We get real world data on what to expect from omicron. Here is a road map for the Utahns.
Trying to hide that I’m getting a bit repetitive and just delivering the third omicron variant update in three weeks, I thought of some smart movie-related titles for this article. Back to Coronavirus, Part III? Lord of Variants: The Return of ‘Cron? Does the dark variant go up? Harry Potter and the Prisoner of Omicron?
Nonetheless, once again, there is compelling news to report about the omicron variant that will soon make a difference here in Utah. The variant already represents 2.9% of sequenced cases in the United States, a number that will undoubtedly become the majority in the coming weeks. Because of its spread, we also have population-level data in ways that we did not have before. It is one thing to study the omicron in a laboratory; it is quite another to see its impact on several countries.
We may have written on this topic recently, but over the past week we learned a lot about the features of omicron and a better idea of the impact it will have on our lives. Here’s the latest – the good, the bad, and the ugly – of what scientists have discovered about omicron.
It is probably no longer graphically correct to say that omicron is behind a fourth wave of cases in South Africa – the graph looks more like a brick wall.
We are also seeing this same size of rapid growth in other countries with the disease, including the United States in some areas. It is now responsible for around 13% of cases in New York and New Jersey.
Why? Well, it seems to be a combination of increased transmissibility and immune breakout. Specifically, British scientists have discovered that when a member of a household became infected with omicron, it was about twice as likely to spread to another member of the household than was delta. Eek.
Thanks to population-level data, we have much better estimates of how effective omicron vaccines are in the real world. In particular, South Africa’s largest insurance company, Discovery, insures 3.7 million people. He found that two doses of the Pfizer vaccine were 80% effective against infection against the delta variant, but only 33% against omicron.
It’s a big drop. People who have not received a booster should consider themselves as likely to be unprotected against omicron infection.
Few in South Africa have received recalls, but more in the UK. The researchers found there that people who were boosted after two doses of Pfizer – three doses in all – were about 70 to 75 percent effective against the infection. It is obviously much better.
And against hospitalization? As always, vaccines are more effective at preventing serious illness than against illnesses in general. Data from Discovery showed that two doses of Pfizer prevented 70% of hospitalizations. (They found that Pfizer prevented 93% of hospitalizations for delta.) The three-dose vaccines could be expected to be much higher.
Worryingly, however, they discovered that the vaccine was more skillful in the prevention of hospitalizations in young people than in the elderly compared to delta. This may be because the elderly were vaccinated first and therefore the antibodies had more time to decrease – or it could be because the antibodies generated were less effective at fighting omicron in them. the elderly.
Either way, it highlights the urgency for older people to be empowered before omicron becomes the biggest local player. Many drugstores and grocery store reminder appointments are busy right now – but county health department reminder appointments are still widely available in Utah.
Efficacy of previous infection
We all know people who have not been vaccinated and instead rely on their previous battle with COVID to prevent their infection. So how well does a previous infection with an earlier variant prevent omicron?
Not great. A New York study took blood plasma from people infected with various variants (alpha, beta, and gamma) and found how well it neutralized the omicron virus. Unfortunately, this is not good news.
There is still some protection there, but it is certainly significantly reduced. The UK found the risk of re-infection to be around five times higher for omicron than other variants in its initial data, while South Africa found a 2.4 times higher rate for omicron. omicron.
I will be interested to see how considerably these re-infections are protected against hospitalization. Re-infections were significantly less likely to be severe for other variants, so I expect this trend to continue, but we just don’t have the sample size to indicate by how much.
Those with so-called hybrid immunity – previous infection plus vaccination – are, however, in very good shape.
And here’s our only silver liner again: Omicron has so far resulted in fewer hospitalizations and deaths than previous variants.
Data from Discovery in South Africa revealed that omicron was 29% less likely send adults to hospital as the first form of the coronavirus. This number adjusts for age, sex, risk factors, vaccination status, and previous documented infection.
What it cannot adapt to is a previous, undocumented infection, of which there are certainly a lot everywhere. One guess is that omicron isn’t necessarily less severe on its own, but just meets people who have higher immune protection than previous waves, even if they don’t know it.
But those who were hospitalized were also less likely to see the intensive care unit – and less likely to go to their deathbed. Of those who were unlucky enough to make it to the ICU, only 16% were vaccinated.
Data from Denmark has a smaller sample size but came to similar conclusions. There, 0.6% of cases of the omicron variant have led to hospitalization in recent weeks, compared with 0.8% of the other variants.
It’s a drop in gravity, but a smaller drop than I expected.
So what happens next?
Considering all of this data, I think it’s actually possible to make an informed guess at how it will all play out. While I wouldn’t dare to risk an estimate of the digital impact, in general terms, here’s what I expect.
1. One parcel people are going to get sick. Unvaccinated people, those who have been vaccinated but not boostered, and people who depend on the previous infection from last year will get sick at high rates. Given the lack of focus on the government’s COVID-19 testing compared to last year, the number of cases will not reflect the true burden of the disease as closely as before, but wastewater monitoring should provide a more accurate picture.
Sometimes we forget this simple fact: being sick sucks.
2. As a result, industries with strict COVID testing and protocols are going to be significantly hampered by it: sports leagues, international travel, healthcare, etc. I predict more frequent cancellations or postponements of events. Supply problems have eased slightly recently; I don’t know if this positive trend will continue.
3. Hospitals are going to be overloaded. The good news is that normal Utah hospital beds are currently 57% full – there’s room to take some increase. Unfortunately, Utah’s intensive care beds at referral centers are 99.3% full at the time of writing. In other words, there is only Three Intensive care beds are opening at referral centers in Utah.
Even though omicron seems less likely to send people to intensive care than delta, thousands of people infected a day will mean these Three the beds will fill up fairly quickly.
So we’re going to have to deal with this, one way or another. I suspect we’ll see a combination of familiar interventions from last winter reintroduced – perhaps longer or more shifts for doctors and nurses, elective surgeries delayed, hospital departments changing to meet demands. needs, etc. The sad truth is that this will impact the level of care even for non-COVID hospital patients.
4. Fewer people will die than in previous waves. The upcoming availability of antiviral pills specifically to fight COVID – Paxlovid and molnupiravir – will help immensely. We’re going to see lower death rates.
5. The coming wave will hammer a reality: COVID is not going to go away. Like other viruses, it occasionally mutates, causing spikes and troughs of infection. We can alleviate these diseases with pills for inpatient and probably regular vaccine treatments for the general public, just like the flu, but the burden will always be great.
COVID will stay with us forever, a new cross to carry on top of the other illnesses we have. There will be times when stress will be particularly painful for health systems and for society as a whole. To deal with the additional threat, we will need to focus on training more nurses and doctors than before. We’ll need more medical scientists to study the evolution of our diseases – and to identify news that could trigger pandemics before they spread.
Too often, public health has not been a priority. I wish, hope and pray that our experience with COVID will change that.
Andy Larsen is a data columnist for The Salt Lake Tribune. You can reach him at [email protected].