can only happen in some very specialized labs. All of these steps just take time and we don't really want the scientists to skip those steps because what we were saying earlier, we don't know how these mutations play together, so we don't want to test a half-baked variant. We want all of the mutations before we look at the results.

Brian Lehrer: This is WNYC-FM HD and AM New York, WNJT-FM 88.1 Trenton, WNJP 88.5 Sussex, WNJY 89.3 Netcong, and WNJO 90.3 Toms River. We are a New York and New Jersey public radio, and of course, at wnyc.org, for those of you who listen via streaming with Apoorva Mandavilli, New York Times Science and Global Health correspondent, as we talk about the Omicron variant.

There's concern I've seen expressed that if the response is to ban people coming in from the region where the first clusters were found, then future variants may not be reported by other countries out of fear that they'll be blacklisted. How do science and policy intersect on that?

Apoorva Mandavilli: There are a lot of people in Southern African countries who are very upset about these travel bans because they did stick their necks on the line by saying, "We have this new variant, everybody else sit up and take notice," and they feel like they're being punished instead of being rewarded for coming out with this information. Southern Africa was already reeling from the lack of travel tourism dollars, and now to have this travel ban, it really just delivers their economy such a strong blow.

A lot of the scientists that I've been speaking to are also frustrated because on the one hand, they're getting requests from scientists all over the world asking them for the sequence of Omicron, asking them for samples of people infected, and at the same time, people from that country are not allowed to go anywhere. They feel like it's a real double standard and there is not really a scientific basis for these travel bans.

Brian Lehrer: Some scientists are saying, I told you so, that in a mostly unvaccinated developing world, new variants were always likely to have the environment to develop. Then of course, they're blaming the west for hoarding vaccines. We've talked about that on this show many times. Do you think that's scientifically supported?

Apoorva Mandavilli: It is because there are a lot of people who are immunocompromised in one way or another in some of these places. In Africa, there are a lot of people who are HIV positive or who've had TB, or who've had other diseases that really weaken their immune system. We know now that the variants grow best in people who have weak immune systems, and so we're basically rolling the dice when we leave millions and millions of people in all of these countries unvaccinated while we get boosters.

Almost every scientist I was speaking to before the boosters were authorized, including a lot of the advisors to the FDA and the CDC, were saying that for people under 65, boosters are not really warranted, but we haven't really delivered those doses elsewhere. We've made a lot of promises. The US has said, it'll deliver, I think 1.1 billion doses by 2023, and we haven't really seen most of those delivered yet. We've seen about 25% maybe. That's true for other countries that have made commitments too. Now that we're talking about Omicron, it looks like the boosters may actually give you some benefit and so I think even more countries will want to just give boosters that can afford them and these countries may get completely left behind.

Brian Lehrer: There was just an ABC News story I saw from last week about how Africa, in particular, had largely avoided the big outbreaks that we've seen in this country and Europe, despite its low vaccination rates. Is that something you had looked into at all?

Apoorva Mandavilli: It's one of those mysteries and we don't know why that's happened, there's a lot of speculation, a lot of theories about why, but I want to note that those theories also existed for India and people were saying that for some reason, India has escaped COVID entirely. Then we saw that really horrific wave this spring. I think it could just be a matter of the variants, not really fully taking off. We did see Beta make quite a dent in South Africa. It's not as if it's done nothing, it's just not been as bad as we thought, but it's not- it could just be luck so far.

Brian Lehrer: Razak in Manhattan, you're on WNYC. Hi there.

Razak: Good morning. I think your guest answered my first question. The thing is about why is Africa the only continent that's found this virus being banned? Just this week, we saw this virus in the Netherlands. Another thing about it, if you look at the time of the Ebola time, they banned certain African countries from not coming to US and Europe. I'm thinking to myself, if COVID-19 was found in Africa, this virus, the way that is killing the West, if it was killing Africa the same way, probably we wouldn't have the COVID-19 vaccines so fast as we're having it right now if you know what I'm talking about?

I think it's definitely a double standard, not just because it's a African nation, but because it's a Black nation, a Black continent, and we have European countries that are white that are having this virus, but they're not banned from this virus.

Brian Lehrer: They may not have it in the same concentration. Now, Razak, let me play devil's advocate with you for a sec. A year ago when the US was having, Apoorva, will correct me if I've got my numbers wrong, but I think last Winter, the US, which has 4% of the world's population was having like 20% of the deaths. Because the outbreak was so bad here, we were doing such a bad job of controlling it, a lot of countries banned travel from here in particular, because the cluster more than anywhere was here. Does it make sense to restrict travel from where the cluster is and maybe it's not as much of a racial double standard since what happened, happened with respect to Americans being restricted so much?

Razak: Well, you might make a little sense there, but if you look at it right now, this virus just came right now and nobody knows about this virus. European countries already having this virus, why are they not banned from coming to the US? Why is it only Africa? The reason why, because it's called African and it's found there. Because they Black, to me, they are Black and don't have that white privilege like European countries, that's why we are being banned.

Brian Lehrer: Razak, I hear you. Please call us again. Apoorva anything on that? Yes, South Africa has been doing a lot of sequencing, so they found the clusters. We do know, as Razak said, that it's been found as well and as we said it at the top of the segment, it's been found in the Netherlands, it's been found in a number of European countries now, UK, elsewhere. Do we know that it's more concentrated in Southern Africa? Do we even know that?

Apoorva Mandavilli: I don't think we know that. I think some of this might just be what we were talking about in terms of the surveillance, how much are we sequencing? How much do we know about what we actually have within our borders? I think it's really a guess at this point exactly where the variant originated, where it's been circulating, how many cases are there anywhere? I think Razak makes a good point but think some of this is less maybe just with race than also poverty.

As a global health reporter, I write about diseases of the poor quite often. I think he's right in that if this had been isolated, a disease or virus that was just in Africa or in Asia, in parts of Asia, we wouldn't be seeing the kind of attention that's being paid to a even if it was killing just as many people, and that's true for HIV, that's true for TB, that's true for malaria. It's true for tons of other diseases that really only affect those parts of the world. The reason we have all these vaccines is because it affects the Western world.

Brian Lehrer: To wrap up, we're expecting a statement from President Biden, anytime now on policy responses to Omicron that I guess he's going to announce today. Any word on what those might be?

Apoorva Mandavilli: I think he's going to ask everybody to get vaccinated as he has been saying over and over. I think he'll urge people to get booster doses, and he's going to ask some governors perhaps to reinstate mask bans, or at least not have bans on mask mandates. We'll see what he has to say.

Brian Lehrer: Apoorva Mandavilli, Science and Global Health correspondent for the New York Times. Thanks for so much information.

Apoorva Mandavilli: Thank you.

Copyright © 2021 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.