









































                                                                                                                         2021, Vol. 1 (S5) 7-10 
 https://doi.org/10.47488/dhrp.v1iS5.35 

 
http://dhrproceedings.org 7 © DHR Health Institute for Research and Development 
 

 

COMMENTARY 

The Newly Detected B.1.1.529 (Omicron) Variant 
of SARS-CoV-2 With Multiple Mutations 
Implications for transmission, diagnostics, therapeutics, and 
immune evasion 
Sohail Rao, MD, MA, DPhil1, 2 and Manish Singh, MD, FACS3 

 1 Executive Vice President, DHR Health, 5501 S. McColl Road, Edinburg, Texas 78539 and President 
& Chief Executive Officer, DHR Health Institute for Research & Development, 5323 S. McColl Road, 
Edinburg, Texas 78539.  
ORCID: https://orcid.org/0000-0001-5027-9992  
2 Correspondence should be addressed to: Sohail Rao, MD, MA, DPhil., DHR Health Institute for 
Research & Development, 5323 S. McColl Road, Edinburg, Texas 78539. Tel: (956) 362-2387. E-mail: 
s.rao@dhr-rgv.com  
3 Chief Executive Officer, DHR Health, 5501 S. McColl Road, Edinburg Tx 78539 and DHR Health 
Bariatric and Metabolic Institute, 500 Raphael Drive, Edinburg, TX 78539  
ORCID: Manish Singh: https://orcid.org/0000-0003-4146-3282  
 
Received 11/27/2021 
Accepted for publication 11/29/2021 
Published 11/29/2021 

Keywords:  COVID-19; SARS-CoV-2; B.1.1.529; Omicron Variant; VBM: Variant Being Monitored; VOI: Variant of Interest; VOC: 
Variant of Concern; VOHC: Variant of High Concern; SDFT: S-gene target failure; ACE2: Angiotensin-converting Enzyme 2; CDC: 
Center for Disease Control and Prevention

The global and regional impact of SARS-CoV-2 pandemic 
continues to be a source of grave concern. While the 
availability of vaccines against the SARS-CoV-2 virus may 
have partially assuaged this anxiety in certain parts of the 
world, it remains a prevailing and unpretentious global public 
health crisis. The latter outcome is fueled by the convergence 
of several factors which include (but not limited to) the lack 
of availability of adequate number of vaccines; poor socio-
economic conditions; vaccine hesitancy; and rampant 
proliferation of misinformation on the social media.   

To date, SARS-CoV-2 pandemic has infected over 48 million 
people in the United States resulting in the death of over 777 
thousand (1).  It is noteworthy that to a large extent, refusal by 
hominoid to get vaccinated in the United States continues to 
be a source of much consternation. Not only do unvaccinated 
people have a much higher rate of infection and 
hospitalization, but they are also a very fertile source for 
generation of SARS-CoV-2 variants. Since the identification 
of the first infected case of COVID-19 in Wuhan, China in 
December 2019, the world has witnessed multiple peaks of 

resurgence of COVID-19 pandemic largely as a consequence 
of mutations in the SARS-CoV-2 with enhanced 
transmissibility and infectivity.  

The US SARS-CoV-2 Interagency Group (SIG) has 
delineated SARS-CoV-2 variants into four distinct categories 
(Table 1). To date, the most impactful in terms of its 
transmissibility and infectivity has been the Delta (B.1.617.2) 
variant of SARS-CoV-2. First identified in India in December 
2020, the Delta variant swept rapidly through that country and 
Great Britain before reaching the U.S., where it quickly 
surged. It is now the predominant SARS-CoV-2 variant, 
accounting for more than 99% of COVID-19 cases and 
leading to an overwhelming increase in hospitalizations in 
some states (2). The Delta variant was believed to be more 
than five times as contagious as previous variants, and studies 
have shown that it may be more likely than the original virus 
to put infected people in the hospital. People who are not 
vaccinated are most at risk, and the highest spread of cases and 
severe outcomes is happening in states with low vaccination 
rates. 

https://orcid.org/0000-0001-5027-9992
mailto:s.rao@dhr-rgv.com
https://orcid.org/0000-0003-4146-3282


DHRP, 2021, Vol. 1 (S5) 7-10  The B.1.1.529 (Omicron) Variant of SARS-CoV-2 

 
http://dhrproceedings.org 8 © DHR Health Institute for Research and Development 

Table 1: US Government SARS-CoV-2 Interagency Group Classification of SARS-CoV-2 Variants (as of 
November 26, 2021; 1400 hrs.) 

