The latest SARS-CoV-2 "variant of concern" contains a number of mutations that have experts worried.

[aepo]

Enter Omicron
On Friday afternoon, the World Health Organization officially reclassified the newly emerged SARS-CoV-2 variant B.1.1.529 as a “variant of concern.” In line with the Greek alphabet naming system adopted by the WHO last May, the decision christens the variant with the name of that alphabet’s 15th letter: Omicron.

The decision to name the variant—made during a special session of the agency’s Technical Advisory Group on SARS-CoV-2 Virus Evolution—comes amid surges in COVID infection rates across the world, including the highly vaccinated populations of northern Europe and the Midwestern United States.

The variant was first detected in South Africa on November 9. On November 24, South African officials notified the WHO that the variant was increasingly present in samples collected during what had become the country’s third “peak” in COVID infections since the start of the pandemic. The variant has since been found in every province in South Africa, which accounts for nearly all of the 87 known cases as of Friday afternoon. The variant has also been detected in Botswana, Israel, and Belgium.

In its statement announcing the reclassification, the WHO said the task force on variants was troubled by Omicron’s “large number of mutations,” as well as by preliminary evidence suggesting “an increased risk of reinfection...compared to other variants of concern.”

Jeffrey Barrett, who leads the Sanger Institute’s COVID-19 Genomics Initiative, tweeted an analysis of the variant’s many spike protein mutations that did not encourage optimism. Two mutations of particular concern, he noted, had previously only been seen “in the wild separately or rarely. Seeing this full combination now (along with everything else) is grim.”

Early reports of the variant have caused global markets to tumble, and officials around the world are instituting restrictions as precautionary measures. In the U.S., the White House announced on Friday that, starting Monday, the country will no longer accept travelers from eight African countries.

Omicron’s appearance will likely revive and intensify the debate over global vaccine equity. Advocates have long argued that the lack of vaccine access in poor countries is unjust and self-defeating, because the longer poor nations go without vaccinating their populations, the longer they will serve as incubators for mutations and variants. In a statement put out by the White House on Friday, Joe Biden drew attention to this connection, and called on nations "to waive intellectual property protections for COVID vaccines, so these vaccines can be manufactured globally. This news today reiterates the importance of moving on this quickly.”

Hours before Biden released his statement, more than 50 leaders from Europe and Asia called for vaccine equity at the closing ceremony of the Asia-Europe Summit in Phnom Penh, Cambodia.

The leaders called for “all countries to have equitable and timely access” to Covid-19 testing, medication and vaccines, and urged the “strengthening of national and multilateral approaches and international cooperation." In a separate statement, European Commission President Ursula von der Leyen said “global solidarity is vital to end the pandemic."

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The relationship between variants like Omicron and vaccine equity is now set to dominate the first-ever special session of the World Health Assembly, which begins proceedings on Nov. 30 in Geneva. The purpose of the three-day meeting is to discuss the parameters of a binding Pandemic Treaty that—based on the lessons of the past two years—could bind governments to new international laws and mechanisms to strengthen global pandemic prevention and response.

Within global public health circles, some have spoken of the special session as a “Bretton Woods moment,” a reference to the 1944 conference that established the postwar frameworks for global finance, trade and development. But where the Bretton Woods agenda was dominated and determined by the United States, next week’s WHO session will take place in a UN system where most of the nearly 200 participating countries will have a chance to express their own views on “the principle of equity” that WHO officials have described as the “sum and substance” of the first-in-kind meetings.