March 23, 2023

Allow rapid spread of milder variants to contain pandemic, two Indian-origin experts suggest | India News – Times of India

WASHINGTON: Two health experts of Indian-origin are arguing that allowing a rapid spread of Omicron, which some experts see as inevitable, may be a better and safer bet to end the pandemic, even as other mainstream professionals are warning that such a strategy would be playing with fire.
“Policies designed to slow the spread of Omicron may end up creating a supervariant that is more infectious, more virulent and more resistant to vaccines…. To minimize that risk, policy makers must tolerate the rapid spread of milder variants. This will require difficult trade-offs, but it will save lives in the long run,” the Indian-origin experts, Vivek Ramaswamy and Apoorva Ramaswamy, argued in an WSJ OpEd that expectedly divided the scientific, medical and healthcare community.
“We should end mask mandates and social distancing in most settings not because they don’t slow the spread—the usual argument against such measures—but because they probably do,” the duo wrote in a counterargument to containment measures now prevalent worldwide. Vivek Ramaswamy is founder and executive chairman of Roivant Sciences and author of “Woke Inc.: Inside Corporate America’s Social Justice Scam” and Dr. Apoorva Ramaswamy is an assistant professor of otolaryngology at the Ohio State University Medical Center.
But their viewpoint was trashed by several medical and healthcare professionals, who conflated it to “intentionally trying to catch Omicron” and said it was a dangerous idea and was akin to playing with dynamite.
A CNN review of such an argument listed several reasons why it could be a questionable idea. 1. It’s not a bad cold, as is widely believed. While many people are asymptomatic or experience mild symptoms, nevertheless there is continued danger to those over 65, particularly those with low or weakened immunity or with underlying co-morbidities 2. There is always the danger of long covid, which is still not fully understood or studied 3. It would strain the healthcare system given the volume of infections from unhindered spread.
The OpEd attracted several angry responses, including from some who had lost family members to Covid.
“I find it interesting that the authors choose to keep the quiet part quiet – the elderly, immunocompromised, others with serious underlying conditions, and the unvaccinated are the ones who will most likely be sacrificed in our quest for herd immunity. They could at least have the decency to articulate that. Their approach may be the right approach. There are legitimate arguments all around. But for them to keep quiet about who and how many we may need to sacrifice is, at best, disingenuous and shameful,” one reader wrote.
The argument by Ramaswamy and Ramaswamy in the WSJ OpEd runs as follows: To understand why it is better to let Omicron run free, one needs to consider the scientific distinction between antigenic drift and antigenic shift. (Antigens are molecules—such as the spike protein of SARS-CoV-2—that an immune system detects as foreign. The host immune system then mounts a response.)
They write:
“Antigenic drift” describes the process by which single-point mutations (small genetic errors) randomly occur during the viral replication process. The result is minor alterations to antigens such as the spike protein. If a point mutation makes the virus less likely to survive, that variant gradually dies off. But if the mutation confers an incremental survival advantage—say, the ability to spread more quickly from one cell to another—then that strain becomes more likely to spread through the population.
Antigenic drift is a gradual, varying process: A single-point mutation alters one peptide, or building block, of a larger protein. Hosts with immunity against a prior strain generally enjoy at least partial immunity against “drifted” variants. This is called “cross-protection.”
Each time an immune host is exposed to a slightly different antigenic variant, the host can tweak its immune response without becoming severely ill. And the more similar the new strain is to the last version the person fought off, the less risky that strain will be to the host.
By contrast, “antigenic shift” refers to a discontinuous quantum leap from one antigen (or set of antigens) to a very different antigen (or set of antigens). New viral strains—such as those that jump from one species to another—tend to emerge from antigenic shift. The biological causes of antigenic shift are often different from those of antigenic drift. For example, the physical swap of whole sections of the genome leads to more significant changes to viral genes than those caused by individual point mutations.
But there’s a sorites paradox: How many unique point mutations collectively constitute an antigenic shift, especially when human hosts are deprived of opportunities to update their immune response to “drifted” variants?
Vaccinated and naturally immune people can revamp their immune response to new viral strains created by antigenic drift. Yet social distancing and masking increase the risk of vaccine-resistant strains from antigenic shift by minimizing opportunities for the vaccinated and naturally immune to tailor their immune responses through periodic exposures to incrementally “drifted” variants.
While their idea was broadly met with scathing responses, with some readers questioning their professional competence and credibility, a few embraced the argument amid growing exhaustion and frustration across the world over the unending mandates, protocols, and shutdowns.

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