Omicron and ADE/Immunity

[url]https://en.wikipedia.org/wiki/Antibody-dependent_enhancement[/url] or https://en.wikipedia.org/wiki/Antibody-dependent_enhancement ;

Antibody-dependent enhancement (ADE), sometimes less precisely called immune enhancement or disease enhancement, is a phenomenon in which binding of a virus to suboptimal antibodies enhances its entry into host cells, followed by its replication.^[1][2] The suboptimal antibodies can result from natural infection or from vaccination. ADE may cause enhanced respiratory disease and acute lung injury after respiratory virus infection (ERD) with symptoms of monocytic infiltration and an excess of eosinophils in respiratory tract.^[3] ADE along with type 2 T helper cell-dependent mechanisms may contribute to a development of the vaccine associated disease enhancement (VADE), which is not limited to respiratory disease.^[3] Some vaccine candidates that targeted coronaviruses, RSV virus and Dengue virus elicited VADE, and were terminated from further development or became approved for use only for patients who had those viruses before.

DJ In short virussses using antibodies (after vaccination/infection) te spread into the body. 

[url]https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant[/url] or https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant ; The number of cases in the B.1.1.529 lineage is increasing throughout South Africa, mainly in the South Africa province of Gauteng.^[9] Some evidence shows that this variant has an increased risk of reinfection.

DJ Only "increased risks" or are all cases reinfected ones ? 

With many countries reporting cases-some countries reporting further spread (Israel, Italy) AND often airtravel only for the vaccinated I try to see background of reported cases..were they vaccinated, did they had prior infection...Since a lot of cases may show only mild/no symptoms comminty spread in unvaccinated, persons with no prior KNOWN infection would need further testing for antibodies...

DJ I am NOT an expert...just trying to "follow the story", make up my mind...This is NOT a scientific forum...science takes time...Omicron is just a recent story...we do not know most of it yet ! 

Known cases; 

-[url]https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant#History[/url] or https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant#History ;

All four initial cases reported from Botswana occurred among fully vaccinated individuals.^[35] All three initial confirmed and suspected cases reported from Israel occurred among fully vaccinated individuals,^[32] as did the single suspected case in Germany.^[36]

On 27 November, two cases were detected in the United Kingdom, another two in Munich, Germany and one in Milan, Italy.^[26] The Dutch health ministry estimated that 61 of the around 600 passengers on two flights from South Africa that had landed at Amsterdam Airport Schiphol on 26 November (which had taken off just before the Netherlands had banned travel from South Africa) tested positive for COVID-19 of as yet unknown variants. Entry into the Netherlands (and thus getting on the flight) generally required having been vaccinated or PCR-tested, or having recovered. One of the flights originated from Johannesburg, Gauteng. Gauteng is where the Omicron variant appears to be dominant already. The passengers of both flights had been tested and quarantined upon arrival because of the newly imposed restrictions.^[37]

On 28 November, two cases were detected in Sydney, Australia. Both people landed in Sydney the previous day, and have travelled from southern Africa to Sydney via Doha, Qatar. The two people, who are fully vaccinated, entered isolation; 12 other travellers from southern Africa also entered quarantine for fourteen days, while about 260 other passengers and crew on the flight have been directed to isolate.^[27

DJ Community spread ; [url]https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/928700-omicron-new-coronavirus-variant-b-1-1529-a-variant-of-concern?view=stream[/url] or https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/928700-omicron-new-coronavirus-variant-b-1-1529-a-variant-of-concern?view=stream ; 

https://www.cnbc.com/2021/11/27/the-...d-variant.html

This is 7 days before Dr Coetzee notified the South African Medical Association. 

DJ Testing positive for what variant ? Omicron or (still) Delta ? From the link [url]https://www.cnbc.com/2021/11/27/the-world-is-on-alert-as-the-uk-reports-cases-of-omicron-covid-variant.html[/url] or https://www.cnbc.com/2021/11/27/the-world-is-on-alert-as-the-uk-reports-cases-of-omicron-covid-variant.html ; The variant was confirmed by Sacco hospital in Milan, and Italy’s National Health Institute said the man had received two doses of the vaccine. Italy’s health ministry is urging all regions to increase its tracing of the virus and sequencing to detect cases of the new variant first identified in South Africa.

So the fully vaccinated man tested positive for Omicron...Family members ? on variant/immunity...

