Will Corona surprise us again?

When the Delta strain (Covid-19) took over the world, it looked as if it would overpower all other strains of corona. For a while, the Delta variant sowed fear with everyone thinking it will split up to another variant and then, not even a surprise, the Omicron appeared in a direction no one anticipated. Is it possible that the next mutation will surprise us again and by chance, become more virulent and even faster to spread?

The fact that the origin of the Omicron is unknown, may have evolved in a fragmentary manner like the Delta, but some experts believe that its variant could have been found by sequencing if that was the case. Thus, there are two other possibilities: the first is a chronic infection in a person suffering from immunodeficiency and the second is that it stayed in an animal, mutated and passed back to humans. Not to mention that the virus can multiply so quickly that patients excrete high levels of it. Previously, the Delta strain seemed to do this and it was more ferocious. On the other hand, the virus may turn out to reproduce mostly in the nose and throat, where it may be easier to spread, rather than deep in the lungs and perhaps the Omicron strain does this, which is less virulent.

However, the Coronavirus (Covid-19) usually has two ways of infecting cells, either by direct fusion with it or entering through a bubble! Interestingly, believe it or not, Omicron has become a specialist in the latter, which just so happens to work less in lung cells than in the nose and throat cells, as such this may explain the lower intrinsic severity of this strain, to circumvent the immune system.

Hence the question here is, do other groups of strains interact in unknown ways to alter the key viral functions? Absolutely we don’t know what they are yet. We will have to wait and watch the strains of Corona (Covid-19) in the coming years and decades. Especially, since if you look at influenza or other seasonal coronaviruses, they have evolved in humans for a long time and have not stopped evolving!

Undoubtedly, there are limits to how the virus is transmitted by its nature. Measles, for instance, is the most transmissible known virus compared to the Delta strain. While Omicron’s extent is not yet known, much of its advantage over Delta appears to come from evasion of existing antibodies rather than its transmissibility!

In a way, the coronavirus now has fewer and fewer people who are not immunized from infection, though immune evasion will become a more and more important constraint on its evolution. Mostly - if you can say here - that the virus will never run out of new strategies because the best is always to switch!

In the end, it is likely that the next variant is not an Omicron, or in some way something distinct from an Omicron. But exactly what would that look like? We shouldn’t try to predict it. Is possible is not it?

Dr Yousuf Ali Al Mulla is a physician, medical innovator and a writer.