Omicron: Cases may have peaked, says top doctor, as studies show variant causing fewer hospitalisations

One of the first doctors to identify Omicron has said cases already look to be falling as new studies show a “dramatic uncoupling” in hospitalisations.

The doctor who was one of the first to bring the world’s attention to the Omicron strain of Covid-19 has said that South Africa is now “over the curve” of new cases.

The comments come as two studies from South Africa have found that fewer people are becoming seriously ill with Omicron compared to Delta and other variants.

One study showed there had been a “dramatic uncoupling of hospitalisation” among those with Omicron. Rates were just 29 per cent of the amount of those with Delta.

However, rather than Omicron being milder, the large numbers of people who have either been vaccinated or infected with Covid-19 could be weakening its effects.

Cases in South Africa apparently falling

Covid-19 cases in South Africa, where Omicron was first identified, remain far above where they were one month ago.

On November 20, the seven-day rolling average of daily cases in the country of 60 million was 500. It’s now averaging 20,000 a day.

However for the last six days the number of new infections has been falling. The peak of individual, non-averaged out daily case numbers was December 12 when almost 38,000 new infections were reported. Yesterday just 8500 new daily cases occurred.

The seven-day average of deaths is now 44, compared to 14 a month ago. That’s far below a peak of 400 daily deaths during the Delta wave.

“What we currently see is our cases, we’re over the curve,” South African Medical Association chair Dr Angelique Coetzee told CNN.

“It’s sort of coming down. In Gauteng (the province which includes the large cities of Johannesburg and Pretoria) – which was the epicentre – the numbers are much lower.”

Dr Coetzee said most patients were being treated with cortisone and ibuprofen to help with muscle pains and headaches.

“That’s what we give. There’s nothing else. There’s no oxygen.”

Dr Coetzee was one of the first to issue an alert about Omicron when she treated a family of four with extreme fatigue who then tested positive to the virus.

But from the moment it was identified, Dr Coetzee has said her observations were that Omicron was “mild”.

“Their symptoms were so different and so mild from those I had treated before,” she told the UK’s Telegraph.

“It presents mild disease with symptoms being sore muscles and tiredness for a day or two [and] not feeling well,” Dr Coetzee said.

It’s been a controversial call with many epidemiologists saying it’s too early to make that assumption.

‘Dramatic uncoupling of hospitalisations’

A study by the UK’s Imperial College, released late last week, found “no evidence” Omicron was less severe than Delta.

However, the academics pointed out that data on the severity of Omicron was still extremely limited with only 24 people in the study suspected of being hospitalised with the strain.

Two new studies have emerged from South Africa this week, and have stated that hospitalisations in those people with Omicron are indeed far lower.

Neither study is peer reviewed, nor was the Imperial College paper.

A study led by Dr Shabir Madhi, a professor of vaccinology at Johannesburg’s University of Witwatersrand, surveyed more than 7000 individuals in Gauteng province to check for infection with Covid-19.

“Epidemiological data showed SARS-CoV-2 infection rates increased more rapidly than in previous waves but have now plateaued,” the paper stated.

“Rates of hospitalisations and excess deaths did not increase proportionately, remaining relatively low.”

The survey found that in some areas 89 per cent of residents tested had likely either been infected with Covid-19 or had received a vaccination.

“We have observed a dramatic uncoupling of hospitalisation and death rates from infection rate compared with previous waves,” the paper said.

“We have seen a high Covid-19 case rate due to the Omicron variant despite the high seropositivity rate for humeral immune responses, consistent with the Omicron variant being antibody-evasive.

“However, the peak hospitalisation rate in the current wave is 29 per cent of the peak in the Delta-dominant third (Delta) wave.”

Omicron not necessarily weaker

But rather than being inherently weaker, the reason for the uncoupling with Omicron was “possibly (due to) the extensive cell-mediated immunity in the population induced by previous natural infection and vaccination”.

A second study funded by the South African Medical Research Council and conducted by the country’s National Institute for Communicable Diseases looked at the clinical severity of Omicron.

It found that compared to earlier Delta infections those with Omicron had “lower odds of severe disease”.

“Some of this reduction is likely a result of high population immunity,” stated the study.

However the study also found that once hospitalised, clinical outcomes of those with Delta or Omicron were similar.

In Australia, modelling leaked yesterday from the Doherty Institute predicted the country could record up to 200,000 Covid-19 cases a day by late January.

Currently Omicron cases are rising in Australia with no sign yet, like in South Africa, that they will plateau and fall.

It assumed that “boosters alone will not be fast enough to halt the spread of Omicron”.

Fast-growing case numbers would lift hospitalisation rates to 4000 per day, which would push emergency departments to breaking point, while up to 10,000 patients could be admitted to intensive care.

However Prime Minister Scott Morrison downplayed the modelling’s forecast outcomes.

Talking on Wednesday, he said those numbers were an “extreme case scenario” and were based on the assumption that “no one exercises common sense”.

“We saw similar numbers at the start of the pandemic that were never realised,” he told Sunrise.

“The chief medical officer and I just want to assure people that those sorts of numbers are not what we expect. They are extreme scenarios.”

He urged Australians to get their booster shoots when they were due and to continue to wear masks indoors.

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