Faced with the advance of the Omicron variant of the coronavirus in the world, on Monday night President Guillermo Lasso announced the measures that the Ecuadorian government will implement to prevent the spread of the virus.

He said that the situation is being constantly monitored. The decisions were adopted in coordination with the National Emergency Operations Committee (COE).

Measures being put in place:

1. Entry ban for all travelers whose point of origin, stopover or transit are African countries: South Africa, Namibia, Lesotho, Zimbabwe, Botswana and Eswatini, Mozambique and Egypt.
2. The opening of the border with Colombia will now be done in phases. The first will be with the transport of goods, under biosecurity protocols, according to agreements of the transport ministries of the two countries.
3. To enter Ecuador, all people—nationals and foreigners—must present a complete vaccination certificate, with at least 14 days of validity, as well as a PCR test taken within the previous 72 hours.
4. Children and adolescents between the ages of 2 and 16 years entering the country must present the negative result of the PCR test performed up to 72 hours prior to departure to Ecuador.
5. If a suspicious case is found among the travelers, a real-time PCR test will be carried out. In case of being positive, 14 days of isolation must be carried out.
6. Mass events will have a maximum attendance capacity of 50% and meet biosecurity protocols.
7. The presentation of complete vaccination certificates will be mandatory for all public sector buildings. The president is also urging that the same requirement be replicated in cinemas, theaters, bars, discos, stadiums, shopping centers and the like.
8. Public transport may have up to 100% capacity, provided there is natural ventilation, and the mandatory use of a mask is required.

President Lasso also called on citizens living in the country to take additional efforts against the pandemic. He asked anyone not inoculated against the virus to complete a vaccination regimen.

Lasso mentioned that 70% of the population older than 5 years is already vaccinated. “If you belong to the minority that has not yet been vaccinated, please do so now. We have enough vaccines for everyone,” he said.

Lasso also urged the Decentralized Autonomous Governments (GAD) to order that the capacity, in open and closed places with ventilation, be a maximum of 50%, and that social distancing be complied with.

The president said that the use of a mask is permanent in all cases, as well as frequent hand washing and surface disinfection. Lasso insisted that the evolution of the new variant be monitored daily. If necessary, he said, the required adjustments will be made.

“The last month of the year is approaching, a month of a lot of movement, a month of meeting, but we all deserve to live in peace,” said the president.

Omicron: the symptoms of the new covid-19 variant

Dr. Angelique Coetzee, president of the South African Medical Association, said that so far patients infected with the new Omicron variant of the coronavirus that causes covid have presented very mild symptoms.

“What we are seeing now in South Africa, and remember I am at the epicenter, is extremely mild,” said Coetzee.

“We have not hospitalized anyone yet. I have spoken with other colleagues and the picture is the same,” she added.

Dr. Coetzee was the one who first South African authorities alerted to the possible existence of a new variant of the coronavirus. Laboratory tests confirmed that she was correct and the WHO declared it a variant of concern.

The doctor explained that it all started on November 18th, with a patient in his 30s who said he had been feeling tired and had pain in the body for several days.

“He had a bit of a headache, he didn’t really have a sore throat, he described it more as an itch, no cough or loss of taste or smell.”

Coetzee found these symptoms unusual and decided to do a quick test in her office.

Both the patient and the rest of his family members tested positive for covid. As the doctor explained, they all had “very, very mild” symptoms.

Throughout the day other patients with similar symptoms appeared. Coetzee decided to alert the Ministry of Health’s Vaccine Advisory Committee, because she is on the committee herself. “It’s easy for me to say “listen, something is wrong today, I have seen a scenario that does not fit with the delta variant,” she said.

Asked whether countries that, like the UK, the US or Israel, have decided to restrict South Africa travel had rushed into a panic, she replied: “At this point, yes, definitely. Maybe in two weeks we will be saying something different.”

Coetzee believes that the Omicron variant is likely already circulating in countries that are adopting travel restrictions.

“Your doctors can focus on the delta variant and miss it because it’s easy to miss. If it weren’t for the fact that we in South Africa hadn’t seen covid cases in recent weeks, we would have overlooked it as well.”

The Omicron variant was reported by the South African authorities to the World Health Organization last Wednesday and declared a variant of concern on Friday by the international organization.

Initial information seems to show that it has a higher transmissibility and a higher risk of reinfection than other known variants of the coronavirus due to its large number of mutations, but scientists warn that more information is necessary to reach a definitive conclusion.

Since its identification, a growing number of countries have reported Omicron cases such as Canada, Germany, the United Kingdom, Belgium, the Netherlands and Italy.

Although the WHO has advised against the adoption of travel restrictions, several countries, including the United Kingdom, the United States and states of the European Union, have closed their doors to travelers from South Africa, Botswana, Swaziland, Lesotho, Mozambique, Namibia and Zimbabwe for fear of the spread of the new variant of the virus that causes covid.

Others have gone further: Morocco has suspended the arrival of international flights for two weeks and Israel has banned foreigners from entering its territory.

What is the Omicron variant?

The Omicron variant – originally known as B.1.1.529 – is a new version with dozens of mutations of the SARS-CoV-2 that produces the disease called covid-19.

The variant originated in Botswana, a country in central Africa. However, there is no analysis of the sequencing of the virus variants.

That is why it was not identified until it arrived in South Africa. In that country, the cases of covid-19 increased exponentially in the three weeks before the new variant was officially confirmed. The first case of B.1.1.529 was found with a sample taken on November 9th.

What differentiates it from other variants of covid-19?

This variant has 32 mutations in protein S, which gives the virus the spike shape. Paúl Cárdenas, a researcher at the Institute of Microbiology of the Universidad San Francisco de Quito, said that the number of mutations surprised them because it is much more than they expected.

According to Cárdenas, in December 2020 there had only been between 7 and 8 mutations of the virus variants. However, at that time Alpha appeared with 14 mutations and that number has been the average for those that appeared later. However, in the Omicron variant the number of genetic modifications is more than double.

The World Health Organization (WHO) declared Omicron a variant of concern because it increases the transmissibility of the disease. Cárdenas says it is more contagious than the Delta variant — the variant that had the highest transmissibility until B.1.1.529 appeared.

Cárdenas says that with Omicron, it appears that each infected person could transmit the virus to more than 14 people. While with the Delta it was contagious to between 6 to 8 people – which was already more than twice as many infections as there were with the version of the virus that left Wuhan and that was identified at the end of 2019.

Omicron has other mutations that are linked to evading the immune system and vaccines, increasing the risk of reinfections. There are also difficulties in detecting it with certain PCR tests.

In the case of Belgium – which reported two other confirmed infections – it was detected in a patient who had symptoms, but his CRP was negative. To confirm the diagnosis, the virus was sequenced. Cárdenas says tests must be constantly updated so they can identify new mutations of the virus and not give wrong results.

Cárdenas says that “so far there is no evidence that it produces a more serious disease,” or that there is an increase in mortality. However, he clarified that being more contagious, it reaches more people in less time and that can cause health services to quickly become saturated. “This is also related to the increase in mortality,” he says.

According to the WHO, when there are cases of variants of concern in a country, it is necessary to notify the Organization, take measures at the local and national level to control their spread and investigate to determine the effectiveness of vaccines against the mutation of the virus.

The WHO says that depending on the characteristics of the variant and the results of the investigations, “additional considerations” will be taken that could include developing new diagnoses or modifying vaccines and treatments.