CLASSIFICATION DEFINITION VARIANTS IDENTIFIED 

Variant Being 
Monitored (VBM) 

Variant for which there is data indicating a potential or 
clear impact of approved or authorized medical 
countermeasures; OR that has been associated with more 
severe disease or increased transmission but are no longer 
detected or are circulating at very low levels in the United 
States, and as such, do not pose a significant and imminent 
risk to public health in the United States. 
 

• Alpha (B.1.1.7 and Q 
lineages) 

• Beta (B.1.351 and 
descendent lineages) 

• Gamma (P.1 and 
descendent lineages) 

• Epsilon (B.1.427 and 
B.1.429) 

• Eta (B.1.525) 
• Iota (B.1.526) 
• Kappa (B.1.617.1) 
• 1.617.3 
• Mu (B.1.621, B.1.621.1) 
• Zeta (P.2) 

Variant of Interest (VOI) Variant with specific genetic markers that have been 
associated with changes to receptor binding; reduced 
neutralization by antibodies generated against previous 
infection or vaccination; reduced efficacy of treatments; 
potential diagnostic impact; or predicted increase in 
transmissibility or disease severity 
 

• None 

Variant of Concern 
(VOC) 

Variant for which there is evidence of an increase in 
transmissibility; more severe disease (e.g., increased 
hospitalizations or deaths); significant reduction in 
neutralization by antibodies generated during previous 
infection or vaccination; reduced effectiveness of 
treatments or vaccines; or diagnostic detection failures 
 

• Delta (B.1.617.2 and AY 
lineages) 

• Omicron (B.1.1.529) 

Variant of High 
Consequence (VOHC) 

Variant of high consequence has clear evidence that 
prevention measures or medical countermeasures (see 
below) have significantly reduced effectiveness relative to 
previously circulating variants. Possible attributes of a 
variant of high consequence (in addition to the possible 
attributes of a variant of concern): 

• Demonstrated failure of diagnostic test targets 
• Evidence to suggest a significant reduction in vaccine 

effectiveness; a disproportionately high number of 
infections in vaccinated persons; or very low vaccine-
induced protection against severe disease 

• Significantly reduced susceptibility to multiple 
Emergency Use Authorization (EUA) or approved 
therapeutics 

• More severe clinical disease and increased 
hospitalizations 

• None 



DHRP, 2021, Vol. 1 (S5) 7-10  The B.1.1.529 (Omicron) Variant of SARS-CoV-2 

 
http://dhrproceedings.org 9 © DHR Health Institute for Research and Development 

On November 13, 2021, Thomas Peacock, a post-doctoral 
fellow in the Division of Infectious Diseases, Imperial College 
London, London, United Kingdom submitted a sequence to 
GitHub of a new variant (B.1.1.529) of SARS-CoV-2 isolated 
from an immunocompromised patient in South Africa (3). 
According to the available data, the new variant has 32 
mutations in the conserved domain of the Spike protein which, 
is the region of the SARS-CoV-2 that binds to the 
Angiotensin-converting enzyme 2 (ACE2) allowing for the 
conformational change that facilitates its entry into host cells 
and is the target of immune responses. Additionally, 19 
mutations were also identified in the conserved non-Spike 
region of the B.1.1.529 variant which, are assumed to be of 
less significance in terms of the transmissibility and infectivity 
of the SARS-CoV-2. 

While most of the mutations in the Spike region of B.1.1.529 
were similar to that in the Delta variant, some were unique 
which raised serious concerns about the transmissibility of this 
variant. In fact, the B.1.1.529 is now the most dominant 
variant identified in patients with COVID-19 in South Africa 
and has already been isolated from patients with COVID-19 
in other Southern African countries (Lesotho, Botswana, 
Namibia, Eswatini and Zimbabwe), Belgium, Israel, and Hong 
Kong (5). According to the modelling using S-gene target 
failure (SDFT) data, the rate of infection from the B.1.1.529 
will be 100-fold higher as compared to that to the Delta variant 
of SARS-CoV-2 (Figure 1). 

 Figure 1: Modeling of Spread of COVID-19 Cases in South Africa 
from Infection with B.1.1.529 Variant of SARS-CoV-2 Using S-gene 
Target Failure Data* 

 
*Source: Financial Times analysis of data from Global Initiative 
on Sharing Avian Influenza Data (GISAID) and the South African 
National Health Laboratory Service  

Given these alarming observations, the Technical Advisory 
Group of the World Health Organization (WHO) met on 
November 26, 2021, and classified the B.1.1.529 as the 
Variant of Concern and named it “Omicron” (6). It is also 
unclear at this moment if the immunity acquired against 
SARS-CoV-2 following natural infection and/or vaccination 
would be effective against this variant. Equally, disconcerting 
is the possibility that the existing molecular tests that are 
commonly used to diagnose infection with SARS-CoV-2 

might be less effective in identifying the B.1.1.529 variant. 
Nevertheless, to contain the spread of Omicron, United States 
has banned flights from seven high-risk countries effective 
Monday, November 29, 2021 (7). Similar travel restrictions 
have also been implemented by many other countries around 
the globe. 