[url]https://twitter.com/yaneerbaryam[/url] or https://twitter.com/yaneerbaryam ; 

Community transmission in Israel of Omicron: Three of the new cases in Israel are not travelers. Health Ministry says 7 people in Israel suspected of contracting Omicron variant https://timesofisrael.com/liveblog_entry/health-ministry-says-7-people-in-israel-suspected-of-omicron-variant/… via 

DJ So a look at the links there...

The Health Ministry says there are currently seven people in Israel suspected of having contracted the Omricron coronavirus variant, in addition the one confirmed case announced yesterday.

Of them, four are unvaccinated and three are vaccinated, the ministry says, with four having recently returned from travel abroad.

Does this mean the unvaccinated do not have antibodies ? Israel has seen (also) a high level of spread...unvaccinated most in orthodox groups-did see a lot of cases...

[url]https://twitter.com/drericding[/url] or https://twitter.com/drericding ; Just a note of caution - We know that getting a rapid understanding of disease severity with #Omicron (particularly in vaccinated individuals and re-infections) is absolutely critical, but it's just too early for reliable data.

DJ Looking at all available info however should be top of the list !!!

[url]https://sum.dk/nyheder/2021/november/to-mistaenkte-tilfaelde-af-omicron-b11529-er-paavist-i-danmark-hos-rejsende-fra-sydafrika[/url] or https://sum.dk/nyheder/2021/november/to-mistaenkte-tilfaelde-af-omicron-b11529-er-paavist-i-danmark-hos-rejsende-fra-sydafrika ; - The authorities have a reasonable suspicion that we have the first two cases of the new variant Omicron in Denmark. The variant has been captured in the variant PCR tests that SSI does on positive samples, and therefore we have quickly captured the variant. We are one of the countries with the most comprehensive monitoring of variants, and therefore it is not surprising that we find cases in Denmark at an early stage.   

DJ I can not find anything yet on vaccination/immunity for DK cases (but very likely they needed vaccination for travel...

[url]https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/928700-omicron-new-coronavirus-variant-b-1-1529-a-variant-of-concern?pp=928777#post928947[/url] or https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/928700-omicron-new-coronavirus-variant-b-1-1529-a-variant-of-concern?pp=928777#post928947 ; 

DJ So also the Hong Kong Omicron cases (now three ?) seem to have been vaccinated...

Austria then ? [url]https://www.tirol.gv.at/meldungen/meldung/ein-verdachtsfall-auf-virus-mutation-b11529-nach-auffaelligkeit-bei-pcr-test-ergebnis/[/url] or https://www.tirol.gv.at/meldungen/meldung/ein-verdachtsfall-auf-virus-mutation-b11529-nach-auffaelligkeit-bei-pcr-test-ergebnis/ ; According to their own information and according to the current state of knowledge, the person concerned has been almost exclusively at home three days ago and currently has no symptoms - the second Covid vaccination with an mRNA vaccine, however, was around nine months ago. Contact persons of the person concerned have been segregated ”

[url]https://ct24.ceskatelevize.cz/domaci/3406500-liberecka-nemocnice-potvrdila-prvni-pripad-varianty-omikron-v-cesku[/url] or https://ct24.ceskatelevize.cz/domaci/3406500-liberecka-nemocnice-potvrdila-prvni-pripad-varianty-omikron-v-cesku ; The Liberec hospital confirmed the occurrence of a new coronavirus variant of omicron in the Czech Republic. He is still waiting for confirmation of positivity in the National Reference Laboratory. The suspect sample was captured by PCR. She is a woman from the Liberec region who returned to the Czech Republic from Namibia via South Africa and Dubai, is vaccinated and has a mild course of the disease. 

DJ Again-I am NOT an expert, this is NOT a scientific forum...almost all cases of Omicron infections outside the Southern Africa region in the vaccinated should not be surprising since only vaccinated could travel...

It may indicate vaccines simply offer "limited" protection...however if almost all cases in Southern Africa would be in people with prior infection more questions come up ! 

Most of the world population may by now have antibodies. Do those antibodies "only" fail to stop infection ? Or do they "help" infection may be the hard question now studied by many !

Another link [url]https://twitter.com/trvrb[/url] or https://twitter.com/trvrb ;

Under a scenario of 90% population immunity against previous variants, we get the following picture where Omicron could lie anywhere along the dashed line ranging from an intrinsic R0 of 3 and 83% immune escape to an intrinsic R0 of 9 and 20% immune escape. 14/18

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DJ; The picture I am getting on Omicron is the R0 (Reproduction number) is (in this link at least) 3x that of Delta, mainly because of immunity evasion...

