Protein shake-up: getting to know Omicron

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Hello and welcome to the Intelligence from the Economist. I'm your host, Jason Palmer. Every weekday we provide a fresh perspective on the events shaping your world. Southeast Asia has long had a methamphetamine problem, both in terms of producers and consumers. Governments are taking a harder and harder line with users, but their compulsory treatment centers seem only to be making matters worse. And research into human diseases involves studying animals with similar biology. And scientists could do with more of these model organisms. We visit an effort to add another to the list by trapping them in the wilds of Madagascar. But first, Britain's Prime Minister Boris Johnson issued a stark warning to the nation last night.

But I need to speak to you this evening because I'm afraid we're now facing an emergency in our battle with the new variant we Omicron.

It's a message being passed on in lots of countries. Omicron is spreading with worrying speed.

No one should be in any doubt. There is a tidal wave of Omicron coming and I'm afraid it is now clear that two doses of vaccine are simply not enough to give the level of protection we all need.

That is one of the few things that's clear about the variant. As Omicron makes its mark around the world, scientists are feverishly working to understand it, its effects and what can be done to stop it.

The first few days to a week of this was characterized by everybody just asking a lot of questions to which they didn't have any answers. And the wiser heads were saying the only thing we can really do here is wait for the data to come in.

Hal Hudson writes about science for the Economist.

Now about two, two and a bit weeks on, a lot of the data has come in and we do start to see the shape of this thing.

When you say shape of this thing, let's start with exactly that. What does this variant look like? What is it doing differently.

So the big difference that Omicron has is that it has a large number of mutations on its spike protein. That's the bit of the virus that binds to the receptors in your cells, lets the virus hijack those cells, use their machinery to make copies of itself, and that's what constitutes an infection. And so when you have mutations on that binding bit of the virus, it means that the bits of your immune system which have been created to recognize that bit and get in its way and stop it binding, they don't necessarily work as well. It also potentially means that that binding bit of the virus works a little bit better. That's kind of what evolution tends to mean. If you're a new kind of a thing that's got a bunch of mutations and you survive, it's probably because you work a little bit better in the environment that you operate in.

And what do those evolutionary changes mean in terms of, for example, the protection that people already have?

It means that Omicron is avoiding some components of the immunity that people have developed either through vaccination or through infection. In particular, it is avoiding their antibodies. Data that's just come in from the UK Health Safety Agency shows us that. And it's still early, but it is pretty solid. Data shows us that the antibodies generated by AstraZeneca don't bind at all to Omicron.

Not at all. I mean, that doesn't sound good.

That sounds really scary. But it is important to remember that there is a whole other component of the immune system that no one is measuring. So all these headlines that are saying, you know, total vaccine escape or, you know, 75% reduction in vaccine efficacy, that's just for one component of the immune system. There's a whole other component called the cellular immune system. It just kicks in at a later stage after the virus has broken into your cells, then the cellular immune system kicks in. And so what this means overall is that we've got way less protection against infection from Omicron. But probably, and unfortunately, we don't have a clear idea because it's much harder to measure, we still have very strong protection against disease and death because that's where the cellular system kicks in.

So that's what it looks like down at the sort of microscopic level. But what about the sort of population level? The. The first question we had about this variant was how far and how fast it was going to spread. And so far, it seems far and fast.

It seems very far and fast. So if you look at the graph of cases in South Africa, it Basically goes straight up far faster than any previous wave cases. In the uk, Omicron cases are doubling every two to three days. It's the same in Denmark, which also has a very strong genomic surveillance system. And the more you see those similarly ridiculously fast spikes in different parts of the world, the more you're like, okay, this is going to be the same everywhere. One of the things that's changed in terms of what we know, is that at the beginning there was a question about whether would this just be a southern Africa kind of a phenomenon like some of the other variants? Some of the other variants, they spread very fast and badly in certain places, but they didn't spread fast and bad all over the world. Unfortunately, it looks like Omicron is spreading fast and bad all over the world.

And what has all that meant so far in terms of infections and deaths?

So, again, probably frustratingly for listeners, we must tell them that we need to wait a little bit longer on that for a clear conclusion. Cases are the first data to come in, but early data does suggest particularly that from South Africa, that there is less hospitalization than with prior variants and that most cases are mild. We hope that that bears out. The flip side of this is that even if the disease is much milder, the immune escape allows it to infect, but not to make anyone ser ill. You've still got this problem that if it spreads really, really widely, even if it's overall much more mild, loads more cases of a more mild disease can still overwhelm hospitals, just in a completely different way. Much less sick people. There's still a large number of sick people.

