WHO: South Africa Omicron Data Suggests 25% Dip in Hospitalization Rate Compared with Delta

A World Health Organization (WHO) update on the Chinese coronavirus pandemic published this weekend, citing South African case data, suggested that the rate of hospitalization of patients with the omicron variant may be 25% lower than the hospitalization rate of people who have the delta variant.

Delta, first identified in India, is believed to be responsible for most Chinese coronavirus cases documented worldwide. Scientists believe omicron, identified in South Africa in November, may soon displace delta because of its greater transmissibility. The WHO report relayed that scientists believe omicron is now the dominant variant in South Africa.

Though first identified by South African scientists, European countries like the Netherlands and Belgium admitted after the WHO branded omicron a “variant of concern” in November that they had evidence of it circulating in that region long before African governments reported its existence. European countries, and the administration of U.S. President Joe Biden, nonetheless imposed travel bans on South Africa and other southern African countries in response to the discovery of omicron, but not on European countries, prompting global condemnation of the policy as racist.

South Africa has not imposed any increased lockdown or social distancing measures in response to omicron. Its top coronavirus management authority suggested this weekend that the country should stop contact tracing and quarantining of coronavirus patients because omicron symptoms are so mild that the government is catching too small a number of them, making contact tracing essentially useless.

The WHO documented a significant rise in hospitalizations generally in South Africa and in the United Kingdom as people began testing positive at increasingly rapid rates for omicron, the weekly report, first published on December 17, read. But it noted that the correlation of hospitalizations directly related to omicron suggested that South Africans diagnosed with it were experiencing less severe disease.

“South Africa has seen a rapid increase in the incidence of hospitalization in the public and private health sectors since the start of the omicron wave,” the United Nations agency reported. “On average, admissions in the Gauteng Province in weeks 47 and 48 have increased by over 450% compared to the average admission rate in weeks 45 and 46, and a 68% increase in COVID-19 hospital deaths has been observed over the same period.”

Guateng has largely been the epicenter of omicron spread in South Africa so far, though data shared by South African media outlets on Monday suggest cases there may have already peaked.

The relative data of hospitalizations, the WHO report noted, suggests that increased hospitalization numbers do not mean that patients are more likely to be hospitalized, but merely that because more people are getting sick, more people are getting hospitalized. The WHO report issued a counterintuitive conclusion: hospitalization numbers suggest patients are less likely to be hospitalized with omicron, even if more patients in absolute terms are hospitalized.

“Preliminary data (13) from a private health insurance provider suggest that the risk of hospitalization may be moderately reduced with omicron compared to previous epidemic waves in South Africa,” the agency reported, “with a 25% reduction in hospitalizations, compared to the delta variant, and proportionally fewer patients in intensive care units.”

“This, in addition to a lower growth rate in hospitalizations compared to that of cases, suggests that the increase in hospitalizations is driven by high levels of transmission, rather than increased severity,” the WHO report noted. The agency warned that, despite that apparent good news, hospitals may face potentially overwhelming numbers of patients due simply to how quickly omicron spreads.

The South African, a domestic news agency, reported on Sunday that several cities in the country may have already passed peak omicron cases, diminishing the chances of the hospital surge the WHO warned about. Citing local statistics, the outlet identified four metro areas where cases appear to be slowing down.

“Gauteng’s new infection numbers continue to tumble, and a peak has been established there,” the South African reported. “But North West, Mpumalanga, and Limpopo all appear to be turning the same corner. The seven-day average for daily reported cases in these regions has dropped enough to alert the experts.”

Surges are possible, the outlet noted, “But South Africa can only report on the data that is available in the here and now. And, as we start the week leading up to Christmas, there are plenty of encouraging signs that our hospitals won’t be overwhelmed any time soon.”

South African Health Minister Joe Phaahla has not issued any new mobility restrictions to stop the spread of the omicron variant, despite reportedly facing pressure for new lockdowns. South Africa’s City Press, citing anonymous “informed sources,” reported on Monday that Phaala “stood his ground” against lockdowns and other mobility restrictions at a key meeting with the national coronavirus command council.

“The ministers were shocked when Phaahla told them about the rising infections, but he soon reassured them that everything was still under control in terms of the capacity of our healthcare systems,” one of the sources said, adding that some cabinet members cited restrictions imposed in Europe as a reason to consider more lockdowns, to which Phaahla reportedly replied, “South Africa cannot criticise other countries for their travel bans against countries in the region and then impose stricter lockdown measures locally.”

City Press noted, like the World Health Organization, that data on omicron appears to show a significant decline in case severity.

“With the peak of the third wave in late June and early July, between 300 and 400 people died daily due to Covid-19, according to the University of Oxford’s Our World In Data,” the outlet reported. “In the past week, an average of 31 people died in the country daily from Covid-19 complications.”

Case numbers, meanwhile, hit record highs in the country.

“The lower death rate is also evident from data on ‘excess deaths’ from the Medical Research Council (MRC). With the previous three Covid-19 waves, ‘excess deaths’ – true deaths due to natural causes compared to the expectation based on historical data – skyrocketed,” the outlet added.

South Africa’s Ministerial Advisory Committee (MAC) advised the government on Sunday to stop attempts at contact tracing and quarantining to prevent the spread of the the omicron variant, as it was so widespread and so mild that the government was missing substantial numbers of cases.

“Crucially, it appears that efforts to eliminate and/or contain the virus are not likely to be successful. Therefore, it is critical that the role of containment efforts like quarantine and contact tracing is re-evaluated,” the committee wrote to Health Minister Phaahla, according to South Africa’s News24.

“The inability of the current testing strategy to identify the bulk of cases is illustrated by the high SARS-CoV-2 seropositivity rates seen across multiple provinces in serosurveys, implying that only a fraction of cases (perhaps one in 10, or even less) are ever diagnosed,” the statement read.  “In addition, among the small proportion of symptomatic cases, testing is far from universal, since patients may not seek testing when their symptoms are mild and when testing would be burdensome and expensive. Furthermore, the SARS-CoV-2 test sensitivity is suboptimal, sometimes leading to false negative results.”

News24 reported that in light of this, the committee deemed the positive effect of contact tracing and quarantining “negligible.”

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