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Substrate Statement Omicron BA.2
As part of its ongoing work on monitoring variants, the WHO Technical Advisory Group on SARS-CoV-2 Virus Development (DAY-MORE) met yesterday to discuss the latest evidence of a worrying variant of Omicron, including its BA.1 and BA.2 substrates.
Based on available data on transmission, severity, re-infection, diagnosis, therapy and vaccine effects, the group confirmed that BA.2 should continue to be considered a variant of concern and should remain classified as Omicron. The group stressed that public health authorities should continue to monitor BA.2 as a separate sub-line of Omicron.
The worrying variant of Omicron is currently the dominant variant circulating worldwide, which includes almost all sequences reported to GISAID. Omicron consists of several subspecies, each supervised by the WHO and partners. Of these, the most common are BA.1, BA.1.1 (or Nextstrain Log 21K) and BA.2 (or Nextstrain Log 21L). Globally, the share of reported BA.2-labeled sequences has been rising relative to BA.1 in recent weeks, however the global circulation of all variants is reportedly declining.
BA.2 differs from BA.1 in its genetic sequence, including some differences in amino acids in spike protein and other proteins. Studies have shown that BA.2 has an advantage in growth over BA.1. Studies are underway to understand the reasons for this growth advantage, but initial data suggest that BA.2 inherently appears to be more transferable than BA.1, which currently remains the most commonly reported Omicron substrate. This difference in transmission seems to be much smaller than, for example, the difference between BA.1 and Delta. Furthermore, although BA.2 sequences increase proportionally compared to other Omicron substrates (BA.1 and BA.1.1), a decline in the total number of cases globally has still been reported.
Studies assess the risk of re-infection with BA.2 compared to BA.1. Re-infection of BA.2 after BA.1 infection has been documented, however, initial data from population-level reinfection studies suggest that BA.1 infection provides strong protection against BA.2 re-infection, at least for the limited period for which data are available.
While reaching the above decision, TAG-VE also looked at preliminary laboratory data from Japan obtained using animal models without any immunity to SARS-CoV-2 which pointed out that BA.2 can cause more severe diseases in hamsters compared to BA.1. They also considered actual clinical weight data from South Africa, the United Kingdom and Denmark, where immunity from vaccination or natural infection is high: no difference in weight between BA.2 and BA.1 was recorded in these data.
The WHO will continue to closely monitor the BA.2 lineage as part of Omicron and urges countries to remain vigilant, to monitor and report on sequences, and to conduct independent and comparative analyzes of the various Omicron substrates.
The TAG-VE meets regularly and continues to discuss available data on the tolerability and severity of variants and their impact on diagnosis, therapy and vaccines.
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