COVID-19 Mutations Like Omicron Are 'All About Replication,' Cincinnati Health Leader Says

Fewer bodies with COVID = fewer opportunities for the virus to mutate.

Dec 1, 2021 at 7:06 pm
click to enlarge Vaccines are key to stopping the coronavirus from replicating, experts say. - Spencer Davis, Unsplash
Spencer Davis, Unsplash
Vaccines are key to stopping the coronavirus from replicating, experts say.

As we make our way further into winter holiday season, Cincinnati health officials are laying down some science to help people understand how COVID-19 spreads and why it's still a major threat within the region.

During a briefing with reporters on Wednesday, Hamilton County commissioner Denise Driehaus and Hamilton County Health Commissioner Greg Kesterman discussed the ongoing coronavirus pandemic and how the latest virus variant — Omicron — could affect the area. Joining the briefing, Dr. Stephen Feagins, chief clinical officer and an internal medicine specialist at Mercy Health, said that Omicron likely won't be the last variant we see, especially if residents aren't vaccinated or don't follow public health protocols such as masking and physical distancing.

"We actually do wonder if we'll have enough Greek letters (to name upcoming variants)," Feagins said on Dec. 1.

COVID-19 continues to circulate heavily within Hamilton County and the surrounding areas, officials said. Kesterman said that there are 6,100 active, known COVID cases in the county, with asymptomatic and untested residents not included in the count. There are about 211 cases recorded per day, which continues an ongoing increase once the lack of testing and data around Thanksgiving is factored in.

Kesterman added that there are 467 people with COVID who have been admitted to regional hospitals. About 128 are in intensive care units and 89 are on ventilators. These numbers also have been increasing steadily in recent weeks as more people gather indoors.

Driehaus echoed Kesterman, saying that she's been tracking weekly COVID-related numbers to find trends and patterns. According to Driehaus's figures over the past several weeks as "indoor season" begins in earnest, the county is averaging 1,568 positive COVID-19 cases, 96 hospitalizations and 17 deaths per week.

"The numbers from my vantage point are very high," Driehaus said. "There are definite indicators here that our numbers are going in the wrong direction at a pretty good clip."

One reason that COVID-19 continues to circulate and mutate is because vaccinations have slowed in many areas. The Centers for Disease Control and Prevention (CDC) still classifies Hamilton County — and all of Ohio — as being an area for high COVID transmission, yet only 55.53% of county residents have completed a vaccination series since vaccinations began in January, according to Dec. 1 figures on Ohio's coronavirus dashboard (the CDC considers a person to be fully vaccinated two weeks past the final dose of a two-shot vaccine series from Pfizer or Moderna or two weeks past the single shot from Johnson & Johnson).

Omicron, the latest coronavirus variant, has shown high transmissibility that may make it somewhat resistant to current vaccines, scientists fear. The variant was first discovered in South Africa and has spread to several countries within just a couple of weeks. The United States announced its first Omicron case on Wednesday. The CDC had just named Omicron a "variant of concern" on Nov. 26.

Until recently, Delta has been the most transmissible, concerning variant.

Feagins explained that variants — including dangerous ones — happen because there are plenty of humans that still host and transmit the coronavirus, giving the virus a chance to change into something else.

"Viruses replicate. That's what they do. It's a numbers game. That's why Delta is more transmissible than other variants, because there's just a lot more of it. It replicates faster and more efficiently. It's all about replication," Feagins said. "Whenever there's a mistake, if you will, in replication, that mistake allows the virus to transmit better, and then that particular mistake will be propagated. A virus has to be in some person or a living animal to do that. An antiviral stops replication one way or another."

"By stopping replication, that's how we fight a virus. It's all about replication inside human beings."

Feagins added that those who are immunosuppressed — people with weakened immune systems — may have a higher viral load and foster more replication or mutations.

"It's a simple numbers thing. It is an exponential number," Feagins said.

The doctor explained that vaccines are critical to protecting individuals as well as entire communities, as the current vaccines overwhelmingly prevent severe health issues and death from COVID-19, plus they eliminate opportunities for the virus to replicate.

"Even if you, as a vaccinated individual, have a positive COVID test, the viral load — the number of replications that occur in a vaccinated individual — is so low that mutations are very unlikely," Feagins said. "That's why vaccination is so important. We talk about herd immunity; that's how that occurs. There's either natural or vaccinated immunity in a certain percentage of the population for which the virus simply doesn't replicate as much and, thus, result in mutations."

Hamilton County continues to aim for an 80% rate of vaccination for its population. Reaching that threshold, Feagins said, would mean less of the virus would be in circulation, activities would be safer and life would get much closer to "normal."

"It's well above 80% of some type of resistance to the replication of the virus in a community for us to start to have some kind of semblance of going to epidemic or endemic status like flu," Feagins said.

COVID-19 vaccines are available to anyone ages 5 and older. The CDC also recommends booster doses for anyone 18 years and older who is six months past their initial Pfizer or Moderna vaccine or two months past their Johnson & Johnson vaccine.

Find information about COVID-19 vaccines, vaccination locations, testing sites and free at-home testing kits.

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