‘Stealth’ Omicron is now the dominant strain in Spain: What you should know

With Spain’s sixth coronavirus wave now over, one of the main concerns among health authorities has seen the large rise in cases of the Omicron BA.2 subvariant in the country. But is there reason to be worried and could it affect the easing of the last Covid restrictions in the coming months?

'Stealth' Omicron is now the dominant strain in Spain: What you should know
The original BA.1 subvariant does continue to be dominant accounting for between 79 and 98 percent of cases across the country. (Photo by Josep LAGO / AFP)

After weeks of record infections over the Christmas period and January, the incidence of the highly transmissible Omicron variant dropped considerably throughout February and plateaued in March to the current roughly 450 cases per 100,000 people. 

Despite 82 percent of the population being fully vaccinated and half having had a booster shot, Omicron and the sixth wave resulted in 12,000+ deaths in Spain and more than five million cases, which equals more than all infections recorded during all other previous waves.

Fortunately, the pandemic is gradually improving and the Spanish government does want to work towards treating Covid-19 as an endemic disease, as in the case of seasonal influenza, the latest measure being to scrap quarantine for asymptomatic and mild cases from March 28th.

Will there be a seventh wave? Opinions vary among health experts in Spain but there is growing concern by the World Health Organisation that the next stage of the global pandemic will have the Omicron subvariant BA.2 at the centre of it. 

It’s been unofficially referred to as the ‘Stealth’ Covid variant or ‘Stealth Omicron’ given that it’s not as easily detectable with standard testing and is reported to be more transmissible than the original dominant BA.1 Omicron variant.

So far it has been detected in at least 80 countries worldwide and it’s become the dominant subvariant in restrictions-free Denmark, the UK as well China, India, Pakistan,the Philippines, and now also Spain.

Will ‘Stealth’ Omicron cause problems in Spain?

According to the latest update by Spain’s Health Emergencies Centre (CCAES), the BA.2 subvariant was now responsible for between 31 and 79 percent of new infections in Spain between March 7th and 13th.

This came after weeks of sequencing carried out in ten regions which showed that BA.2 cases tripled, then quadrupled throughout February. 

The original BA.1 subvariant, which just over a month ago accounted for between 79 and 98 percent of cases across the country, has now been replaced as the dominant strain by the BA.2 subvariant.

And we may still not have a clear picture of just how much the subvariant is spreading across Spain given the low rate of sequencing carried out at Spanish laboratories: six percent of tested cases, below the 10 percent recommended by the European Commission.

Spain is following the global trend in rising ‘Stealth’ Omicron cases, with the latest data seeing the World Health Organisation urge countries to keep a close eye on this subvariant.

Scientific studies have so far shown that the BA.2 is 40 percent more transmissible than BA.1, but that the difference isn’t as great as between the Omicron variant as a whole and Delta.

When it comes to how capable ‘Stealth’ Omicron is of causing serious illness or death, the scientific results are more mixed.

“It’s too early to draw conclusions about the characteristics of this strain,” CCAES reported, whilst Spain’s Health Ministry has stated that “so far no differences have been found regarding the risk of hospitalisation between BA.1 and BA.2”.

Lab testing from Japan in February showed that BA.2 may have features that make it as severe as previous variants of Covid, including Delta.

Covid hospitalisations are also up in Denmark and the UK where the subvariant is dominant, but this may be more closely linked to the fact that all Covid restrictions including mask wearing have been dropped in those countries.

Other questions remain, including the risk of reinfection with BA.2 compared to BA.1.

The most common reported symptoms of the ‘Stealth’ subvariant are the same as for the original Omicron subvariant: high temperature, cough, nasal congestion, headache and sore throat. 

What could all this mean in practice for the Covid-19 pandemic and restrictions in Spain? 

At present not enough is known about ‘Stealth’ Omicron for it to be clear to Spanish health authorities whether it should affect its plan to lift the remaining Covid rules in the coming months. 

As of late March, it doesn’t seem that BA.2 is a major concern for health authorities as they have decided to scrap the mandatory seven-day quarantine for asymptomatic and mild Covid cases and to stop counting each and every positive case.

