The WHO is calling this morning for countries to drop travel restrictions and end the mass hysteria, and instead be cautiously optimistic as more and more reports out of South Africa suggest the new Omicron variant is not more lethal than the previous Delta variant.
In fact, there have been no reports of hospitalisations or deaths as a result of anyone being diagnosed with Omicron.
Most patients merely experience a severe headache, nausea, dizziness and a high pulse rate, according to hospitals and medics across Southern Africa.
However, the news of the new variant, first reported in South Africa, led to mass hysteria around the world: markets thumbed and dozens of countries imposed travel restrictions and additional checks, including the UK, US, EU, Israel, Australia and Japan after the new mutation popped up in the UK, Germany, Italy, Czech Republic and Israel among other countries.
South Africa’s health minister Joe Phaahla also said the majority of cases of Omicron seen by doctors in his country have been “mild”.
Asked what he knows about how unwell people are who have it, Dr Phaahla said: “It is still too early at this stage.
He added he has heard from GPs that the “majority of the people they’ve been seeing are mild.”
“Our clinicians have not witnessed severe illness. Part of it may be because the majority of those who are positive are young people,” Dr Paahla added.
National daily cases have gone from 274 on 11 November to 1000 a fortnight later. While the rate of growth has been fast, absolute numbers are still relatively low compared with the UK, which saw 50,000 cases on 26 November. More than 80 per cent of South Africa’s cases are currently in the country’s Gauteng province. All of the 77 cases sequenced in the province between 12 and 20 November were identified as being caused by the variant. The estimated reproduction number, the average number of people that an individual is likely to infect, is almost 2 in Gauteng compared with nearly 1.5 nationally.
What do B.1.1.529’s mutations tell us?
The variant has a “very unusual constellation of mutations”, says Sharon Peacock at the University of Cambridge. There are more than 30 mutations in the spike protein, the part of the virus that interacts with human cells. Other mutations may help the virus bypass our immune systems, make it more transmissible and less susceptible to treatments, according to the HSA. But the body notes that “this has not been proven”.
What the mutations mean is currently theoretical and based on experience of past mutations of SARS-CoV-2 rather than lab tests. Wendy Barclay at Imperial College London says “we don’t really know” if it will reduce the effectiveness of vaccines. Nonetheless, she adds that, in theory, the number of changes across the antigenic sites on the variant’s spike means the effectiveness of antibodies produced by covid-19 vaccines would be compromised.
Mutations on a part of the virus known as the furin cleavage site are similar to those seen in the alpha and delta variants, which could help the variant spread more easily. Barclay says “it’s very biologically plausible” that B.1.1.529 has greater transmissibility than delta.
The mutations also mean that the new variant is likely to be more resistant to antibody treatments such as those developed by Regeneron, which have been shown to save lives. “That is really a cause for concern,” says Barclay. One small bright spot is that, to date, there are no signs that the variant causes more severe disease.
How far has it spread?
Genomic sequencing has found the variant in South Africa, Botswana and Hong Kong. There are also reported cases in Israel, apparently originating from a traveller from Malawi, and in Belgium, from someone who had travelled from Egypt. UK health secretary Sajid Javid said it is “highly likely” that the variant has spread to other countries. As of 27 November, two cases had been detected in the UK, where about a fifth of positive cases are sent for genomic sequencing. Even in countries with low levels of sequencing, it may be possible to get early warning signs, because the variant is linked to a mutation called S-gene dropout, which is picked up by PCR tests, says Jeffrey Barrett at the Wellcome Sanger Institute in Hinxton, UK.
How have other places responded?
The UK and EU have both imposed restrictions on people travelling from countries in southern Africa, with Javid saying the variant is of “huge international concern”. Prime minister Boris Johnson announced further travel restrictions on 27 November.
Is it a given that this will outcompete the delta variant?
We don’t know. “We don’t have definitive evidence at the moment that this is more transmissible, but there are hints there that it may be,” says Peacock, pointing to the growth in South Africa and the higher R number in Gauteng. Some earlier variants have failed to get a toehold in certain countries because of the competition from other variants: beta hasn’t become established in the UK, for example, while alpha spread from Europe but never reached high levels in South Africa. “If this variant is not as transmissible as delta that would be good news for sure,” says Barrett.
What can I do?
All the usual measures of social distancing, handwashing, mask-wearing, getting vaccinated and having a booster shot still apply. The emergence of such a potentially worrying variant is, however, a reminder of the risk of uneven vaccination rates globally – only 24 per cent of people are fully vaccinated in South Africa.
How much do we really know about this variant?
Most of our knowledge is from the Network for Genomic Surveillance in South Africa, and the South African government, both of which have been praised by researchers for acting fast to share information on the variant. But there is more that we don’t know than we do. Tulio de Oliveira at Stellenbosch University, South Africa, said yesterday that the full significance of the variant’s mutations “remain uncertain.” Peacock adds: “It’s important to stress how much we don’t know this new variant.“
A San Francisco resident has contracted a mild case of the new Omicron variant, officials announced on Wednesday — the first person in America to have been confirmed infected with the strain. The development may reflect San Francisco’s status as an international travel hub. It also comes nearly two years after Solano County recorded the nation’s first non-travel infection, a harbinger of the nascent global outbreak. It later emerged that America’s first known Covid casualty was a Santa Clara County woman who died in February of that year.
