Want to Avoid Omicron Two? We Have to Start Supporting Poorer Countries, Scientists Say

Rich countries need to do more to protect people in developing nations if the world is to prevent future outbreaks of dangerous new variants, scientists said.

Their concern comes as several researchers have suggested that the Omicron variant of COVID might have evolved in someone with a compromised immune system.

Omicron has dominated headlines over the past week or so after scientists voiced worries about its large number of mutations—more than 50 in all.

It's thought that some of these mutations could boost the variant's ability to spread between people or resist natural or vaccine-induced immunity, and studies are ongoing to determine if this is the case.

A lot is still unknown about Omicron, which was only identified last month. The earliest known samples were collected from South Africa, according to the GISAID virus reporting network, but scientists still aren't sure where or how the variant originated.

Some have proposed that the variant could have emerged in animals before being spread to humans; others think it's more likely that it emerged due to a prolonged infection in someone with a compromised, or weakened, immune system.

It's not the first time this idea has cropped up. Ravindra Gupta, a virologist at the University of Cambridge, proposed in 2020 that the Alpha or B.1.1.7 variant could have come from an immunocompromised patient who had a long-running COVID infection.

He proposed the theory after observing a cancer patient who had caught COVID and died. The patient's cancer medication had weakened their immune system and made it hard for them to shake the virus, meaning they were COVID-positive for a long period of time. Gupta noted that the COVID virus that had infected them had acquired several mutations, according to an article in the journal Science.

There are other reasons someone may be immunocompromised, such as through an inherited genetic disorder, having leukemia, or being HIV-positive. This latter cause is significant, according to Tulio de Oliveira, a South African scientist who was one of the first to detect the Omicron variant last month.

COVID and HIV

According to the HIV and AIDS charity Avert, an estimated 37.7 million people were living with HIV worldwide in 2020, with around 6.1 million unaware they had the virus.

De Oliveira told The Los Angeles Times that large populations of people with unrecognized or poorly treated HIV could become "a factory of variants," the newspaper reported.

In an essay published in the journal Nature, De Oliveira and colleagues urged governments around the world to "devote more of their resources and attention to the interactions between COVID-19 and HIV" and curb both diseases simultaneously.

Multiple experts told Newsweek that this theory is concerning and at the same time warned against further stigmatizing these groups, especially since there isn't yet any hard evidence of how Omicron actually emerged.

"I think it's a compelling idea that HIV patients could have prolonged SARS-CoV-2 infection that could increase the circulating diversity of SARS-CoV-2—create variants of concern—however this hypothesis is nowhere near proven," said Spyros Lytras, a researcher at the University of Glasgow Centre for Virus Research. "In fact diverse VOCs have been first detected in places where HIV prevalence is much lower than South Africa, for example South America for Gamma and India for Delta.

"In my opinion, vaccine distribution inequality is a problem much more closely linked to VOCs appearing in these countries and probably the first thing the West should try to solve to improve the course of the pandemic, as the WHO has stressed multiple times."

Vaccinating Developing Countries

Professor Stuart Neil, head of the Department of Infectious Diseases at King's College London and senior research fellow at the Wellcome Trust, echoed the point.

He told Newsweek that De Oliveira's concern "is legitimate and one we need to take seriously," adding that throughout the pandemic there has been evidence of persistent COVID infection in people with compromised immune systems for many different reasons.

"A hallmark of these infections is that these individuals can remain SARS-CoV-2 positive for many months and there is very clear evidence of mutations accumulating in the viral genome during this time," he said.

"So ultimately, we need to act very rapidly to up our game in sharing and vaccinating developing countries, particularly those where large proportions of the population are infected with other pathogens that may compromise their abilities to clear SARS-CoV-2."

Africa, for instance, is home to more than 1.2 billion people. Yet the continent had only administered 2 percent of the total COVID vaccines administered globally in September this year, Tedros Adhanom Ghebreyesus, head of the World Health Organization (WHO), said at the time.

"That's not because African countries don't have the capacity or experience to roll out COVID-19 vaccines," he said. "It's because they've been left behind by the rest of the world."

Professor Graham Cooke, a professor of infectious diseases at Imperial College London, told Newsweek that it's important not to further stigmatize groups living with immunocompromised immune systems, but "continue to ensure access to the necessary healthcare all immunosuppressed individuals need to ensure they are protected from the severe consequences of infection."

Health worker holding a syringe
A Rocky Mountain Regional VA Medical Center technician holds a COVID vaccine in Aurora, Colorado, in December 2020. Scientists have called for global vaccine equality. Michael Ciaglo/Getty