Omicron – the latest Covid-19 chapter

While Omicron, the latest Covid-19 variant to emerge is less likely to cause serious illness than its delta predecessor, it’s also a lot more infectious. Given this, and the New Zealand government’s policy change to ‘learning to live with’ this virus rather than wanting to return to lockdowns, the country is probably on the verge of a rapidly spreading outbreak.

We should be thankful that New Zealand avoided the extensive outbreaks of the more virulent delta variant experienced in most other countries, and omicron may even be the ‘beginning of the end’ phase of the global disruption caused by the SARS-CoV-2 virus over the past two and a half years. Most will experience a relatively mild infection, and around 20% of those infected with omicron are likely to be asymptomatic(1, 2).

Omicron can, however, still produce serious illness particularly in those with underlying health conditions or who are unvaccinated, and due to the likely rapid spread and extent of the outbreak, there are worries it may overwhelm hospitals and other health care services as has occurred overseas. These concerns are heightened due to staff and resource shortages within New Zealand’s mainstream health care system(3).

After two years of very low rates of influenza due to social distancing and lockdowns, New Zealand is now also overdue for a flu epidemic, and to my mind the risks of a double whammy of both influenza and omicron hitting us this winter, are relatively high. Together with the highly debilitating nature and protracted recovery time of so-called Long Covid, which can continue or develop long after the initial infection is over(4), the omicron form of Covid-19 is therefore a virus to try and avoid.

For New Zealanders, avoiding infection with omicron in the coming months, will probably be difficult. This is likely to be the case both for those who are vaccinated and unvaccinated. While vaccination and in particular having had the 3rd booster Pfizer vaccine is associated with milder symptoms(5, 6), the level of protection against omicron appears to be less than that against the delta variant(7, 8, 9).  The duration of the protective action of the current Pfizer booster vaccine, is also as yet unknown.

Vaccination strategy

Researchers in the U.S. who tracked the evolutionary trajectories of vaccine-resistant mutations over time in more than 2.2 million SARS-CoV-2 genomes, have found the occurrence and frequency of vaccine-resistant mutations to correlate strongly with vaccination rates in Europe and America(10). Their data suggests that vaccine-resistant mutations will gradually become one of the main evolutionary tendencies of new variants, particularly in populations with high rates of vaccination.

Despite the good intentions of the Covid-19 Vaccines Global Access (COVAX) scheme for providing vaccines to low-income countries, global vaccine inequities have also worsened with the recent focus on booster vaccines, and huge disparities continue to exist between vaccine access in high versus low income countries(11, 12, 13). This has ethical and many other implications.

While the development of new generation and multivariant vaccines may have broader spectrums of action and avoid the need for frequent booster immunisations, these factors are cumulatively reasons to reconsider the relative contribution that vaccines will make to the world’s future Covid-19 management strategy(14, 15).

Herbal approaches to dealing with omicron

Given most of us will need to manage an omicron infection at home, it’s a good time to consider other medicines that may be useful. Official government Covid-19 communications are now encouraging us to stock up on medicines such as paracetamol, ibuprofen and nasal decongestants in preparation for the omicron outbreak.

I’ve previously discussed herbal interventions that may help with either a prophylactic or treatment approach to Covid-19(16, 17, 18, 19, 20). Since this coronavirus first emerged more than two years ago, there’s also been a huge amount of research into potentially useful herbal medicines, and a lot of encouraging findings published in the scientific literature(21, 22, 23, 24, 25).

For many years I’ve promoted the benefits of herbs such as Echinacea in helping to both enhance immunity and reduce inflammation in a wide range of infectious conditions (18), provided the appropriate type and dose is used.

There’s a lot we’ve learnt about omicron from other countries in recent weeks. It has several differences to earlier variants of Covid-19, and understanding these and its particular symptomatology and pathology is helpful. A runny nose, headache and fatigue are the most common symptoms, with body ache, muscle ache, cough and fever also being frequently experienced(1).

