By DR AMIR KHAN | AL JAZEERA
■ Even if Omicron is milder than Delta, high transmissibility means three times more cases, hence more hospitalisations and deaths
■ If the public hold onto this ‘milder’ narrative, there is a risk that some people may become complacent … This will then result in further cases and eventually an increase in hospitalisations and deaths
(AL JAZEERA) — Globally, Omicron is becoming the most frustrating good news/bad news story of the moment. As we learn more about the coronavirus variant, the information and the risk it poses keeps changing. That is to be expected with any novel disease of course, but it is enough to put anyone’s head in a spin.
First, the good news… An Imperial College London study has backed up what South African clinicians have been saying since they broke the news in November, that there is much less likelihood of being hospitalised with an Omicron infection than from Delta.
The study looked at 325,000 people who tested positive for COVID-19 via a PCR test in England between December 1 and 14—56,000 cases of Omicron and 269,000 cases of Delta. It found that the risk of needing any hospital treatment was down by 20-25 percent with Omicron compared with Delta, but the need for an overnight hospital stay was down by 40-45 percent. For those included in the study who had not had the vaccine or previous infection, the risk of hospitalisation was about 11 percent lower for Omicron versus Delta.
The study showed that two doses of the vaccine were not enough to provide any serious level of protection and that boosters are the safest and best way to protect against serious illness from Omicron and Delta. It also found that having had a previous COVID-19 infection reduced the risk of hospitalisation from Omicron by about half. Still, I would exercise caution when relying on natural immunity to protect against COVID-19 as this involves getting infected with a highly unpredictable virus that risks not only serious illness and death but also Long COVID; it is much safer to opt for the vaccines.
Professor Neil Ferguson, who led the study, said it was good news but still warned about the sheer number of infections from Omicron leading to more hospital admissions in the long run.
Another study from South Africa also suggested Omicron results in fewer hospitalisations. The study led by the National Institute for Communicable Diseases (NICD), followed more than 160,000 people who tested positive for COVID-19 between October 1 and December 6, and found that those infected with Omicron were 80 percent less likely to end up in hospital when compared with other variants. The authors of this study, which is yet to be peer-reviewed, have said it is difficult to know how much this is due to Omicron being more “mild” or how much is due to immunity levels in the South African population from previous infections and vaccinations.
Meanwhile, an Edinburgh study used national surveillance data to compare Omicron and Delta infections from November 23—when Omicron was first detected—to December 19. The study only involved a small number of cases, and has yet to be peer-reviewed, but found a 65 percent lower risk of hospital admission when compared with Delta. Jim McMenamin, the national COVID-19 incident director at Public Health Scotland, described the findings as a “qualified good news story”.
Good news this may all be, but it is probably not yet time to rest on our laurels.
Which brings us to the bad news… Omicron cases have been rising across the world, far faster than initially thought. The United States and the United Kingdom are reporting record daily cases, with cities like London and New York worst affected.
Even accounting for 40-50 percent less severity and hospital admissions, if there are three times more cases, that will result in more hospitalisations and deaths than what we saw with Delta.
But it is not just about hospitalisations and deaths. When people test positive for COVID-19 they must then isolate. With Omicron being so transmissible, numbers of positive cases are rising steeply, resulting in more and more people being off work. This will inevitably start to affect front line services: transport, the police force, fire services and healthcare.
When this starts to happen, these vital services become unviable, and cancellations start to happen. Perhaps we can tolerate trains being cancelled—it is an inconvenience but not life-threatening—but when hospital procedures have to be cancelled due to a lack of staff, then lives begin to be put at risk. Many healthcare systems around the world are just beginning to ease the backlog of procedures caused by the initial phases of the pandemic when medics were mostly focused on COVID-19 patients. Now we hear about people having to wait hours for an ambulance due to crew shortages, cancer treatments risking further delays, and surgical operations risking cancellation yet again. Omicron may be milder, but it poses an equally lethal threat to healthcare systems as any previous variants before it.
The other danger is if the public holds onto this “milder” narrative, there is a risk that some people may become complacent about regular lateral flow testing, mask-wearing and ventilating indoor spaces. It may even lead to fewer people taking up the booster vaccines. This will then result in further cases and eventually an increase in hospitalisations and deaths.
Governments across the world have reacted differently to the emergence and spread of Omicron. Countries like the Netherlands have adopted a firm lockdown approach whereas the US and UK have very lax measures in place. History has shown us the quicker we act the better the outcome when it comes to putting restrictions in place. Relying on the “milder” narrative may well come back to haunt some of our world leaders who most likely have their eyes closed and their fingers crossed, hoping that the surge in cases will not translate into hospital admissions.
