Initial data from a major hospital complex in South Africa’s omicron epicenter show that while COVID-19 case numbers have surged, patients need less medical intervention.
The Steve Biko and Tshwane District Hospital Complex in Pretoria had 166 new admissions between Nov. 14 and Nov. 29, with 42 patients currently in the COVID-19 wards, according to a report showing the early experience of patients at the hospital group. Most originally sought treatment for ailments unrelated to the coronavirus and were discovered to have it in testing required for admission.
This only represents the first two weeks of the omicron wave in Tshwane and the “clinical profile of admitted patients could change significantly over the next two weeks,” said the paper’s author Fareed Abdullah, a director of the South African Medical Research Council and an infectious disease doctor at the Steve Biko hospital. The report has not been peer reviewed.
While the National Institute for Communicable Diseases has confirmed that almost all new cases in the epicenter are the variant, Abdullah and his team were not able to establish that in every instance the variant is omicron. Even so, a “reasonable assumption is being made that the cases” in this data represent infection with the new variant, Abdullah said.
Main observations include:
- Most patients in the Covid wards have not been oxygen dependent — a departure from previous waves.
- Of 38 adults in the Covid wards on Dec. 2, six were vaccinated, 24 were unvaccinated and eight had unknown vaccination status.
- Only a single patient on oxygen was fully vaccinated, but the intervention was required to treat chronic obstructive pulmonary disease.
- Two were admitted to intensive care within the past two weeks, but neither with a primary diagnosis of Covid pneumonia.
- No fewer than 80% of admissions were younger than 59. Some 19% were children up to 9, and 28% were patients age 30 to 39.
- Pediatric Covid wards reported no deaths over the last two weeks. Children accounted for 17% of the deaths over the previous 18 months
- Ten of the patients died, or 6.6%, though it hasn’t been determined that omicron was the cause The number of deaths may increase.
- The trend will become clearer over the next two weeks — enough time to see if the cases worsen.
- Average length of stay in Covid wards was 2.8 days versus 8.5 days for the past 18 months.
Separately on Sunday, top U.S. pandemic adviser Anthony Fauci said that early indications of the severity of the omicron variant are “a bit encouraging,” while cautioning more information was still needed.
“Omicron has a transmission advantage” in South Africa, Fauci said in a CNN interview, noting the country had a low level of cases before it saw “almost a vertical spike upwards, which is almost exclusively omicron.”
“Though it’s too early to really make any definitive statements about it, thus far, it does not look like there’s a great degree of severity to it,” he said.
“Thus far, the signals are a bit encouraging.”
Medical experts have in recent days underscored that the South African population skews young and that more severe cases could emerge in the coming weeks.
Lab tests are under way to determine whether omicron — a heavily mutated strain of the virus — is more transmissible than other strains, resistant to immunity from vaccination and infection or more severe, with results expected within weeks.
“I think that there’s a real risk that we’re going to see a decrease in effectiveness of the vaccines,” Stephen Hoge, president of vaccine producer Moderna, told ABC.
“What I don’t know is how substantial that is,” he added. “Is it going to be the kind of thing that we saw with the delta variant, which is, ultimately vaccines were still effective, or are we going to see something like a 50% decrease in efficacy, which would mean we need to reboot the vaccines.”
Moderna, like other pharmaceutical companies, including Pfizer, has already started work to adapt their vaccines if necessary.
Cases of the omicron variant have so far been confirmed in some 40 countries.
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