While omicron has a greater ability than delta to infect us through our upper nasal cavity and mouths, it seems more likely to be confined to the upper nasal passages, throat and sinuses, and somewhat less able to produce a serious infection of the lower respiratory tract or lungs(1, 26).

As such, the rationale of optimising our body’s own inbuilt defence system at the top end of our respiratory tract, would seem to make particular sense. Providing a local physical barrier to the entry of airborne viruses is how masks work, and inhalations or sprays through the oral or nasal cavities are also often the route of administration of drugs used to treat lung conditions such as asthma or nasal congestion.

Many traditional applications of herbal medicine including Maori Medicine (Rongoā Māori), Ayurvedic, Chinese and European herbal medicine, utilised inhalation through the lungs as a popular method of administration. This pulmonary route of administration through inhalation or sprays, is also widely used to treat conditions such as asthma or sore throats, or as a way to deliver drugs to the general blood circulation and treat other systemic conditions. 

When I researched herbs for the 1996 bird flu and 2009 swine flu pandemics, I formed the view that there is merit in the use of local applications to the upper airways of decongestant, anti-inflammatory and antimicrobial herbs, as part of a strategy to both prevent or treat these other highly virulent respiratory tract viruses. This lead me to subsequently formulate and develop both a throat spray and a lung care spray, each administered as fine sprays through the oral cavity.

These products contain some of our wonderful New Zealand grown herbs such as elecampane, horseradish, thyme and kawakawa, as well as New Zealand propolis. Each of these has specific benefits of relevance to optimising and enhancing our own natural and ‘first line’ upper respiratory tract defence barriers to infection(19, 20). Their anti-inflammatory, antimicrobial and expectorant actions provide a healthy and natural support for the body’s mucous membranes, immune system and cilia within our respiratory tract whose job is to try to keep unwanted bugs and other nasties out of our lungs.

Elecampane has long been traditionally used for coughs, chest infections, asthma and other lung conditions. Beneficial effects included suppression of pulmonary pathological changes, neutrophil infiltration, pulmonary permeability, and pro-inflammatory cytokine expression(27, 28). Promising affinity towards both the SARS-CoV-2 viral proteins and host receptors has also been reported for elecampane phytochemicals(29), suggesting a potential dual. action to simultaneously improve host immunity while targeting viral proteins to reduce the severity of the infection. Such multiple actions and sites of action, are a key strength of plant derived phytochemicals, particularly given the ability of the viral genome to mutate so rapidly and outpace our ability to develop and distribute effective new vaccines on an ongoing basis.

The common weed ribwort (Plantago lanceolata), can be safely taken as a tea or in herbal products, regarded as a tonic and food for mucous membranes, while having additional expectorant and anti-inflammatory properties(30). In sufficiently high doses, it can also act as a wonderful natural decongestant.

Other useful herbs for upper respiratory tract support include peppermint, elderflower and yarrow, all of which are easily grown in our country, and are available in various forms. The warming and sometimes diaphoretic (sweat inducing) properties of these particularly when drunk as dried or fresh herb infusions, and their traditional uses for infections such as colds, influenza and other viral infections, inflammation and fevers for many centuries, make them also worthy of use.

Apart from Echinacea, I’m now making sure I have plenty of these various herbs and products made from them, in my own medicine cabinet at home.  Given omicron’s affinity to affect the upper rather than lower respiratory tract, I think they will be at least as useful as cough syrups for most people who contract this virus. That’s not to say that we wont also need these, as lung infections will still occur.

To summarise, as well as stocking up on drugs such as paracetamol and ibuprofen, coffee, toilet paper and disinfectant, there’s a lot we can do in terms of increasing our intake of certain dietary herbs and spices, and quite a number of different medicinal herbal products out there for which there is compelling evidence that they can help get us through the forthcoming omicron outbreak in Aotearoa.

Based upon their powerful tradition and strong scientific basis, I urge everyone to incorporate effective plant medicine in addition to other measures to help soften the impact of the forthcoming outbreak of the omicron variant of Covid-19, and other potential respiratory tract infections this autumn and winter.


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