Work from 

@seabbs

 and colleagues gives a similar result of Rt increasing from ~0.8 to above 2 over the course of November in Gauteng (https://epiforecasts.io/covid/posts/subnational/south-africa/gauteng/…). 7/18

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DJ Numbers/estimates based on early info from SA/Gauteng...

The information that we need is the difference between it infecting vaccinated and unvaccinated people. If ADE is present then the outcome in vaccinated people will be key.

Pixie wrote: https://www.science.org/content/blog-post/antibody-dependent-enhancement-and-coronavirus-vaccines Long article but…. The Bottom Line I just don't see it. Some of that is well-intentioned caution, and some of it is probably flat-out anti-vaccine scaremongering.

It seems Dr. Lowe has a very kind side to him.  

Technophobe wrote: I too had my cautions, but they were mostly dispelled very quickly.  What is left:  "very long term" effects, would seem to be a diminishingly, no - vanishingly small risk,  hugely, colossally outweighed by the benefits - both to myself and society as a whole.

Techno, how can you honestly say that? The vaccine has been administered for about 14 months. The fact that it's gone to millions of people does not in any suggest that there will be no long term effects from having it. Prior to this vaccine, it took 5-7 years to get that data. I understand that the world panicked over Covid and let these safety precautions go in a gamble that all would be well, and perhaps all will be well, but right now, it is a plain fact that no one knows if they will prove to be safe in the long term. There is a reason why safety protocols exist. 

I sincerely hope that they do prove to be fine, but right now, to say that they are safe is a guess and a hope at best. And that's not my opinion, that is widely acknowledged scientific fact.

Kiwimum

Why are you still crapping on about this vaccine ,go away ,come back in 5 years tell us you where right or wrong.....

Every is sick of it .......

I know from the PM's I get......

carbon20 wrote: Kiwimum Why are you still crapping on about this vaccine ,go away ,come back in 5 years tell us you where right or wrong..... Every is sick of it ....... I know from the PM's I get......

Yep!

And don't forget the 1/100 rule: for every one who steps up to comp!ain, 100 more are thinking the same thing.

carbon20 wrote: AI .... Thought you said this would be all over when the democrats took over...... So all your comments are null and void...... Still an orange faced clown worshipper...... Can't you ever ever find anything constructive to say ? Or are you so bitter and twisted your hero LOST......

Do you really want to go political? Too bad your in AU your hero Bidum could use your support here in the US about right now. Seems his poll numbers just keep going DOWN LOL  In fact his poll numbers are lower than Trumps were at the same time in his presidency imagine that. Mid term elections are gonna be great LOL.  And just remember the words of your hero Bidum 

"You’re not going to get COVID if you have these vaccinations," and "If you’re vaccinated, you’re not going to be hospitalized, you’re not going to be in the ICU unit, and you’re not going to die." 

Well that pretty much has been shown to be false as those numbers just keep going up. Seen the latest UK vaxxed death numbers? YIKES way more vaxxed deaths than non vaxxed of those that get covid.   And now there's new and improved Omnicrom seems to really like the vaxxed. Too early to tell how that's gonna play out.

Oh and I do seem to remember you crowing and blathering on about how well AU was doing with Covid. How's that working out for ya now?? Your little country sure seem's to have went full NAZI pretty quick over it. LOL

I did say that KiwiMum, but I also stated how tiny the risks were and how big the alternative risks were in comparison.

Yes, AI, KiwiMum you have the right to your opinions and to express them, but carping on about things which have been scientifically demonstrated to be in error is getting a bit tiring.

The tidbit was a tiny part of said report.  The conclusions you draw from it are also open to alternative enterpretation.  As I said, the report drew very different conclusions to you.

And the vaccine does stop infection, it reduces transmission; no one said the stop had to be confined to the vaccinated.  

It prevents disease from the virus, reduces transmissionof the virus and reduces the opportunities for the virus to mutate.  Yes, it is far from perfect - roll on the "whole virus" vaccination - but it is by far the best option we have at present.

We did speak about ADE a lot while the vaccines were being developed.  Especially as vaccines to the original SarsCoV1 and MersCoV never got passed animal trials due to it.  Also in natural infection SarCoV2 disease tends to worsen in week2 around about time of seroconversion (natural Anitibody production).  Leading some scientists to believe antibodies can be helpful to the virus.  