After the Bay Area became an early coronavirus epicenter, it transformed into a national leader in aggressive health orders that kept cases relatively low. So while none of us wanted to hear Anthony Fauci yesterday intone the words “California,” “San Francisco” and “Omicron” during a White House briefing, Gov. Gavin Newsom and California public health officials moved quickly on Wednesday to urge vigilance over panic.
Gov. Gavin Newsom announces the confirmation of California's first case of the omicron variant of Covid-19 during a visit to a vaccination clinic at Frank Sparkes Elementary School in Winton, Calif., on Wednesday, Dec. 1, 2021.
Their central message was one of calm competency. Newsom and the California and San Francisco health departments credited the state’s mass testing, genome sequencing and early detection infrastructure with letting them swiftly identify Omicron. They noted California had already stepped up airport testing in anticipation of variant’s near-inevitable landing on our shores (the positive individual had traveled from South Africa). State health secretary Mark Ghaly said 20 months of pandemic-fighting experience helped California act quickly.
“It’s not surprising in many respects that California is announcing the first case,” Newsom said. “This state, after all, is the birthplace of biotech, of life sciences.” He cautioned that as news of the case rippled out, “the panic’s gotten ahead of the information,” and he repeated the winter-is-coming admonition he’s broadcast for weeks now.
“Let’s continue to do what we’ve done,” Newsom said, touting California’s high vaccination rates. “Let's double down on our vigilance.”
LOOKING AHEAD: There is an undeniable anxiety hovering behind this. Will we see another round of lockdowns or restrictions on commerce and education? Newsom’s answer: Not if you do your part to suppress infection rates by getting vaccinated.
“We can avoid shutting down our schools or businesses,” Newsom said. “None of us want to see that happen. I certainly don’t want to see that happen. And I see no indication at this moment whatsoever that that’s in our immediate future, as long as we continue our nation-leading efforts.”
The “highly transmissible” Omicron variant of coronavirus ripping through South Africa is putting disproportionately large numbers of children under 5 years old in hospitals, a top South African government medical adviser said Friday.
The alarming development raises the prospect of a new global battle cycle against the virus, given that the new variant has already spread to dozens of countries. The South African scientists also said the new variant was spreading much quicker than any previous wave of the coronavirus.
In a worrying virtual press conference, government adviser Waasila Jassat, speaking about the worst-affected area of Gauteng province (which includes the city of Johannesburg), said: “It’s clear in Gauteng, the week-on-week increase we’re seeing in cases and admissions is higher than we’ve seen it before. We’ve seen quite a sharp increase [in hospital admissions] across all age groups but particularly in the under 5s.”
She added: “The incidence in those under 5 is now second highest, second only to those over 60. The trend that we’re seeing now, that is different to what we’ve seen before, is a particular increase in hospital admissions in children under 5 years.
“We’ve always seen children not being very heavily affected by the COVID epidemic in the past, not having many admissions. In the third wave, we saw more admissions in young children under 5 and in teenagers, 15-19, and now, at the start of this fourth wave, we have seen quite a sharp increase across all age groups, but particularly in the under 5s.”
Jassat produced graphs that clearly showed how children under 5 years old are now being hospitalized at an alarming rate.
She said, for example, that in the city of Tshwane Metro, more than 100 children under the age of 5 were admitted to hospitals with COVID in the first two weeks of the new fourth wave (Nov. 14 to 27). In the first two weeks of the country’s third wave, in May of this year, fewer than 20 children were admitted to hospitals.
In a follow-up question-and-answer session, asked about the extraordinary numbers of children being admitted to hospital, Jassat said she suspected there might be an “immunity gap” and that the lack of vaccination of children might account for the numbers.
She said that with adults increasingly vaccinated, children are the ones who are “getting sick and need to be admitted.”
She added that pediatricians at the Tshwane hospital had told them, anecdotally, that “all” of the children ages 12-18 who were admitted were not vaccinated, even though they were eligible. “And the younger children, younger than 12, who were not eligible for vaccination, none of their parents, except for three, were vaccinated.”
She said this showed “the value of vaccination in the adult protecting the children in the homes.”
Just over 42 percent of all adults have received at least one vaccination dose in South Africa, Health Minister Joe Phaahla said.
Another specialist, epidemiologist Michelle Groome, told the virtual meeting that daily hospital admissions in the worst-affected parts of Gauteng province have rocketed to 78 from 19.
Groome sounded the alarm over the “rapidly increasing” seven-day average of cases which has gone from 332 on Dec. 1 to 4,814 today.
She said: “If you have a look at the slope of this increase, you can see that we really are seeing an unprecedented increase in the number of new cases in a very short period of time, really just climbing right up.”
She said the virus’ reproductive number—a measure of how many people each infected person infects—had climbed to 2.33 in Gauteng.
Groome said: “This is the highest we’ve ever seen it since the start of the pandemic.”
Phaahla said daily cases have rocketed by 9,000 cases per day, climbing from “2,465 new cases last Thursday when this variant was announced to yesterday’s high of 11,535.”
“This variant is indeed highly transmissible, including in people who have already been vaccinated,” he said.
This remark echoed the findings of a paper published Friday, not yet peer-reviewed, which, The Washington Post reported, claims Omicron is three times as likely to cause reinfection than previous variants. The Post said: “Statistical analysis of some 2.8 million positive coronavirus samples in South Africa, 35,670 of which were suspected to be reinfections, led researchers to conclude that the Omicron mutation has a ‘substantial ability to evade immunity from prior infection.’”
Phaahla attempted to sound an optimistic note by saying that he believes the new variant is more transmissible “but less severe” than previous variants.