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Thursday, January 27, 2022

New Omicron variant is causing mild disease -South African Medical Research Council

Health New Omicron variant is causing mild disease -South African Medical Research Council

A key question regarding the new Omicron outbreak is whether disease severity is similar, milder or more severe than with the other variants, given the large number of Omicron mutations.

Upon conducting a clinical profile on patient admissions associated with the Omicron variant in the Gauteng province, the South African Medical Research Council (SAMRC) has said the Omicron outbreak has not presented with the severe outcomes seen during the other waves.

In a report the SAMRC said the main observation that they have made over the last two weeks is that the majority of patients in the COVID wards have not been oxygen dependent. SARS-CoV-2 has been an incidental finding in patients that were admitted to the hospital for other medical, surgical or obstetric reason.Therefore the SARS-CoV-2 positivity is an incidental finding in these patients and is largely driven by hospital policy requiring testing of all patients requiring admission to the hospital.The exponential increase in the positivity rate in these patients is a reflection of the rapidly increased case rate for Tshwane but does not appear to be associated with a concomitant increase in the rate of admissions for severe COVID (pneumonia) based on the high proportion of patients not requiring supplemental oxygen.

This is a picture that has not been seen in previous waves. In the beginning of all three previous waves and throughout the course of these waves, there has always only been a sprinkling of patients on room air in the COVID ward and these patients have usually been in the recovery phase waiting for the resolution of a co-morbidity prior to discharge. The COVID ward was recognizable by the majority of patients being on some form of oxygen supplementation with the incessant sound of high flow nasal oxygen machines, or beeping ventilator alarms.

The relatively low number of COVID-19 pneumonia hospitalizations in the general, high care and ICU wards constitutes a very different picture compared to the beginning of previous waves. A detailed analysis comparing the current picture with previous waves is still being conducted. This may very well be related to the early upswing of the fourth wave, with the more classical pattern becoming evident over the next two weeks. What is clear though is that the age profile is different from previous waves. It may be that this is a vaccination effect as 57 % of people over the age of 50 have been vaccinated in the province compared to 34% in the 18-to-49-year group.The high proportion of COVID incidental adult patients and the increased number of SARS-CoV-2 positive admissions among children aged 0-9 may reflect higher rates of community transmission compared to previous waves (variants) that is not translating into higher admission rates for a primary COVID-19 diagnosis. More time is required to fully answer the questions about the severity of COVID-19 caused by the new Omicron Variant.

The trend over the next two weeks will be clarified as the number of deaths is currently low, and sufficient time will have elapsed for the development of greater severity of disease and the number of deaths might be expected to increase. For now, the death rates over the last two weeks as well as over the past 18 months at the Steve Biko/Tswane District Hospital Complex are lower than the overall in-hospital death rate of 23% for the country over all previous waves, as reported by the National Institute for Communicable Diseases(NCID).

A significant early finding in the analysis is the much shorter average length of stay of 2.8 days for SARS-CoV-2 positive patients admitted to the COVID wards over the last two weeks compared to an average length of stay of 8.5 days for the past 18 months. The NICD reports a similar shorter length of stay for all hospitals in Tshwane in its weekly report. It is also less than the Gauteng or National average length of stay reported by the NCID in previous waves.

The South African Medical Research council however said it is essential to recognize that the patient information they presented only represents the first two weeks of the Omicron wave in Tshwane. The clinical profile of admitted patients could change significantly over the next two weeks, by which time they can draw conclusions about the severity of disease with greater precision.

Source:SAMRC News

5 COMMENTS

  1. This is what’s lacking with our Zambian scientists, they don’t say anything about their observation of patients and statistics. In the last 3rd Wave it was shocking to learn that most of the people that died in health facilities were due to a lack of care and not the disease. The revelations by a private nurse that was hired by a family to nurse their patient should have called for an enquiry. She explained how some patients were begging for things like water with no one to assist them. Relatives weren’t allowed in those centers and govt workers were nowhere to be seen, the so called front-line workers! Some foods delivered went stale without being given to the patients. What kind of nation are we?

  2. Doesn’t mean you are free to have unprotected $ex.
    I like that !! Instead of some of the trash being posted on here
    Humor is the best medicine

  3. This shows that the so called developed nations are alarmists and do not have Africa’s interest at heart.(BUT we know this already!) We should come up with own protocols relevant to our context and clinical patterns. USA has over 100 000 covid daily cases when are we putting them on our restricted travel list?

  4. The real issue is that the big boys in the global pharmacetical industry were jealousy about SA independent work on sequencing the Omicron virus. They saw a potential future competition from SA in the development of COVID 19 drugs and vaccines. So SA had to be punished for this to discourage it from such threats on the status quo. They think 90% business and 10% politics. Africa is pre-occupied with 90% politics and 10% business.

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