The threat posed by Omicron is tenuous and it will still be a few weeks before a comprehensive understanding of it emerges, but what is known unambiguously is that this latest variant of the coronavirus is extremely infectious. Nearly 50 countries now have reported its presence within their borders but insight into its effects is available only from South Africa . A preliminary analysis of patients in Tshwane district, in Gauteng Province of South Africa, which has been the global epicentre of the Omicron-led fourth wave, suggests that despite its infectiousness, Omicron is less deadly than other variants that have led the country’s previous three waves. When 166 new admissions were analysed, there were 10 deaths in the past two weeks, making up 6.6% of the 166 admissions. By comparison, the death rates in previous waves ranged from 17%-23%. The major caveat, as scientists who are part of the South African Medical Research Council point out, is that patterns could rapidly change in the next two weeks as it takes nearly a month for infection to reveal its worst-case outcome of death, and so the current data of two weeks are insufficient. Trends in hospitalisation too are encouraging, the scientists say.
Finally, the third piece is that an overwhelmingly large number of those needing intensive care were unvaccinated. Of 38 adults in the COVID wards, six were vaccinated, 24 were unvaccinated and eight had unknown vaccination status. Of nine patients with COVID pneumonia, eight are unvaccinated. Therefore, the prevalent wisdom that despite being highly infectious, vaccination — it is not clear if those in the wards were fully or partially vaccinated — significantly protected against disease and death. But vaccination trends in South Africa are not encouraging. Only about 30% of the country has had one dose and only 25% fully vaccinated. Reports have suggested that the South African government has actually had to delay vaccination because it claimed it had “too much stock”, underlining that problems of vaccine hesitancy or easy access for the greater part of the population was a challenge. As observed in previous waves, the first line of defence — or neutralising antibodies produced as a result of a prior infection or vaccination — was significantly reduced when confronted with the Beta or Delta variants. The same appears to be the case with Omicron, but the second line of defence, or cellular immunity, continues to be effective from the extant evidence. Hence, the lesson for the world continues to be that rather than focus on the novelty of Omicron, it is wiser to double up on efforts to completely vaccinate people and then, based on the evidence, consider booster or subsequent doses.