In conclusion, the identification of a new potentially more 
dangerous variant is a somber reminder that the world is still 
living under the umbrella of a pandemic and remains highly 
vulnerable to another wave of SARS-CoV-2 infection. 
Despite these travel restrictions, it is only a matter of time that 
the B.1.1.529 variant will be identified in patients in the US. 
In fact, we predict that the B.1.1.529 variant has already 
penetrated the US eco-system. While it must be confirmed 
unequivocally, given some similarities of observed mutations 
in B.1.1.529 to that to the Delta variant, we envisage that the 
immune responses raised by the currently available vaccines 
will be effective in protecting against this variant.  It is the 
degree of protection afforded by these vaccines against 
Omicron which is the focus of studies currently underway. 
Hence the need for universal vaccination all around the world 
otherwise, the threat of evolving new and more dangerous 
SARS-CoV-2 variants will always be lurking in the 
background. Recent affirmative news about the gradual 
decline in the rate of infection and hospitalization in some 
states has perhaps bestowed false reassurance prompting 
many to abandon US Centers for Disease Control & 
Prevention guidelines for limiting the spread of COVID-19.  
It is, therefore, imperative that we continue to exercise 
extreme caution in our social congregations and all those 
who are eligible must get vaccinated including the third 
and/or the booster doses. 

Diclosures 

SR declares no conflicts of interest.  

MS declares no conflicts of interest. 

Funding 

The project is funded by a Seed Grant from the DHR Health 
Institute for Research & Development 

References 

1. The Coronavirus Resource Center. The Johns Hopkins 
University. 2021. https://coronavirus.jhu.edu/map.html . 
(Accessed November 26, 2021, at 13:00 hrs) 

2. CDC Data Tracker. Monitoring Variant Proportions. 
2021 https://covid.cdc.gov/covid-data-tracker/#variant-
proportions  ((Accessed November 26, 2021, at 14:00 
hrs)) 

https://coronavirus.jhu.edu/map.html
https://covid.cdc.gov/covid-data-tracker/#variant-proportions
https://covid.cdc.gov/covid-data-tracker/#variant-proportions


DHRP, 2021, Vol. 1 (S5) 7-10  The B.1.1.529 (Omicron) Variant of SARS-CoV-2 

 
http://dhrproceedings.org 10 © DHR Health Institute for Research and Development 
 

3. FDA Authorizes Additional Monoclonal Antibody for 
Treatment of COVID-19. 2021. 
https://www.fda.gov/news-events/press-
announcements/coronavirus-covid-19-update-fda-
authorizes-additional-monoclonal-antibody-treatment-
covid-19 . (Accessed November 26, 2021). 

4. Peacock, T. B.1.1 Descendant Associated with Southern 
Africa with High Number of Spike Mutations. 2021. 
GitHub. https://github.com/cov-lineages/pango-
designation/issues/343 .   

5. Cheng, M. What is this New COVID Variant in South 
Africa. November 26, 2021. Associated Press. 
https://www.aol.com/explainer-covid-variant-south-
africa-111307372-142856393.html  

6. Classification of Omicron (B.1.1.529): SARS-CoV-2 
Variant of Concern. World Health Organization. 
November 26, 2021. 
https://www.who.int/news/item/26-11-2021-
classification-of-omicron-(b.1.1.529)-sars-cov-2-
variant-of-concern  

7. Statement from President Joe Biden on the Omicron 
COVID-19 Variant. The White House. November 26, 
2021. https://www.whitehouse.gov/briefing-
room/statements-releases/2021/11/26/statement-by-
president-joe-biden-on-the-omicron-covid-19-variant/  

 

 

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-monoclonal-antibody-treatment-covid-19
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-monoclonal-antibody-treatment-covid-19
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-monoclonal-antibody-treatment-covid-19
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-monoclonal-antibody-treatment-covid-19
https://github.com/cov-lineages/pango-designation/issues/343
https://github.com/cov-lineages/pango-designation/issues/343
https://www.aol.com/explainer-covid-variant-south-africa-111307372-142856393.html
https://www.aol.com/explainer-covid-variant-south-africa-111307372-142856393.html
https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern
https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern
https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern
https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/26/statement-by-president-joe-biden-on-the-omicron-covid-19-variant/
https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/26/statement-by-president-joe-biden-on-the-omicron-covid-19-variant/
https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/26/statement-by-president-joe-biden-on-the-omicron-covid-19-variant/

