Blocking the Third Wave
This is the most recent variant to emerge from the series of coronavirus mutations that are aggressively destroying Europe today.
Passengers wearing personal protective equipment (PPE) queue to check-in for their flight at the Kuala Lumpur International Airport (KLIA) in Sepang on November 29, 2021, as countries across the globe shut borders and renewed travel curbs in response to the spread of a new, heavily mutated Covid-19 coronavirus variation dubbed Omicron.
The microscopic coronavirus is continuing to turn the world upside down.
At the beginning of World War II, Germany surprisingly launched a blitzkrieg, or lightning attack, in 1939 and succeeded in crushing Europe, and then crossed into Africa in 1941. Because of his success in claiming power all the way to Africa, Erwin Rommel, the general of the 7th Panzer division, was nicknamed the “Wolf of the Desert”.
Eighty years later in November 2021, it was the “African troops” that launched a blitzkrieg against Germany. The difference is, these troops are invisible armed forces formed of the Covid-19 virus from the Omicron "division". This is the most recent variant to emerge from the series of coronavirus mutations that are aggressively destroying Europe today.
Germany, a developed country and the most powerful economy in Europe, was attacked by a third wave of the coronavirus blitzkrieg. Even though 75 percent of the German population has been vaccinated, it still saw a surge, reaching 76,000 cases per day (24/11/2021).
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The day before, Germany broke its record to surpass 100,000 Covid-19 deaths. In fact, at the peaks of the first two waves, Germany recorded daily figures of only around 30,000 cases and slid to below 1,000 cases per day in June-July. Now chaos has returned. The German Air Force, which participated in the bombing of Africa 80 years ago, is today being used to evacuate Covid-19 patients from overwhelmed hospitals. Only people who have been fully vaccinated are allowed to leave their homes or attend public events.
The third wave has also spread to Greece, France, England, Italy, the Netherlands, Turkey, Russia and surrounding region
The third wave of infections has also targeted small countries such as Slovakia, where the vaccination rate reaches 45 percent but has experienced a spike of up to 8,324 cases per day. Likewise in Austria, where the number of cases has skyrocketed since mid-November to a record 15,809 cases per day. The country has imposed a lockdown, and unvaccinated residents are prohibited from leaving their homes. The third wave has also spread to Greece, France, England, Italy, the Netherlands, Turkey, Russia and surrounding regions.
From Europe, we now look at the domestic situation. If you look at the curve of confirmed cases from early 2020 to 2021, it can be seen that the curve does not show linear progression, but uncertainty. In January 2021, we never imagined (or actually underestimated) there would be a spike in Covid-19 cases, even though surges had occurred in other countries.
We also did not imagine that this virus could destroy life in all sectors, including paralyzing the national health system. July 2021 saw a second wave of Covid-19 that was four to five times greater than the first wave in January 2021. The peak of this second wave reached 57,000 daily cases as a result of the Delta variant, the name derived from the fourth letter in the Greek alphabet.
A passenger wearing a face mask queues to check-in for her flight at the Kuala Lumpur International Airport (KLIA) in Sepang on November 29, 2021, as countries across the globe shut borders and renewed travel curbs in response to the spread of a new, heavily mutated Covid-19 coronavirus variation dubbed Omicron.
This is proof that this virus develops in an uncertain manner. Why? It is because of the natural factor that every creature has the ability to adapt dynamically, according to developments across space and time. This is also the case with this coronavirus, which has the “intelligence” to adapt by mutating many times.
Omicron, a Delta upgrade
Generally, a virus will continue to mutate until eventually, it becomes weaker so it can be controlled. Examples are the influenza and polio viruses. However, this has not happened with the coronavirus. The decline in daily cases over the past five months seemed to show that the virus was still there but that it was "asleep" (dormant), and one day it would awaken again. And indeed this was finally proven early in November, when we were surprised by the emergence of a new mutated variant in South Africa, coded B.1.1.529 and named Omicron (small O), the 15th letter in the Greek alphabet.
This variant is thought to have emerged from African tourists traveling to Hong Kong, or possibly tourists traveling to Africa and then to Hong Kong. The genome of the virus’s latest mutation was then studied and was found to be potentially more virulent than the Delta variant, at least in terms of the speed of transmission. In fact, the Delta variant was known as the most dangerous variant to devastate the world, including the second Covid-19 "tsunami" that hit Indonesia.
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It was proven that the Omicron variant had spread in a short time from Africa to Europe, to Asia, and then to Australia and the United States. Countries with high vaccination rates were still affected. In Singapore, the vaccination rate has reached 90 percent. The US, which has a vaccination rate of 60 percent using mRNA vaccines, was also affected. This indicates that the Omicron variant can penetrate the defenses formed through vaccination.
The European continent is currently facing a third wave triggered by the Omicron variant (B.1.1.529). The Washington Post (27/11/2021) reported that this new variant could have 50 mutations in total, of which 32 mutations are in the spike protein that serves as the entry point for infecting human cells.
In comparison, the Delta variant that recently battered India and Indonesia through a second wave has 13-17 mutations in the spike protein. This means that the new Omicron variant is potentially more dangerous than the Delta variant. More specific studies have identified the Omicron variant as having 30 mutations, three minor deletions and one small insertion in the spike protein, 15 of which are in the receptor binding domain (RBD).
Several Covid-19 variants that have emerged in the world have mutations in the spike protein, which looks like thorns on the surface of the virus.
Using the term commonly used in human resources training, it seems that the Omicron variant is an “upgrade” of the Delta variant. The World Health Organization (WHO) has therefore included the Omicron variant on its list of variants of concern (VOC). Several Covid-19 variants that have emerged in the world have mutations in the spike protein, which looks like thorns on the surface of the virus.
