Omicron outbreak: questions remain but there could be ‘silver lining’
Much has been learnt about the latest coronavirus variant, but a lot remains to be discovered
A little more than two weeks since Omicron’s discovery a lot has been learnt about the latest coronavirus variant. A lot remains to be discovered.
Early data from SA, the epicentre so far, shows that the virus appears to spread far faster than earlier strains but also does not appear to be causing severe disease.
Nothing is definitive yet, so the world is still somewhat in the dark. With Omicron cases doubling every few days in the UK and spreading in other places, policymakers and investors are grasping at any clues.
They had been moving towards the end of year with a little hope that the Covid era was shifting into a newer, more manageable phase.
But now it’s not clear yet if 2022 will succeed where 2021 has been defeated: suppress the spread of the virus enough to stop the rolling infection waves and finally end social restrictions.
Initial lab studies indicate Omicron is much more transmissible than even Delta, the strain that spread rapidly across the globe, filling hospitals and boosting death rates. They also show that it can infect the vaccinated or those who have already been ill with Covid-19.
What’s not known yet is how it developed, and whether it will cause more severe disease in countries with older populations than SA. Also unclear is if it can outcompete Delta in places where that version is dominant now, such as Europe and the US. New cases in SA, following a severe Delta-led third wave, were negligible for weeks before Omicron’s unwelcome emergence.
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said this week that information so far points to a less severe mutation.
“The big challenge we’re going to have is confirming that over the next two weeks,” he said on his Osterhom Update podcast. “From there, then we can figure out what does it mean in terms of the next leg of the pandemic for the world.”
This is what we know so far:
How fast is Omicron spreading?
- In Gauteng, where SA’s outbreak is centred, the reproduction rate — how fast the virus spreads — is over 3. That’s the highest it’s been and means that every infected person on average infects three more.
- Cases in SA are rising at a near-record pace, and the rate of increase has outstripped SA’s three earlier waves.
- Omicron is 4.2 times more transmissible than Delta, according to a study in Japan.
- The mutated virus may be spreading faster in England than in SA, with UK cases possibly topping 60,000 a day by Christmas, according to epidemiologist John Edmunds. On Friday, the UK reported almost 58,200 cases.
How severe are infections?
- With the outbreak just a few weeks old it’s too early to tell definitively, but doctors have reported patients with fatigue and headaches and little more. That’s a big contrast to Delta’s racing pulse rates and respiratory problems.
- SA’s three biggest private hospital operators say cases are much milder than in earlier waves. There are few people on oxygen or ventilators and only a slight uptick in deaths.
- There are now about 5,000 people with Covid in SA hospitals, a quarter of the peaks seen in the previous two waves.
Does it affect children differently from earlier variants?
- Initial hospital admissions in SA saw a higher number of children under the age of five than previously.
- Still, most only stay in hospital for a short time, and health minister Joe Phaahla says there are no reports of respiratory complications.
Do vaccines work?
Yes and no
- The Africa Health Research Institute was the first to isolate the virus and test it against Pfizer’s shot. Omicron is able to largely, but not completely, evade the antibodies generated in response to the inoculation, the research showed. Pfizer’s own study backed that up.
- But data from hospitals in the municipal area of Tshwane presented on December 3 showed that 68% of coronavirus hospital admissions were in people under 40. That compares with individuals over 50 accounting for 66.1% of hospital admissions during the first weeks of the third wave. South Africans over 60 are about twice as likely to have been vaccinated than those under 34.
Where did it come from?
There are three theories.
- The first is the virus mutated in someone who was immunosuppressed and harboured the pathogen for a long time, allowing it to change and then infect others. SA has 8.2-million people carrying HIV, which causes the immune system disease Aids.
- The second is that the coronavirus crossed back into an animal, mutated, and then reinfected a human.
- The third is that it developed by circulating somewhere with little genetic sequencing and not much access to health care. It was then picked up in SA, where sequencing of samples is comparatively common. Some of the world’s weakest health systems are in Africa.
So where to from here?
Depends who you listen to.
- Richard Friedland, the CEO of SA’s biggest private hospital group, Netcare, is optimistic. “I actually think there is a silver lining here and this may signal the end of Covid-19, with it attenuating itself to such an extent that it’s highly contagious, but doesn’t cause severe disease,” he said. “It’s early days, but I’m less panicked. It feels different to me on the ground.”
- The World Health Organisation is remaining cautious for now given so many unknowns, and the concern that any variant is a risk. “If they’re allowed to spread unchecked, even though they’re not individually more virulent or more lethal, they generate more cases, put pressure on the health system and more people die,” said Mike Ryan, executive director of the WHO emergencies programme. “We should hope for the best outcome, but in this particular case, hope is not a strategy. We need to be very careful on making any final determinations on severity.”
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