Variants and Infection Control

UPDATE: Omicron Variant detected in more
than 50 Countries and 19 States

Many unknown aspects of new variants take time to determine.  Such factors as the efficacy of vaccines, transmissivity, severity of illness and ability of current COVID-19 test technologies to detect the new variants are yet to be ascertained, but should become known in the coming weeks.

 

New Variants will continue to emerge as the SARS-Corona Virus-2 continues to replicate around the globe in mass scale. How these mutations effect the mitigation methods we use in Media Production and Live Events will need to be determined, however established principals of infection control still apply. When aspects such as transmissivity, vaccine efficacy, testing accuracy are less certain due to new variants, we must scale up our mitigation efforts in other areas — such as mask wearing, disinfection, hand hygiene, ventilation/air filtration, social distancing etc.

Now is a good time to review the Chain of Infection principles and review which tools may become less effective with emergent variants and which tools we will need to rely upon more.

For example; should vaccination efficacy diminish with new variants, we can no longer allow those vaccinated to remain in our work environment after a close contact even if they are without symptoms. There are many other considerations, such as the ability for existing test to detect positives of the new variant, until this is determined we need to rely more on temperature screening along with health & screening to offset any diminished accuracy or sensitivity of our existing tests to the new variant. 

While it is impossible to eliminate all risk of infection in a production setting, We have better technology and more tools to lower risk to acceptable level than we did at the beginning of the pandemic. It is not time to panic, but time to review our strategies and ensure we minimize risk where ever possible. 

 

 

The Chain of Infection is the basis for all infection control and infection mitigation measures. Each link provides an opportunity to disrupt the cycle of infection, lowering the odds of tranmission at our productions.

 

Until now new variants, including the delta variant, have remained detectable with most current covid antigen and molecular testing technologies. Molecular, antigen, and serology tests are affected by viral mutations differently due to the inherent differences in the mechanisms of each test.  Each test type needs to be re-evaluated with every significant variant. It is important to note over time SARS-CoV-2 virus mutations can result in enough genetic variation in the population of circulating viral strains over the course of the pandemic and may require us re-engineer assays / reagents based on viral RNA of new variants to ensure accuracy in detecting infection.

A mutation  of the SARS-CoV-2 virus is a change in the genetic sequence of the SARS-CoV-2 virus  when compared with a reference sequence such as Wuhan-Hu1 (the first genetic sequence identified) or USA-WA1/2020 (the first identified in the United States). A new variant  of SARS-CoV-2 may have one or more mutations that differentiate it from the reference sequence or predominant virus variants already circulating in the population. Variants of SARS-CoV-2 can have different characteristics. For example, some may spread more easily or show signs of resistance to existing treatments or vaccinations. Some may be less detectable, While some may have no impact when compared with previous and currently circulating virus.

Omicron Variant

Initially detected in South Africa, Omicron Variant has now been detected in Europe, Asia, Oceania and North America. This new variant is have 50 characteristic mutations from the original SARS Cov-2 virus. Based on the ability of Omicron Variant to out compete Delta Variant, it is inherently more transmissive, other aspects of the variant are yet to be determined. 

Some of those mutations were already recognized from other variants and were known to make them more dangerous, including one called E484K that can make the virus less recognizable to some antibodies — immune system proteins that are a frontline defense against infection and that form the basis of monoclonal antibody treatments. This may make this variant more evasive of vaccine promoted immune response. It may also make it less detectable from established diagnostic testing. also carries a mutation called N501Y, which gave both the Alpha and Gamma variants their increased transmissibility. This particular mutation made the virus better at replicating in the upper airway — think in the nose and throat — and likely makes it more likely to spread when people breathe, sneeze and cough. Like Delta, Omicron also carries a mutation called D614G, which appears to help the virus better attach to the cells it infects.

Most worrisome to scientists is the number of mutations affecting the spike protein. Most of the leading vaccines target this spike protein. Vaccines made by Pfizer/BioNTech, Moderna, Johnson & Johnson, AstraZeneca and other companies all use just small pieces or genetic sequences of the virus and not whole virus, and all of them use bits of the spike protein to elicit an Immune response. Any mutation in the spike protein can make the virus less recognizable to our immune system.

As of now there is no evidence this has occurred. The next weeks will determine if more breakthrough infections are caused by Omicron than by other variants. In the mean time we do need to scale up all mitigation measures we utilize in media production and live events, if we are to continue to work.

Please feel free to contact our infection control experts to discuss how to best protect your production or events. info@showhss.com

Scott Zelenetz is an Advanced Life Saving-Critical Care EMS provider and has been involved public safety and emergency management since 1988 in the states of NY, NJ and FL. He is the Director of Safey & Medical for NICA and has written mitigations plans and protocols for many public and private entities including municipalities, public safety agencies, schools, film and television productions, live events, theatrical productions, sporting events and businesses. He has served as an infection control officer at the Javits US Naval Field Hospital and NJ DOH Paramus testing site.