Early reports from Omicron indicate disease may be less severe

JOHANNESBURG – The Covid-19 virus is spreading faster than ever in South Africa, the country’s president said on Monday, an indication of how the new Omicron variant is causing the pandemic, but there is has early indications that Omicron may cause less severe illness than other forms of the virus.

Researchers at a large Pretoria hospital complex have reported that their coronavirus patients are much less sick than those they have treated before, and that other hospitals are seeing the same trends. In fact, they said, most of their infected patients have been admitted for other reasons and show no symptoms of Covid.

But scientists have cautioned against placing too much stock either in the lesser potential good news or bad news as the first evidence that a previous coronavirus infection offers little immunity to Omicron. The variant was only discovered last month, and more studies are needed before experts can say more with confidence. Beyond that, the true impact of the coronavirus is not always felt immediately, with hospitalizations and deaths often lagging far behind the initial outbreaks.

Dr Emily S. Gurley, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said of the signs that the variant is less severe: “It wouldn’t be shocking if it’s true, but I’m not sure. that we can conclude for the moment. . “

In the absence of more concrete information, governments reacted to Omicron with strict restrictions on international travel and new vaccination requirements. World leaders who have been accused of reacting too slowly or too weakly earlier in the pandemic are eager to be seen as taking action, though some experts question whether travel restrictions are an overreaction.

The variant has spread rapidly and has been detected in more than 30 countries on six continents so far. Health officials and researchers say it may be the most contagious form of the virus yet, and may soon replace the Delta variant that emerged last year as the predominant form. This has fueled fears that a world eager to emerge from two years of pandemic hardship is heading into another cycle of disease, lockdown and economic suffering.

In Europe, as in South Africa, there are early indications that cases of Omicron can be quite mild, if they are easy to contract.

In Britain, the government said on Monday the number of Omicron cases there rose to 336, two and a half times more than on Friday. Denmark reported 261 cases, quadruple the number on Friday, and local media there reported that a high school holiday lunch may have been a superspreader event, with dozens of people catching the new variant.

Britain and Denmark perform an unusually large amount of genomic sequencing of virus samples, to distinguish one variant from another and detect changes, suggesting that many cases of Omicron in other countries do not. are simply not detected.

On Monday, the United States began requiring international travelers arriving in the country to provide proof of a negative coronavirus test taken no earlier than the day before departure, a standard that can be difficult to meet. Previously, fully vaccinated travelers could show negative test results up to 72 hours before departure.

China, a major part of the global travel and tourism economy, has announced that to maintain its zero Covid approach, it will keep international flights at 2.2% of pre-Covid levels during the winter. Since August, it has almost entirely stopped issuing new passports, and it is forcing travelers who arrive to quarantine themselves for 14 days and provide numerous documents and several virus tests.

In South Africa, where scientists say Omicron is already dominant, the pandemic is on the move. A month ago, South Africa had less than 300 new cases of the virus per day; on Friday and again on Saturday the figure was over 16,000. It declined somewhat on Sunday and Monday, but this may be due to a gear lag often seen on weekends.

“As the country heads for a fourth wave of Covid-19 infections, we are experiencing a rate of infections that we have not seen since the start of the pandemic,” President Cyril Ramaphosa wrote in a statement . open letter to the country. He added: “Almost a quarter of all Covid-19 tests now come back positive. Compare that to two weeks ago, when the proportion of positive tests was around 2%. “

A report published this weekend doctors from Steve Biko Academic and the Tshwane District Hospital Complex in Pretoria, the administrative capital of South Africa, offer the strongest support yet for a more optimistic view of Omicron, although its author, Dr Fareed Abdullah, gave reasons to be wary of drawing conclusions.

Dr Abdullah, director of the Office of HIV / AIDS and Tuberculosis Research at the South African Medical Research Council, examined the 42 coronavirus patients who were in hospital last Thursday and found that 29 of them they, 70%, breathed ordinary air. Of the 13 using supplemental oxygen, four had it for reasons unrelated to Covid.

Only one of the 42 patients was in intensive care, according to figures released last week by the National Institute of Communicable Diseases, showing that only 106 patients were in intensive care in the previous two weeks, despite the surge in infections.

Most of the patients were admitted “for diagnoses unrelated to Covid-19,” the report says, and their infection “is a fortuitous discovery in these patients and is largely driven by hospital policy requiring screening of all patients” . He said two other major hospitals in Gauteng province, which include Pretoria and Johannesburg, had even lower percentages of infected patients needing oxygen.

Dr Abdullah said in an interview that he walked into a Covid ward and found an unrecognizable scene from the previous phases of the pandemic, when it was said to have been full of buzzing and beeping oxygen machines.

“Of 17 patients, four were on oxygen,” he said. “It’s not in a Covid service for me, it’s like a normal service.”

Dr Gurley, of Johns Hopkins, noted that the severity of the disease reflects not only the variant, but also who it infects. Two years after the start of the pandemic, many more people have some level of immunity to the virus through vaccination, natural infection, or both, and this could translate into milder cases.

“We don’t know how to read the genetic sequences to tell exactly how this variant will play out,” she said. “We are now getting more information from South Africa, which is a particular population with a particular profile of pre-existing immunity.”

Dr Maria D. van Kerkhove, World Health Organization technical officer for Covid, told CBS News on Sunday that even if a lower percentage of Omicron cases turn out to be serious, it could be offset by more cases, which means more hospitalizations and deaths.

Dr Abdullah also examined the 166 coronavirus patients who were admitted to the Biko-Tshwane complex between November 14 and 29, and found that their average hospital stay was only 2.8 days. and that less than 7% died. Over the past 18 months, the average stay for these patients was 8.5 days and 17 percent died. Shorter stays would mean less pressure on hospitals.

Eighty percent of the 166 patients were under 50, and similar numbers were reported across Gauteng – a stark contrast to previous cohorts of hospitalized Covid patients, who were typically older. This could be because South Africa has a relatively high vaccination rate among people over 50 and a low rate among young people, but one of the big unknowns regarding Omicron is whether existing vaccines provide strong protection against it.

Part of the caution in interpreting Dr Abdullah’s report is that the numbers are low, the results have not been peer reviewed, and he does not know how many patients have had Omicron, as opposed to others. variants of the coronavirus – although the government reported last week that it already made up three-quarters of the virus samples in South Africa.

Dr Abdullah recognized these drawbacks and noted that there could be a lag between the first appearance of Omicron and an increase in serious illness and death. But so far, despite the huge increase in cases, Covid deaths have not increased in South Africa.

Lynsey chutel reported from Johannesburg, and Richard Perez Peña and Emilie Anthès from New York. The report was provided by Megan specia, Isabelle Kwai, Sui-lee wee, Juston jones and Jenny gross.

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