And so where does that leave us with that sort of partial knowledge in terms of public health efforts?

Yeah. So all of the things that everyone has been told to do throughout the pandemic remain a good idea. Wearing masks, having good ventilation, filtering, air distancing, and most importantly, we've got vaccines and prior infections. All of that stuff does matter. The other thing that's important to remember is that even when antibodies are sort of less effective per antibody, it can still be very, very helpful to have a large number of these slightly less good antibodies in your system. And this is why getting a booster still makes sense for Omicron. Even though the antibodies that you're boosting are not sort of specific to Omicron as much as they were to the older versions of the virus, once you get boosted with, say, the Pfizer shot, you're still getting up to around 75% efficacy against just infection, which means you are 75% protected against even catching the disease at all. And so that's still good news, still makes sense for as many people as possible to get those boosters, because if more people aren't getting infected, that means the virus is spreading more slowly through the population. And that's pretty much good for everyone. But it's particularly good for the health service because it's less likely to get overwhelmed.

So, so far, we know that this thing is getting around, but the measures we already understand are the ones still to be followed. But what are the data we're still looking for? What are you looking out for? To know more about Omicron, I'm watching cases.

Particularly interesting to see how quickly the Omicron cases are going to grow in the United States. We're already seeing very, very fast doubling in places like the UK and Denmark. But the big, big thing is hospitalizations. We want to see whether hospitalizations and cases are running together or whether, if we're lucky. And what it looks like there is early evidence to suggest is that there will be much fewer hospitalizations and much, much fewer deaths under Omicron than there have been under previous variants. And really what that will be is just a signal that our vaccines are working.

Hal, thanks very much for your time.

Thank you for having me, Jason.

In October, police in Laos intercepted a truck carrying more than 55 million pills of methamphetamine and a ton and a half of crystal meth.

Police intercepted a truck carrying beer crates, leading them to a nearby house where two men were detained. Laos has been a gateway for drug.

Traffickers transporting meth shipments into Thailand and Myanmar. Southeast Asia has been awash in methamphetamines for decades, and the problem's only getting worse. When it comes to drug users, the usual response is a harsh one and counterproductive.

Governments in the region are, by and large taking a zero tolerance approach.

Charlie McCann is our Southeast Asia correspondent.

So what that means in practice is that most drug users apprehended by the police will wind up in what's called compulsory treatment centers. As the name suggests, users are not asked if they want to go to these facilities, and if they were asked, they probably would not want to go. Conditions there are often worse than prison.

How so? What are the conditions like?

I spoke to a drug user who I will call, and he has spent a bit of time in one of these facilities. Tell me a little bit about the facility you were in and living conditions. What he told me was just really awful. So the compulsory treatment center he went to was in a prison in Bangkok, and this place was just really quite desperately overcrowded. He says that There were about 300 to 400 people in this room. And when they went to sleep at night, they would lie on the ground and space was so tight that they would sort of arrange their bodies head to toe. Head to toe. And when he got up in the middle of the night to go to the bathroom, he would just inevitably lose his spot. So by the standards of these places, Somcla actually had it pretty good. Human rights organizations have documented instances of physical and sexual abuse and even torture detained drug users. They don't appear before a judge, and they're not informed of the length of their course of treatment, which can last from anywhere to two weeks or all the way up to three years.

And is there good reason to believe that this way of going about it is effective?

In short, no. The idea behind these places is that abstinence is the best cure for addiction and that physical labor might kind of steal the body against temptation. So because of that view, medical assistance or psychological support are rarely provided. Members of staff have little or no medical training. And I think it's telling that a lot of these places are run by the police or military. So, unsurprisingly, relapse rates are very high. And that's how it went for Somchai. So he told me that all he got out of his experience were tips on where to score cheaper drugs. And when he was let out, he started using again and has used ever since.

And so why has this stuff spread so widely in Southeast Asia in particular?

The reason there's so much meth in this part of the world is because the meth labs that feed Asia's habit are found in this lawless patch of Myanmar. So drug cartels have been operating there for several years now. It's a good place for them to do their work because the authorities have struggled to stamp them out or occasionally turned a blind eye to their activities there. But since the coup in Myanmar in February, the authorities have just been completely distracted. And that makes this part of the world even more enticing to these syndicates. So mess is readily available, and it's also just getting cheaper and cheaper. One drug user I spoke to said that dealers were practically giving it away on the streets of Bangkok.

But do the authorities in the region realize that what they're doing with these compulsory treatment centers isn't working? May, in fact be making matters worse?

