Omicron likely milder than Delta: South African doctors

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JOHANNESBURG – As the Omicron variant sweeps across South Africa, Dr. Unben Pillay sees dozens of patients daily. However, he did not have to send anyone to the hospital.

This is one reason why he, along with other doctors and medical experts, suspect that the omicron version actually causes milder COVID-19 than Delta, even if it appears to be spreading faster.

“They are able to manage the disease at home,” Pillay said of his patients. “Most of them recovered during the 10- to 14-day isolation period.” Bailey said.

This includes older patients and those with health problems that could make them more susceptible to serious illness from coronavirus infection, he said.

In the two weeks since omicron was first reported in South Africa, other doctors have shared similar stories. Everyone warns that it will take several more weeks to gather enough data to be sure, and their observations and early evidence provide some clues.

According to South Africa’s National Institute of Infectious Diseases:

  • Only about 30% of those hospitalized with COVID-19 in recent weeks became seriously ill, less than half the rate that occurred during the first weeks of previous pandemic waves.

  • Average hospital stays for COVID-19 were shorter this time around – about 2.8 days compared to 8 days.

  • Only 3% of recently hospitalized patients have died of COVID-19, versus about 20% in the country’s previous outbreaks.

“Right now, just about everything indicates it’s a milder disease,” said Willem Hanikum, director of the Africa Institute of Health Research, citing NIHR figures and other reports. “It’s early days, and we need to get the final data. Hospital admissions and deaths often happen later, and there’s only two weeks left on this wave.”

Meanwhile, scientists around the world are watching the number of cases and hospitalization rates, while testing to see how well existing vaccines and treatments will last. While Delta remains the dominant coronavirus strain worldwide, cases of Omicron have appeared in dozens of countries, with South Africa the epicenter of the earthquake.

Pillai practices in the country’s Gauteng province, where the Omicron version dominated. With a population of 16 million, it is the most populous province in South Africa and includes Johannesburg, its largest city, and the capital, Pretoria. Gauteng saw a 400% rise in new cases in the first week of December, and tests showed Omicron was responsible for more than 90% of them, according to health officials.

Pillay says his COVID-19 patients during the recent Delta wave “had difficulty breathing and low oxygen levels. Many of them required hospitalization within days,” he said. He said the patients he treats now have milder, flu-like symptoms, such as body aches and coughs.

Pillai is the director of an association representing about 5,000 general practitioners across South Africa, and his colleagues have documented similar observations about Omicron. Netcare, the largest private healthcare provider, is also reporting less severe cases of COVID-19.

But the number of cases is rising. South Africa confirmed 22,400 new cases on Thursday and 19,000 on Friday, up from about 200 a day a few weeks ago. Health Minister Joe Bhalla said on Friday that the new increase had infected 90,000 people in the past month.

“It’s Omicron that has led to the resurgence,” Bhalla said, citing studies that say 70% of new cases nationwide are from Omicron.

He said the coronavirus reproduction rate in the current wave – which indicates the number of people likely to be infected by one person – is 2.5, the highest rate South Africa has recorded during the pandemic.

“Because this is a transmissible variable, we’re seeing increases that we haven’t seen before,” Wassila Jasat, which tracks hospital data for the National Institute of Infectious Diseases, said.

Gassat said 86% of hospitalized patients in the current wave have not been vaccinated against the coronavirus. And COVID patients in South African hospitals are now younger than they were in other periods of the pandemic: about two-thirds of them are under the age of 40.

Jasat said that although early signs are that Omicron’s cases are less severe, the volume of new COVID-19 cases may still overwhelm South African hospitals and result in a greater number of severe symptoms and deaths.

“This is always the danger with the waves,” she said.


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