March 23, 2023

To end pandemic, let milder strains spread, say PIO experts, draw flak – 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…. Policy makers must tolerate the rapid spread of milder variants. This will require difficult trade-offs, but it will save lives in long run,” Vivek Ramaswamy and Apoorva Ramaswamy, argued in an WSJ OpEd. “We should end mask mandates and social distancing in most settings not because they don’t slow the spread…but because they probably do,” the duo wrote.
Vivek is founder of healthcare firm Roivant Sciences and Apoorva is an assistant professor of otolaryngology at the Ohio State University Medical Center. But their viewpoint was trashed by several medical professionals, who said “intentionally trying to catch Omicron” 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. 2) There is always the danger of long Covid. 3) It would strain the healthcare system. The OpEd also attracted angry responses from those who had lost family members to Covid.
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.
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 strains —such as those that jump from one species to another—tend to emerge from antigenic shift.
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 minimising opportunities for the vaccinated and naturally immune to tailor their immune responses.
While their idea was broadly met with scathing responses, with some readers questioning their professional competence and credibility, a few embraced the argument amid frustration over unending protocols.

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