Although they originate from the same virus, the variants that emerged in the UK and Africa are different. The variant that emerged in the UK has 17 mutations in the spike protein, while the variant that emerged in Africa has 32 mutations in the spike protein. The additional mutations have made experts suspect that the Omicron variant is more virulent than previous variants.
A medical worker prepares a BioNtech-Pfizer Covid-19 coronavirus vaccine at a colisium in Makati City, suburban Manila on November 29, 2021, as the Southeast Asian nation launched a three-day vaccination drive targeting nine million people as young as 12 in an effort to accelerate the roll-out of jabs, amidst the threat of heavily mutated coronavirus variant Omicron.
This Covid-19 variant can be said to be unique and "intelligent", and experts are still studying its pattern of mutation. This virus variant contains very high mutation potential that could explode
at any time. Experts studying the Omicron variant have found that its mutation process is unique and can produce new, highly virulent variants that can penetrate the defense system formed through vaccination.
Inside the virus is a molecule called a nucleotide that consists of different combinations. A combination of nucleotides is like opening a lock consisting of different combinations. The genome of a virus contains approximately 30,000 "combination keys". Each time the virus spreads, its genomic combination is duplicated. Imagine if you have to duplicate approximately 30,000 genomic combinations: one day, a condition will emerge in which the combinations do not match.
If the variation in this combination is very small, it will not have much impact on the virus. Even if the combination is incorrect, the resulting variant can weaken and die. On the other hand, if the genomic combination is successful, a new variant is created that has the ability to spread more quickly and is more resistant to immunity. This variant is very dangerous and can live much longer.
Child vaccination
Western media have reported that the latest variant has been an "alarm" for the world. A few days before the WHO added the Omicron variant to the VOC list, many countries had already closed flights to and from South Africa, both direct and transit, as recommended by the European Centre for Disease Prevention and Control (ECDC). In principle, it is better to prevent from the outset than to concede later.
The ECDC also recommends increasing testing of confirmed cases, and contact tracing of cases originating from areas affected by the Omicron variant. Because it is indicated that Omicron can reduce the efficacy of vaccines, the ECDC also recommends giving people aged 40 and above a third vaccine dose, with priority on the elderly and vulnerable.
We have already learned that the Delta variant that caused the second Covid-19 "tsunami" in July came from a foreign country that was blocked late, even though we had imposed social restrictions at that time.
It is better if we use the ECDC’s recommendations as a reference to prepare anticipatory scenarios. The government's move to ban entry to foreign travelers from 10 African countries as well as Hong Kong is appropriate. We have already learned that the Delta variant that caused the second Covid-19 "tsunami" in July came from a foreign country that was blocked late, even though we had imposed social restrictions at that time.
Another good step is to impose level 3 of the public activity restrictions (PPKM) ahead of the Christmas and New Year holidays. What is needed is enforcement of this policy in the field, which, based on past experience, is not easy. There are still too many people who persist and ignore the PPKM in traveling to their hometowns on vacation. In fact, this started the recent second tsunami of the coronavirus.
A staff member (C) wearing protective equipment guides a traveller at the arrival hall of Incheon International Airport on November 30, 2021, amid growing concerns about the Omicron Covid-19 variant.
Although it is feared that Omicron could penetrate the shield provided by vaccination, it is still better to speed up vaccination and expand its coverage. Vaccination can still reduce the risks of death and transmission.
For this reason, as the Office of the Coordinating Minister for Human Development and Culture has stated, what must be studied and implemented is vaccination against Covid-19 for children, including those under 11 years old, because it is impossible to limit the movement of these growing, small human beings, as physical movement and socializing is necessary for their growth and development. This includes direct activities at school and in their surroundings.
In addition to the policies that have been implemented and scheduled, the Health Ministry, with the authorization of the Food and Drug Monitoring Agency (BPOM), also needs to consider this step of vaccinating children, so that our children do not become the most vulnerable group during the pandemic. It is possible that while their mothers and fathers are relatively immune, they can still carry the virus and transmit it to their unvaccinated children. So for the sake of our safety, it is necessary to speed up the vaccination of little ones so that herd immunity covers all ages. No one must be left behind in vaccination.
Also, what we should be wary of is the tendency for us to begin to relax at this time. In the last few months since the vaccination program started, Indonesia was finally able to breathe a sigh of relief because good news was starting to arrive in the number of Covid-19 cases. Confirmed cases started to decline, Indonesia's prevalence ratio started to reach below 1 percent, hospitals were no longer flooded with Covid-19 patients, and some regular activities had started to resume at places like schools, offices and shopping centers, while still following the health protocols. No wonder optimism spread that the Covid-19 pandemic had begun to end and was moving towards becoming an endemic like ordinary diseases. Many people even stopped wearing masks and started to visit crowded places.
Human beings have the capital to beat this virus. However, people should not be arrogant and must always be in harmony with their ecosystems. Humans must realize that other creatures also need the space and time to progress according to sunnatullah. Humans can take the step to restore the environment, such as restoring green land and reducing waste. As UNESCO stated, “living together and life from it”. Lifelong learning is for the benefit of humankind and their ecosystem.
Djoko Santoso
If even developed countries in Europe are unable to withstand the attack of the Omicron variant, it is appropriate that developing countries, including Indonesia, anticipate it more seriously. Retighten the health protocols, as well as work hard to achieve 70-80 percent in vaccinating the population against Covid-19, and increase self-restraint while focusing on a healthy lifestyle. We must prevent and block the arrival of the third wave so that we can continue to recover in all fields.
Djoko Santoso, Professor at Unair medical school, chair of the East Java MUI Health Council, Covid-19 survivor
(This article was translated by Kurniawan Siswoko).