Yeah, that realization is starting to sink in. I mean, politicians, all they need to do is look at the numbers on the rates of usage, rates of addiction. They're just going up, up and up, as are their prison populations. The UN and many NGOs think it would be much more effective to treat addicts like patients rather than criminals. And politicians are coming round to that view. So in 2015, eight Southeast Asian countries agreed to phase out mandatory treatment and replace it with the voluntary kind. And that consists of a range of psychological services provided locally, which have been proven to be much more effective. The trouble is that many detention centres remain open. It's just the case across the region that an enormous number of funds are currently earmarked for law enforcement agencies, the agencies that run these compulsory treatment centers. And diverting those funds to health ministries is necessary, but is going to take a long time. You have to remember that these countries are places where governance is pretty weak and corruption is pretty high. So progress is happening, but it's happening slowly. I sort of liken this transition to getting clean. It takes time and you have to affirm your commitment to doing so again and again and again.

Charlie, thanks very much for joining us.

Thank you, Jason.

There's something of a catch 22 in using animals to answer questions about human biology. The more human like a creature is, the more fraught the research tends to be, both ethically and pragmatically. The hunt for a useful animal that's similar, but not too similar, includes a unique effort involving the lemurs of Madagascar. Not the giant indri of the northeast or the ring tailed lemur, familiar from zoos and certain animated films, but rather a much smaller member of the family.

Mouth. Lemurs are really fascinating. I mean, so super cute. They're slightly bigger than a mouse, they've got enormous eyes which seem to glow orange when you shine a torch on them.

Our correspondent Tim Judah has been to Val Bio, a scientific research center in Madagascar.

Ran Up Farmer is a big national park. It's a kind of tropical park and it's stuffed full of lemurs. The reason for my trip was to see mouse lemurs, which are being looked at as a possible new, what scientists call a model organism and might possibly save us from Alzheimer's and all sorts of other human diseases in the future. And the most important thing about a mouse lemur is that they look like a mouse, breed like a mouse, walk like a mouse, but they're definitely not a mouse. They're a primate. And that's why they're interesting to scientists.

And you say, you got to see some of these mouse lemurs for yourself?

Well, I did get to see them. We got there and the Malagasy scientists, the Julie went out with me, had these kind of metal boxes. They smear them with a slice of banana. They put in the piece of banana into the metal box, and then they tie them up on trees. A couple of hours later, they went back to collect them. And of course, for the mouse lemur, the next thing they know, they're in the valbiocentre being tested.

Tested how?

Well, what happens is they're taken out of the traps. If they're male, they have their testes measured, then they all have blood taken from them. And most importantly of all, they have a little chip injected in them. They also make them do a little gym work to see how strong they are. Within a few hours, these mouse lemurs are back home on the tree that they came from.

So you mentioned that the scientific value here is that lemurs are closer to us as humans because they're primates. And also that there's a connection to Alzheimer's research.

Well, that's right. And what was discovered in existing colonies of mouse lemurs was that unlike mice, as they age, they tend to get some of the diseases that older humans get. I mean, heart problems, uterine cancers, and Alzheimer's. If you want to do serious research on Alzheimer's or heart diseases or anything of that nature, you would like to have an animal that is very close to us. For example, a chimpanzee. Of course, it's not really acceptable to keep chimpanzees in captivity for scientific experimentation anymore. And also, they don't breed very fast. So the little mouse lemur, which breeds very fast and lives quite a long time, up to 14 years in captivity, is absolutely ideal. The point of the research, not simply to test for Alzheimer's, etc. The bigger, broader question is whether mouse lemurs can become another kind of model organism. Now, there are very few types of model organisms, which are zebra finches, fruit flies, mice, but they're things that scientists can coalesce around and do a lot of research on. The question is, can mouse lemurs become a new model organism?

So how to find that out? What's next, beyond trapping and chipping?

Well, the point is to do research over many years and hopefully to see what that yields. But with a mouse zimur that in the wild, the chipping means that you can still research them. Over the years, you can look at any differences in those mouse lemurs that there may have been from when they were caught previously.

And so the big picture here is hoping to provide insights into lots of human diseases.

Being primates, they are much more similar to humans and human DNA than mice. The development of the mouse lemur as a possible model organism will mean much, much more research on mouse lemurs, which is relatively easy since there are millions and millions of them and they breed very fast.

Tim, thank you very much for joining us.

Thank you for having me.

That's all for this episode of the Intelligence. If you like us, leave us a rating and a review and you can subscribe to the economist@examiner.com intelligenceoffer. The link is in the show notes. See you back here tomorrow.

Sam.