Sikhulile Moyo led the team of scientists that first identified the omicron variant of COVID-19 in November 2021. It's gone on to dominate the world. Moyo directs the laboratory for the Botswana–Harvard AIDS Institute and is a research associate with the Harvard School of Public Health.
Moyo was disturbed to see the world's reaction to the more transmissible variant. Other nations closed off travel and trade with southern African countries, including Botswana, even as they discovered the variant was already within their own borders. In fact, it was subsequently found that the variant was circulating in the Netherlands a week before the announcement from Africa.
"How do you reward the countries that alert you of a potential dangerous pathogen with travel bans? My country was put on a red list, and I didn't feel good about that," Moyo told NPR.
NPR touched base with Moyo to see what he's been working on – and thinking about – since this landmark discovery.
This interview has been edited for length and clarity.
You discovered omicron. Did omicron discover you?
I got COVID. Funnily enough, the omicron discoverer gets omicron.
I had three days of very serious symptoms of COVID, and I had to stay at home. So I would say mild to severe, but not too severe.
Then I had long COVID. I had almost three months of difficulty trying to recover my lung volume, my breathing. Walking, I was fatigued. All of a sudden, the COVID made my [blood] sugar worse, and I had to change my diabetes doses. I had to step up my meds, because it was no longer controlling [my diabetes] the way it was.
These are the complications that come with COVID, while people think COVID is gone.
Do you think the world has made any progress in learning not to cast blame?
There was a global awakening. Those events around the omicron discovery showed us the triumph of science but the failure of global health policy.
While we suffered, we were a catalyst to make people aware of the value of global public health — that we cannot be inward-looking, because the virus knows no borders.
You see the response to monkeypox is different than the response to COVID. No one is blacklisting anyone from the monkeypox-endemic areas.
Has your work changed because of this discovery — are you and your lab collaborating more with scientists around the world?
Yes! We have established collaborations with the Africa CDC. We've established what is called the Pathogen Genomics Initiative, a network of labs that are working together, and we have a lot of demand for training.
I was named one of the TIME magazine's 100 most influential people of 2022. That gives us a voice to share our experiences but also access to a lot of collaborations that I never thought I would have. That is really pushing us forward.
Have you made more ground-breaking omicron discoveries?
Earlier this year, around April, May, there was the discovery of BA.4 and BA.5, and we detected them in Botswana a few days after South Africa detected them. And these are the variants that have taken over the world. Some of the questions have been: What's happening in southern Africa that [the region] is seemingly detecting more variants?
What is unique about southern Africa, especially Botswana and South Africa, is the ability to detect these variants in near real-time because of the pathogen genomic sequencing that has been established [examining DNA to identify it or see if it's changing]. We think it's not that they are not circulating elsewhere, but it's just that maybe we are looking deeper.
We are always doing pathogen genomic sequencing. The most resourced in the world, in terms of sequencing, is of course the U.K. and the United States, and many parts of Europe. But I think the systematic, real-time, sampling and sequencing [in southern Africa] has been very, very useful.
How has southern Africa become so good at finding new variants and subvariants?
Southern Africa was the hotspot for HIV. We have passed through difficult times. I think we have taken this to our advantage to find solutions for ourselves. With funding — from PEPFAR and from other international agencies, U.S. institutes, some donors — southern Africa began to implement pathogen genomics focusing on HIV.
Some of us were involved in setting up population-based sequencing to understand the movement of viruses, to characterize transmission dynamics — and that has spilled out to malaria, to TB. And we used those technologies to quickly adapt to SARS-CoV-2. That has been the strength of southern Africa.
We're even thinking beyond COVID. We are preparing ourselves to be able to adapt for pathogen discovery. If a [new] outbreak happens, we should be able to quickly check within 24 to 36 hours what it is.
New subvariants seem to be getting better at reinfecting people. What does that mean moving forward?
BA.4 and BA.5 are masters in terms of evading the fury of the immune system. The subvariants were able to elicit an immune response, but magnitudes lower than what we saw before.
As the immunity wanes down, that's where my worry is: How far can we hold on with the current levels of immunity?
The vaccine immunity still provides some protection against severe disease. We know that you may get infected, but you may not get hospitalized with BA.4 and BA.5.
It may get a little bit rough. Many people are spending days at home and [developing] long COVID afterward.
What do you think needs to happen next?
Research, training and development cost a lot of money, but as cases go down, people forget that we need to make sure these systems are sustained. That's one of the challenges: Are we going to be able to sustain some of this innovation that we have developed over a very difficult time of our lives during COVID?
The virus is still finding some pathways to escape immune pressure.
And there's always a possibility of a more virulent variant?
The variant that is going to really dominate is a variant that would have a massive escape to antibody neutralization or to vaccine neutralization. Chances are low of that happening. But omicron taught us that anything can happen.
So we need to be very careful. We need to continue with surveillance, so that if we notice anything, we should be able to go back and say: Do we need to change the way we are doing things?
While I support loosening and going back to our lives [when cases are low], I also feel that's when you need to be more vigilant. When you see signs of wildfire starting, then you can try and put it out.
Melody Schreiber (@m_scribe) is a journalist and the editor of What We Didn't Expect: Personal Stories About Premature Birth.