Delta, Omicron Coinfection Could Create a Super-Variant

The Delta and Omicron variants of COVID-19 could possibly infect one person at the same time, creating an opportunity for incubation of a super variant. That was one of the concerns raised about Omicron by Paul Burton, MD, the chief medical officer at Moderna, when he testified last month before the United Kingdom’s Science and Technology Committee of Parliament. (Burton’s testimony begins at 11:09:16.)

Delta and Omicron coinfection “certainly gives an opportunity for the two viruses to, what we call, recombinate,” Burton told the committee. “They can now share genes and swap genes over.”

Burton also spoke of the hope that many have of a more infectious but less severe version of COVID-19 that would push the more deadly variants aside, effectively turning COVID-19 into a case of the yearly sniffles. However, Burton said that he does not think that Omicron is that variant.

“Omicron—which again I maintain is actually a severe disease—will now infect people on a background of very, very strong Delta pressure,” Burton said. “It will also lead to a situation where individuals will become—and there’s certainly documented evidence of this from earlier variants and infection—where individuals will become coinfected. That gives the opportunity of these viruses to further evolve and mutate, which is a concerning and worrying situation.”

Burton didn’t mention influenza, the incidence of which, in the United States, was the lowest last flu season since records have been kept. Flu had been kept so low because of the mitigation efforts people utilized—hand hygiene, social distancing, masking—to stave off COVID-19 infection. Those mitigation tools are much less in use by the public this year and flu has spiked recently, according to the Centers for Disease Control and Prevention (CDC). This has spurred concern that the already overburdened US health care system might have to fight the triple whammy of Delta, Omicron, and influenza.

Regarding the recombination events that Burton spoke about, medical experts say that they can happen only under very specific conditions. But one of those conditions is a spike in cases, which both the UK and the US currently deal with.

“We certainly don’t have to panic,” Burton said. “We have many, many tools at our disposal. We’ve learned so much about this virus over the last few years, we can continue to fight it. But I think Omicron poses a real threat.”

Omicron can replicate up to 70 times more than Delta, presenting a challenge to health care systems already overburdened and understaffed.

Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, wrote recently that “those who are not vaccinated or immunosuppressed are at risk for severe disease. Just these additional patients alone could easily collapse our overrun health care system. A transitory collapse has already happened in many regions of our nation during this pandemic which resulted in needed and sometimes urgent non-COVID-19 care to be delayed and sometimes unavailable.”