It’s controversial whether or not viruses are alive, however – like all residing issues – they do evolve. This truth has develop into abundantly clear throughout the pandemic, as new variants of concern have emerged each few months.
A few of these variants have been higher at spreading from individual to individual, ultimately turning into dominant as they out-compete slower variations of SARS-CoV-2, the virus that causes COVID-19. This improved spreading means has been ascribed to mutations within the spike protein – the mushroom-shaped projections on the floor of the virus – that permit it to bind extra strongly to ACE2 receptors. ACE2 are receptors on the floor of our cells, equivalent to people who line our airways, that the virus attaches to with the intention to acquire entry and begin replicating.
These mutations allowed the alpha variant, after which the delta variant, to develop into globally dominant. And scientists count on the identical factor to occur with omicron.
The virus can’t, nevertheless, enhance indefinitely. The legal guidelines of biochemistry imply that the virus will ultimately evolve a spike protein that binds to ACE2 as strongly as potential. By that time, the flexibility of SARS-CoV-2 to unfold between individuals is not going to be restricted by how effectively the virus can keep on with the surface of cells. Different components will restrict virus unfold, equivalent to how briskly the genome can replicate, how rapidly the virus can enter the cell by way of the protein TMPRSS2, and the way a lot virus an contaminated human can shed. In precept, all of those ought to ultimately evolve to peak efficiency.
Has omicron reached this peak? There isn’t any good cause to imagine that it has. So-called “gain-of-function” research, which take a look at what mutations SARS-CoV-2 must unfold extra effectively, have recognized loads of mutations that enhance the spike protein’s means to bind to human cells that omicron doesn’t have. In addition to this, enhancements could possibly be made to different features of the virus life cycle, equivalent to genome replication, as I discussed above.
However let’s assume for a second that omicron is the variant with maximised spreading means. Maybe omicron received’t get any higher as a result of it’s restricted by genetic chance. In the identical method that zebras haven’t advanced eyes in the back of their heads to keep away from predators, it’s believable that SARS-CoV-2 can’t choose up the mutations required to succeed in a theoretical most as these mutations have to happen suddenly, and that’s simply too unlikely to emerge. Even in a situation the place omicron is the most effective variant at spreading between people, new variants will emerge to deal with the human immune system.
After an infection with any virus, the immune system adapts by making antibodies that keep on with the virus to neutralise it, and killer T-cells that destroy contaminated cells. Antibodies are items of protein that keep on with the particular molecular form of the virus, and killer T-cells recognise contaminated cells by way of molecular form as effectively. SARS-CoV-2 can due to this fact evade the immune system by mutating sufficiently that its molecular form modifications past the immune system’s recognition.
This is the reason omicron is so apparently profitable at infecting individuals with earlier immunity, both from vaccines or infections with different variants – the mutations that permit the spike to bind to ACE2 extra strongly additionally scale back the flexibility of antibodies to bind to the virus and neutralise it. Pfizer’s information means that T-cells ought to reply equally to omicron as to earlier variants, which aligns with the remark that omicron has a decrease fatality price in South Africa, the place most individuals have immunity.
Importantly for humanity, previous publicity nonetheless appears to guard in opposition to extreme illness and dying, leaving us with a “compromise” the place the virus can replicate and reinfect, however we don’t get as severely sick as the primary time.
Herein lies essentially the most possible future for this virus. Even when it behaves like knowledgeable gamer and ultimately maxes out all its stats, there isn’t a cause to assume that it received’t be managed and cleared by the immune system. The mutations that enhance its spreading means don’t tremendously improve deaths. This maxed-out virus would then merely mutate randomly, altering sufficient over time to develop into unrecognisable to the immune system’s tailored defences, permitting waves of reinfection.
We would have COVID season every winter in the identical method we’ve flu season now. Influenza viruses also can have an analogous sample of mutation over time, often called “antigenic drift”, resulting in reinfections. Every year’s new flu viruses aren’t essentially higher than final yr’s, simply sufficiently totally different. Maybe the most effective proof for this eventuality for SARS-CoV-2 is that 229E, a coronavirus that causes the widespread chilly, does this already.
Omicron will due to this fact not be the ultimate variant, however it could be the ultimate variant of concern. If we’re fortunate, and the course of this pandemic is tough to foretell, SARS-CoV-2 will in all probability develop into an endemic virus that slowly mutates over time.
The illness may very probably be gentle as some previous publicity creates immunity that reduces the probability of hospitalisation and dying. Most individuals will get contaminated the primary time as a toddler, which may happen earlier than or after a vaccine, and subsequent reinfections will barely be observed. Solely a small group of scientists will monitor SARS-CoV-2’s genetic modifications over time, and the variants of concern will develop into a factor of the previous – no less than till the subsequent virus jumps the species barrier.
Ben Krishna doesn’t work for, seek the advice of, personal shares in or obtain funding from any firm or organisation that may profit from this text, and has disclosed no related affiliations past their educational appointment.