Science

Omicron: South Africa is a variant “factory”?

Are some countries more likely than others to see the emergence of risky variants of Covid-19 within their populations? One might be tempted to believe this by looking at the recent history of South Africa. In the space of a few months, this country has seen the appearance of two worrying new versions of Sars-CoV-2: Beta and Omicron. However, according to the scientific community, more is needed for South Africa to be considered a “factory” variant, even if certain national characteristics are of concern.

To explain the appearance of Omicron and its multiple mutations, the same argument often comes up: the presence of HIV. Seven million people are living with this virus in South Africa. This represents 12% of the population or 19% of adults aged 15 to 45 years. Furthermore, the rate of trafficked persons appears relatively low, reaching 57% in 2017 (latest available data). “In fact, there are a large number of potentially immunosuppressed people in South Africa, says Olivier Schwartz, director of the Virus and Immunity Unit at the Pasteur Institute. However, we do know that variants can arise in these people.” In fact, in normal times, the virus multiplies and disappears from the body in a week or two. In the case of an immunosuppressed person, contamination can last for several months. This was the case, for example, of a 36-year-old South African woman with HIV who tested positive for SARS-CoV-2 for 216 days.

“In immunosuppressed people, the antibody response may be ineffective and therefore the virus will tend to evolve. If mutations appear, they can be transmitted to other people,” explains Olivier Schwartz. “However, stigmatizing the population affected by HIV would be a mistake,” said the scientist. Because there are several reasons that can explain the appearance of less effective immune systems. It can happen due to a pathology. For example, cancer treatments weaken the immune system. Naturally, people can also be more susceptible to infection and therefore retain the virus for longer. Therefore, it is not always about HIV.

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A study carried out by German researchers and published in the journal Nature Communications reports the case of a 58-year-old man with kidney disease who received treatment with immunosuppressive drugs. This patient had been positive for Covid for more than six months. Meanwhile, mutations had appeared in the virus. The same had happened in an American patient who previously suffered from cancer. His Covid had lasted 355 days. A record, with unprecedented key changes.

“Blaming South Africa is unfair”

“It only takes one immunosuppressed person for mutations to appear. This can happen in any country. Some like India have a lower proposal for HIV-positive people than South Africa, but they have produced drugs. Risk variants ”, says Olivier Schwartz. “The mutations observed for Omicron are undoubtedly the result of an evolution that took place within a single organism, before spreading to the population,” says Charity Dean, director of The Public Health Company, an American biotechnology company, in the Business Insider site. However, blaming South Africa is unfair, says the doctor. Because at the moment no one is sure that Omicron is really from this country. We should thank South Africa for showing transparency by conveying everything it knows. ”

This statistical equality against the variants is confirmed by the Gisaid database: mutations appear everywhere, even in France (remember the Breton version of Sars-CoV-2, detected last spring). Nor should we forget that if variants appear it is also due to a high level of virus circulation in the general population. “If a virus is actively circulating, statistically, a variant may appear. Immunosuppression plays a role, but we do not know what the relative weight of the two phenomena is,” confirms Olivier Schwartz.

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If South Africa is currently in the spotlight, it is also due to its relatively strong detection ability, several scientists say. “For a long time, the country has implemented a monitoring system for epidemics, such as HIV, Ebola or tuberculosis. This detection and alert capacity is today frustrating for the country that has to suffer the closing of the borders of some of their commercial partners. But if there is a lesson to be learned, it is that it is necessary to continue vaccination, “one of them specifies. In South Africa, only a quarter of the population is vaccinated. However, the doses are not lacking. According to one count recent, there are sixteen million in stock.

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Anne Rosencher is the managing editor of L'Express.Anne rosencher

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Robin Rivaton, essayist, member of the scientific council and evaluator of the Foundation for political innovation (Fondapol).Robin rivaton

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