A Commentary on "Omicron SARS-CoV-2 variant: Reasons of emergence and lessons learnt" (Int J Surg 2022;97:106198) Contact-tracing and global vaccine equity: Crucial responses to emergence of the Omicron SARS-CoV-2 variant.

Dear Editor,

On November 26, 2021, Omicron was recognized as a variant of concern by WHO [1]. The rapid spread of Omicron to more than 120 countries expectedly have heightened the uncertainty about the future of this devastating pandemic. We read the manuscript by Dhawan et al. titled “Omicron SARS-CoV-2 variant: Reasons of emergence and lessons learnt” published in a recent issue of the International Journal of Surgery [2]. Dhawan et al. pertinently enumerated several factors supporting the emergence of Omicron; for example, low vaccination rates in many low-income countries, many immunocompromized individuals, and inadequate health-related infrastructure to cope with the exacerbating pandemic [2]. We would like to add two points that may strengthen the arsenal against the SARS-CoV-2 pandemic.

In November 2021, after initial surge of new cases infected with Omicron, the U.S. Centers for Disease Control and Prevention recommended that all adults should receive a third vaccination booster dose [3]. Many high-income countries have already recommended and administered the booster vaccine dose among their citizens. Thus, thanks to widespread administraion of boosters, neutralizing antibodies should ideally prevent or at least lessen the occurrence of severe illness [4] among the vaccinated people. However, administraion of boosters has aggravated the vaccine inequity globally while many individuals have not received even a single dose of any of the COVID-19 vaccines, especially in the African continent. According to up-to-date statistics from Africa (https://ourworldindata.org/covid-vaccinations), only 15% of the entire population have received at least a single dose of a COVID-19 vaccine. Two years into the pandemic, providing vaccines to countries with lowest vaccination rates and hence with highest susceptibility to infection by SARS-CoV-2 and its variants must be the priority of any action plan undertaken by international health agencies, including WHO [5].

A relatively long incubation time by SARS-CoV-2 is an excellent precondition to generate asymptomatic positive cases. Asymptomatic hosts may develop symptoms after they already have transmitted the virus to other individuals. Thus, asymptomatic carriers should be traced and documented in any community [6] so they could be identified and self-isolate although the extent of viral shedding by the asymptomatic carriers is not well understood.

In conclusion, international efforts against the COVID-19 pandemic should include provision of equitable vaccination globally and widespread, comprehensive contact-tracing. Large amounts of vaccines are required in African countries to increase the vaccination rate. International health agencies could play a crucial role in the success of vaccination campaigns in low-income countries. Contact-tracing should be undertaken in countries with higher vaccination rates and in low-income countries that have started to roll out vaccines. Nevertheless, low-income countries have limited resources for contact-tracing like limited vaccination. Implementing these additional countermeasures will help abate the ongoing pandemic by the viral variants. Countermeasure efforts should be across borders and low-income countries should be supported throughout.

Provenance and peer review

Commentary, internally reviewed.

Sources of funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical approval

This article does not require any human/animal subjects to acquire such approval.

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Author contributions

Amin Talebi Bezmin Abadi: Conceptualization, Data Curation, Writing – Original Draft, Writing – review & editing. Farid Rahimi: Writing – Review & editing. All authors critically reviewed and approved the final version of the manuscript before submitting.

Guarantor

Both authors.

Declaration of competing interest

None.