But the government is dragging its feet on the removal of the indoor face mask requirement which Prime Minister Pedro Sánchez promised would happen “very soon”, and the lack of knowledge about the ‘Stealth’ Omicron variant could be one of the reasons behind this. 

Spanish health experts are also divided over whether there will be a seventh wave, but the possibility of a “more aggressive variant” is one of the reasons given for there being another spike in Covid cases. 

Only a drastic rise in Covid hospitalisations and deaths caused by the subvariant could force them to change their stance. 

This pandemic has surprised us before, and no doubt it has the power to do so again, but currently it doesn’t appear that ‘Stealth’ Omicron will change the direction of the pandemic strategy in Spain.  

READ ALSO: Will Spain change its domestic and travel Covid rules ahead of Easter?

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Outbreak or seventh wave? Health experts divided as Covid cases rise in Spain

Spain’s decision to stop counting all infections has some epidemiologists arguing health authorities are turning a blind eye to rising cases. But is the country truly heading towards a seventh wave?

Outbreak or seventh wave? Health experts divided as Covid cases rise in Spain

Three weeks since the Easter holidays came to a close and the indoor face mask rule was lifted in Spain, the Covid infection rate among over-59s has increased considerably, for most health experts predictably. 

It’s double what it was on April 1st – going from 459 cases per 100,000 up to 813 per 100,000 – and although Covid hospitalisations have risen by 78 percent in a month, pressure on hospitals remains stable. 

Not that this can be considered a complete picture of the epidemiological situation in Spain as the health ministry decided last March it would stop requesting data from the regions for infections among under-60s. 

This is part of the Spanish government’s plan of managing Covid-19 in a similar way to other endemic diseases such as seasonal influenza. 

The focus in recent weeks has been lifting Covid restrictions, not counting and reporting all Covid infections as frequently and rigorously and keeping a close eye only on the elderly and vulnerable. In a nutshell, returning to life pre-coronavirus.

But for some epidemiologists, the 55,578 new infections and 234 Covid deaths in the past week are indicative of the fact that the virus is still raging strong and that the end of Covid rules may have come too soon.

“We’re not facing a silent wave of the pandemic.  We’re walking blindfolded into a new wave, we don’t want to see it and we don’t want to name it,” Daniel López-Acuña, former director of emergencies at the World Health Organisation, told public broadcaster RTVE.

“There is a considerable rise in the infection rate, and  a rise in the infection rate sustained over time is a new wave, whether you want to call it that or not , López-Acuña added, arguing that if the incidence in under-60s were also analysed, “we would see the same infection rate or greater”.

Epidemiologist Quique Bassat argues that although there is talk among health experts of a seventh wave, “what we don’t know is how long it will last and if this is the beginning of what will end up being a seventh wave, or if it’s really just a new outbreak.” 

For Bassat, who is regularly interviewed on La Sexta and Antena 3 news, a rise in cases after the Easter holidays and the removal of face masks indoors is “what was expected”, but that “doesn’t mean that the population should be scared” and it “isn’t necessary to change the current strategy” of the health ministry.

“Pressure on healthcare is what has to determine if we should take a step back in the de-escalation of Covid-19 measures,” Bassat concludes.

It’s clear that the Spanish government’s approach to this stage of the pandemic is subject to a variety of opinions among the scientific community.

Some health experts, such as immunologist Matilde Cañelles of Spain’s Higher Council for Scientific Research (CSIC), consider it “irresponsible” to stop quarantine for positive cases and not count infections when there are still 30 people dying of Covid every day in Spain. 

Others take a more pragmatic approach and call for the fourth dose (second booster) of the Covid-19 booster vaccine to be offered to over-80s in the country as previously suggested, as the infection rate in this group is now over the 1,000 per 100,000 mark.

For epidemiologist Oriol Mitjà, Covid-19 adviser for the Catalan government, the coming weeks will shed more light on how big this coronavirus wave will be.

“Omicron is a variant with vaccine escape and with the potential to infect up to 60-70 percent of the population. 30 percent were infected at Christmas, 30 percent will avoid it and 30 percent can be infected now,” Mitjà tweeted.