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We’re getting real-world data on what to expect from omicrons. Here is a road map for the Utahns.

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In trying to hide that I’m being a bit repetitive and simply providing the third omicron variant update in three weeks, I thought of clever movie-related headlines for this article. Back to Coronavirus, Part III? The Lord of Variations: The Return of ‘Cron? Dark Variation Rises? Harry Potter and the Prisoner of Omicron?

Yet again, there’s compelling news to report on the omicron variation that will soon make a difference here in Utah. This variant already accounts for 2.9% of sequence cases in the US, a number that is certain to increase to the majority in the coming weeks. Because of its spread, we also have population-level data the way we did before. It’s one thing to study omicrons in the lab; it’s another thing to see its impact on many countries.

So we may have written on this topic recently, but we’ve learned a lot over the past week about the properties of omicrons and a better idea of ​​how much of an impact it can have on our lives. we. Here’s the latest – Good, Bad and Bad – about what scientists have discovered about omicrons.

Transmission ability

It’s probably not pictorially accurate to say that omicrons are causing the fourth wave of cases in South Africa – the graph looks more like a brick wall.

Coronavirus cases in South Africa. In recent weeks, it has been almost all due to omicron variation.

We also see a similarly rapid increase in scale in other countries with outbreaks, including the United States in some areas. It is currently responsible for about 13% of cases in New York and New Jersey.

Why? Well, it seems to be a combination of increased transmissibility and immune escape. Special, UK scientists discovered that when a family member is infected with omicron, it is twice as likely to spread to other members of the home than in plains. Eek.

Vaccine efficacy

Thanks to population-wide data, we have much better estimates of how vaccines work against omicrons in the real world. In particular, South Africa’s largest insurance company Discovery has insured 3.7 million people. It found that two doses of the Pfizer vaccine were 80 percent effective against infections for the delta variant — but only 33 percent effective against omicrons.

That is a huge drop. People who have not received a booster shot should consider themselves potentially unprotected from omicron infection.

Not many people in South Africa receive boosters, but more in the UK. Researchers there found that people who received a booster shot after two doses of Pfizer – three doses in all – were about 70% to 75% effective against the infection. That is obviously much better.

What about against hospitalization? As always, vaccines are more likely to prevent serious illness than to fight disease in general. Discovery data showed that two doses of Pfizer prevented 70 percent of hospital admissions. (They found that Pfizer prevented 93% of hospital admissions for delta disease.) You can expect a much higher three-dose vaccine.

Worryingly, however, they discovered that the vaccine more adept in preventing hospital admissions in young versus older versus lowland populations. That could be because older people were vaccinated first, and so the antibodies took longer to wear off – or it could be because the antibodies produced were less effective at fighting the omicrons. older people.

Despite that, it shows the urgency of boosting the elderly before omicron becomes the biggest local player. Many pharmacies and grocery stores book booster appointments now – but county health department booster appointments are still widely available in Utah.

Effect of previous infection

We all know some people who are unvaccinated and instead rely on their previous COVID shot to prevent infection. So, how well does a previous infection with an earlier variant prevent omicrons?

Not so good. A New York study took plasma from people infected with different variants (alpha, beta and gamma), and saw how well it neutralized the omicron virus. Unfortunately, that’s not great news.

Plasma taken from people infected with other variants was significantly less effective against omicrons. (https://drive.google.com/file/d/1zjJWsybGaa3egiyn5nQqTzBtl0kmvMUu/view)

There’s some protection still out there, but it’s definitely dropped significantly. The UK found that the risk of reinfection for omicrons was about 5 times greater than for other variations in their original data, while South Africa found a 2.4 times greater proportion of omicrons.

I would like to see data on the extent to which these reinfections are significantly protected from hospitalization. Other variations are significantly less likely to be severe, so I would expect that trend to continue, but we don’t have a sample size to indicate to what extent.

People with so-called hybrid immunity – previous infections plus vaccinations – are in really good shape, although.

Severity

And here’s our one-piece silver lining, again: Omicron, to date, has resulted in fewer hospitalizations and deaths than previous variants.

Discovery data in South Africa shows that the omicron is 29% less likely to get adults to the hospital rather than the first form of coronavirus. That number adjusted for age, sex, risk factors, immunization status, and prior infection was recorded.

What it can’t correct is the undocumented previous infection, which certainly abounds everywhere. One theory is that omicrons are not necessarily less severe by themselves, but only hit people with better immune defenses than previous episodes, even if they don’t know it.

But people who are hospitalized are also less likely to go to the intensive care unit — and less likely to go to a hospital bed. Of those unlucky enough to make it to the ICU, only 16% were immunized.

The Danish data have a smaller sample size but reach similar conclusions. There, 0.6% of omicron variant cases resulted in hospitalization in recent weeks, compared with 0.8% of other variants.

That’s a reduction in severity, but a smaller drop than I was hoping for.

So what happens next?

With all this data, I think it’s really possible to make an informed prediction as to how this will all play out. While I wouldn’t risk estimating the numerical impact, just in general, here’s what I’d expect.

1. A great number of of people who are about to get sick. Unvaccinated people, people who have been vaccinated but do not have a booster, and people who rely on previous infections last year will get the disease at high rates. Due to the government’s lack of focus on COVID-19 testing compared to last year, the number of cases will not reflect the true disease burden as it once was – but wastewater monitoring will provide a more accurate picture.

Sometimes we forget this simple truth: Being sick sucks.

2. As a result, industries with rigorous and experimental COVID protocols will be significantly hampered by this: sports tournaments, international travel, healthcare, etc. I predict the event to be cancelled. or postponed more often. Supply problems have smooth it out a bit lately; I don’t know if that positive trend will continue.

3. The hospital will be burdened. The good news is that Utah’s normal hospital beds are now 57% full – there’s some room for a little more. Unfortunately, Utah’s ICU beds at referral centers are 99.3% full as of the time of this writing. In other words, only father ICU beds open at referral centers in Utah.

Although omicrons seem less likely to send people to the ICU than delta, the thousands of people infected each day mean that father Beds will be filled up pretty quickly.

So we’re going to have to deal with that, somehow. I suspect we’ll see some of the familiar interventions from last winter reintroduced – possibly longer or more shifts for doctors and nurses, elective surgeries being re-introduced. delays, hospital departments changing to meet demand, etc. The unfortunate truth is that this will affect the level of care even for non-COVID patients at the hospital.

4. There will be fewer deaths than previous waves. There will be special antiviral drugs to deal with COVID – Paxlovid and molnupiravir – which will be of great help. We will see a lower death rate.

5. The coming wave will bring a reality: COVID will not go away. Like other viruses, it will mutate occasionally, causing peaks and valleys of infection. We should be able to reduce those illnesses with hospital pills and possibly routine vaccine treatments for the general public, like flu, but the burden will still be enormous. tell.

COVID will be with us forever, a new cross to carry on our shoulders the other illnesses we have. There will be times when stress is particularly painful for health care systems and society as a whole. To deal with the growing threat, we will need to focus on training more nurses and doctors than before. We will need more medical scientists to study the progression of our diseases – and identify new diseases that could cause pandemics before they spread.

Usually, public health is not a priority. I wish, I hope, and I pray that our experience with COVID will change that.

Andy Larsen is the data columnist for The Salt Lake Tribune. You can contact him at alarsen@sltrib.com.

https://www.sltrib.com/news/2021/12/16/were-getting-real-world/ We’re getting real-world data on what to expect from omicrons. Here is a road map for the Utahns.

Yasmin Harisha

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