Scientists searching for the source of Omicron suspect it originated in someone whose immune system was already weakened by a severe disease such as HIV or cancer.
The idea that the emergence of new Covid variants such as Omicron could be linked, in some cases, to mutations taking place inside immunosuppressed people was described as a highly plausible hypothesis .
Immunosuppressed people who might have hosted Omicron or other new variants include those with diabetes, auto-immune diseases, chronic TB, hunger, and obesity.
That is because the virus can linger for months in some of these patients compared to a few weeks for most people as their immune systems are too weak to combat it.
During this prolonged stay the virus can replicate itself over and over again. Occasionally, an error occurs during the viruss copying process, which is how a mutation is created. Most disappear but occasionally they can lead to a new variant.
The longer a virus stays inside a person, the greater the risk of generating a game-changing mutation.
One woman in South Africa continued to test positive for Covid-19 for nearly eight months earlier this year, while the virus underwent more than 30 genetic mutations.
She is thought to be one of around 10 to 15 such cases of ultra-high mutations in the world, including the UK.
Its a very rare event. But it is a plausible explanation that individuals that are immuno-suppressed can basically be a source of virus evolution, Professor Tulio de Oliveira, head of the team at South Africas Centre for Epidemic Response and Innovation, which discovered Omicron, told the BBC.
Keen to avoid stigmatising HIV patients, scientists point out that there is no evidence yet to suggest a link between the condition and Omicron. Instead, they are making a more general point about weakened immune systems and an increased risk of mutations.
They stress that anti-retroviral medication does restore the immunity of HIV patients, and say that the lingering cases occur in patients who are HIV positive but who have not been taken their medication, for various reasons.
The emergence of the Alpha variant has been linked to a patient receiving treatment for cancer in the UK, Professor Oliveira noted.
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