ADE ( Antibodies that enhance viral entry to cell) and iADE  ( antibodies that switch protective intracellular  antiviral responses off  by decreasing interferon gamma and increasing an immunosuppressive cytokine IL-10).  Have always been a worry for both natural viral infections, monoclonal therapies and for all vaccines.  

We cant say for sure if it is occuring at present or not. The data isnt there and S Africa data is generated from a population where HIV infects 20% of the younger population.

The original data points to a type of IgG2a antibody generation by vaccines that isnt known for ADE., but at the moment everything is new. We have to be open minded.  

Importantly I feel we cant draw conclusions from S Africa alone.   19% of population under 40 are HIV positive. These people got vaccinated at their clinics so may be skewing the data as those with weaken immune systems were vaccinated.

All we can do is wait. It is a realistic worry.  We have quite a few cases of omicrom in Scotland so will see how that goes.

Hz x

[url]https://www.lrb.co.uk/the-paper/v43/n24/rupert-beale/on-omicron[/url] or https://www.lrb.co.uk/the-paper/v43/n24/rupert-beale/on-omicron ;

Viral origins aren’t always easy to determine. It’s interesting that Omicron has arisen not from Delta but from a different branch of the Sars-CoV-2 evolutionary tree. Delta has had plenty of opportunity to become its most transmissible version. There are suggestions that Omicron might have been transmitted to an animal reservoir (reverse zoonosis), and then jumped back to humans. It’s not impossible, but I doubt it. It seems more likely that Omicron arose as the virus lingered in an immunosuppressed individual, gradually acquiring all the mutations it needed to escape ineffective immunity – plenty of such cases have been described. Untreated HIV is the most prevalent cause of immunosuppression in Southern Africa: yet another reason, if any were needed, to take global health inequality more seriously.

Still, it seems that only a modest quantity of neutralising antibodies is needed to prevent Covid-19. Three doses of vaccine, in people with normal immune systems, provide enormous amounts of antibodies to previous variants: they will be less effective against Omicron, but the hope is that they might still be enough. Other aspects of vaccine-induced immunity that help protect against severe disease (mediated by our T and B cells) will still work. The next generation of vaccines may include Spikes from multiple variants and should possess an even broader neutralising capability. The antiviral drugs will be useful. We aren’t going back to square one, but some hospitals are already struggling. Many intensive care beds are still occupied by unvaccinated adults infected with Delta. Also at high risk are immunocompromised people whom we must do all we can to protect. Get your third jab.

DJ Vaccines may be far from perfect-but among the best-limited-tools we have...in combination with NPI (LOCKDOWN NOW !!!! Omicron is no joke !)

[url]https://twitter.com/Dr_D_Robertson/status/1466807346487869445/photo/1[/url] or https://twitter.com/Dr_D_Robertson/status/1466807346487869445/photo/1 

I'm not sure if I'm reading that right Josh, but is it saying that on the first wave of Omicron, it will present itself as a mild disease in vaccinated people but once it is the dominant strain and is everywhere, that the people who are vaccinated and have had the mild disease will then be primed to catch it again in a more severe form? 

Please correct me if I've misread that.

Josh I suspect with 7 billion of us on the planet, we would have been damned if we did and damned if we didn't. Amongst us all there would have been many Typhoid Marys regardless of what we did or didn't do. We can only act with the information we have to hand at the time and hindsight is always in 20.20 vision. 

A friend of mine, whilst doing his medical degree, found an extra bone in the foot of his cadaver, and all the other students came to view it. He thought he had found something unique but the lecturer told him that the human body was so incredible and complicated that many people were walking around with an anomaly or two and were never even aware of it. There are bound to people around right now who are incubating something deadly, much as there must be people around with an inbuilt, and as yet, unexplained immunity to all sorts of nasties.

Hazelpad/KiwiMum-thanks for reacting....ADE (in any form) would be such a major factor it would show itself up in statistics...

My big worry (at least one of many in this phase) is ADE has to be the "end of the road" for the virus...it will end up there ?  The higher the level of immunity (via natural infections or vaccinations) the more the virus will "react" in it in its evolution...

In my opinion NOT going for vaccines was not an option...(but maybe more limited would make a difference ???) ...NPI should have stayed #1 as strategy....

Basic point-well known by almost all of us by now-coronavirus is very "elastic"...will find away around any blockade we try to use...as seen in coronavirusses in animals....

Time will tell, to limited data for now...