As Omicron advances, South Africa sees little severe disease

South African hospitalisations from the omicron coronavirus variant are rising at a slower rate than surging case numbers, while severe disease is limited and there’s only a small uptick in deaths.

Data presented by the government on Friday reinforces theories that while omicron spreads more rapidly than earlier strains, it exhibits less pathogenicity, or the ability to make people very ill.

Previous waves showed an increase in hospitalizations before a dramatic rise in case numbers, said Michelle Groome, the head of health surveillance for the country’s National Institute for Communicable Diseases. Now, “we first saw the increase in cases and then started seeing these hospitalizations, so early indications are that we may be starting to see a disconnect,” she said.

The findings will come as some relief for South Africa, the epicenter of the omicron outbreak, and the world as the mutation spreads to more than 50 countries. Case numbers in Africa’s most developed economy are nearing a record and the reproduction number, a gauge of how fast a virus spreads, is higher than it has been at any time during the pandemic.

But that’s not translating to overloaded hospital wards. While the number of people hospitalized with Covid-19 is nearing 5,000, that’s about a quarter of its peak in the mid-year third wave.

Most of the early infections with the variant, the discovery of which was announced by South Africa on Nov. 25, have been in Gauteng, the province where Johannesburg and the capital, Pretoria, are located. Data from that province has shed light on the potential severity of disease.

“There are early indications that we haven’t seen dramatic increases” in the number of people who need oxygen, ventilators or need to be moved to intensive care units,” Groome said. “We have also looked at the case fatality rate, the number of people who are dying in hospital, and once again there is no indication that has been increasing.”

While initial studies show that vaccines are less effective against omicron, most hospital admissions are in age groups with lower vaccine coverage, Groome said.

As many as 68% of coronavirus hospital intakes in the Tshwane municipal area — that includes Pretoria — were under 40, according to NICD data presented on Dec. 3. That compares with individuals over 50 accounting for 66% of hospitalizations during the early weeks of the third wave.

South Africa’s mass vaccination drive only began for those over 60 years old in May, before younger categories were added. More older South Africans are vaccinated than younger ones.

The initial rush of omicron admissions included many children under the age of five, a marked difference from earlier bouts of infection. Children below the age of 12 are not eligible for vaccination in South Africa.

For now, Groome says, there is little reason for concern.

“Severity among children is being monitored,” she said. “But, at this stage, anecdotally, most paediatricians” are saying children in hospital with Covid were already admitted for other problems and the duration of their stay is short.

There is no indication of respiratory problems for young children with Covid-19, Joe Phaahla, South Africa’s health minister, said at the same briefing.


Read: Majority of South Africans being admitted to hospital for Covid-19 are unvaccinated: minister

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As Omicron advances, South Africa sees little severe disease