Omicron might not be that bad after all

Travel bans, renewed fears of harsh lockdowns and concerns of worse to come have greeted the identification of the new Covid-19 variant, along with some anger directed at scientists and countries accused of acting impulsively and prematurely.

Now, a few weeks later, the question arises: Is Omicron worse than the earlier variants?

The World Health Organisation (WHO) designated Omicron as a “variant of concern” a few days after its discovery, and noted in a statement on November 26 that it was not yet clear if this variant is more transmissible, is more severe, or if there is an increased risk of reinfection in people who have previously had Covid-19.

The WHO statement did not mention the other fear, that of whether existing vaccines are effective against Omicron.

“Researchers in South Africa and around the world are conducting studies to better understand many aspects of Omicron and will continue to share the findings of these studies as they become available,” it said.

“Preliminary data suggests that there are increasing rates of hospitalisation in South Africa, but this may be due to increasing overall numbers of people becoming infected, rather than a result of specific infection with Omicron. There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants.

“Initial reported infections were among university students – younger individuals who tend to have more mild disease – but understanding the level of severity of the Omicron variant will take days to several weeks,” the WHO pointed out at the time.

Current situation

It is telling that the two leading private hospital groups in SA both published statements to report their real-life experiences with regard to hospitalisation and, in particular, with regards to Omicron.

“Having personally seen many of our patients across our Gauteng hospitals, their symptoms are far milder than anything we experienced during the first three waves,” states Netcare CEO Dr Richard Friedland.

“Approximately 90% of Covid-19 patients currently in our hospitals require no form of oxygen therapy and are considered incidental cases. While we fully recognise that it is still early days, if this trend continues, it would appear that with a few exceptions of those requiring tertiary care, the fourth wave can be adequately treated at a primary care level.”

One cannot disregard the importance of Friedland’s statement – he is putting his reputation on the line.

Read: Netcare seeks digital expansion as Covid-19 pressure eases

Netcare found that there seems to be a possible decoupling of the rate of community transmission and the rate of hospital admissions, meaning that fewer people end up in hospital than the official infection figures might suggest.

Latest figures from the Department of Health show that 19.83 million tests have been conducted to date in SA, of which 3.05 million tested positive for Covid-19. Most recovered (2.86 million) and some 90 000 people have died to date.

Netcare says experience has shown that during the first three waves, the rate of hospital admissions rose in tandem with the rate of community transmission (the number of people testing positive).

Friedland notes that in the first three waves of the pandemic Netcare treated 126 000 Covid-19 patients across its 49 acute hospitals, with 55 000 (44%) patients requiring admission and 26% of these patients being treated in high care and intensive care units (ICUs).

“Significantly, all Covid -19 patients admitted [then] were sick and required some form of oxygen therapy. The high admission rate, as well as the high percentage of patients requiring ICU or high care is indicative of the severity of cases during the first three waves,” he says.

Read: Fourth wave sees daily Covid-19 infections increase five-fold

“As of today [Wednesday, December 8], we have 337 Covid-19 positive patients admitted [72% of these patients are in the Gauteng area and 18% in KwaZulu-Natal]. Of these patients approximately 10% [33] are on some form of oxygenation versus 100% in the first three waves.

“Eight of these patients [2%] are being ventilated and of these, two are primary trauma cases that are also Covid-19 positive,” says Friedland.

Netcare’s policy is to test all patients for the virus before or on admission. Patients admitted for other primary diagnoses or surgical procedures who test positive for Covid-19, but do not require any form of oxygenation, are considered to be incidental Covid-19 cases.

Currently 90% of Covid-19 cases in Netcare hospitals are considered incidental.

“The very rapid rise in community transmission as compared to previous waves may partially explain this relatively low hospital admission rate. However, there does appear to be a decoupling in terms of the rate of hospital admissions at this early stage in the evolution of the fourth wave,” says Friedland.

He makes another startling statement: “Of the total of 800 Covid-19 positive patients that were admitted since 15 November, 75% of patients were unvaccinated.”

Mediclinic

The Mediclinic group says in a statement that its data shows that a fourth wave has started in Gauteng and is moving into the Western Cape.

“The current wave has not yet had a marked impact on our facilities within these regions. At this time, we are seeing more cases coming through to our emergency centres, but only a few require admission for further care.

“The patient profile for this wave includes younger patients and children under 12 years, which is significant in comparison to the previous three waves. These younger patients are overall not critically ill,” adds Mediclinic.

“We are also noting a number of asymptomatic patients, who were identified through testing on admission for other non-related procedures,” says Dr Gerrit De Villiers, chief clinical officer of Mediclinic Southern Africa.

He adds that, to date, there is insufficient information to understand the potential impact of the new Omicron variant on the severity of infections in the country.

Read: Mediclinic emerges stronger from pandemic

“We are currently aware that it appears to be highly transmissible, leading to a big increase in numbers, but are unable to provide further evidence yet on the severity or impact on the individual.

“So far, a lower percentage of admitted Covid-19 patients required intensive care and ventilation,” says De Villiers.

Both Mediclinic and Netcare stress the importance of people taking care of themselves, once again repeating the message of social distancing, wearing a mask, getting fresh air, exercising good hygiene, and vaccination.

Hopefully sharing the real data will also reduce illogical reactions and hysterics.