Status of Omicron Variant of COVID As of January 18 2022

 

Status of Omicron Variant of COVID

As of January 18, 2022

By Ken Karch, PE, MPH

(New material (since 1/8/22) in yellow)

 

 

The COVID-19 Omicron variant is much more transmissible than any of the earlier variants.

 

This is both good news and bad news.

 

Bad News

 

The bad news is that Omicron spreads very rapidly, giving little time to develop prevention and treatment strategies…if it were as deadly as the plague, cholera, typhoid, or smallpox (in their day) or MERS more recently, it would be a human calamity, given the ease of spread around the world.  The R value for Omicron (a measure of transmissibility) was recently about 2.5 in South Africa (the most advanced nation in terms of disease stages), as opposed to about 1 for Delta.  Of all new COVID cases, in South Africa, virtually 100% are Omicron, with Delta having shrunk to near zero. In the UK it is over 95% and in the US over 90%.  The Omicron variant has displaced the Delta variant in all three regions.

 

The R factor of about 2.5 means the rate of new recorded cases is doubling about every 2-3 days, indicating the entire population of the UK (a second exemplar) will likely be virtually totally exposed within a week, and the US during January.  It is important to remember that exposure does not equal infection. Infection will result in no clinical symptoms in most, mild symptoms in some cases, and severe enough cases to result in hospitalization in a small percentage of those infected. The latter will result in the need for ICU treatment, including intubation, oxygen, or monoclonal antibody treatment in a small fraction of those hospitalized.  

 

This is likely to lead to many, horrific, ill-founded, and contradictory actions by poorly-informed elected officials and private organizations.

 

Omicron also appears to be much more transmissible, and with more severe consequences, for young people, than did Delta, whose consequences were largely centered on older adults with immune system problems and health care workers.

 

Good News

 

The good news is that the Omicron variant is apparently much less deadly and results in much less hospitalization than any of the previous variants, including the Delta variant…perhaps by a factor of 10 (as against the Delta variant).  Normalized hospital admission and death rates are far below those for Delta, and both are much reduced from just 2 months ago. COVID hospital admissions in Washington State have risen to levels which have again created capacity concerns comparable to those experienced in the August/September, 2021 period, before declining. Recent reports indicate that “incidental” Omicron variant hospital admission rates are in the 50-65% range in New York hospitals, indicating that 50-65% of the admissions are for causes other than Omicron, with hypertension, diabetes, and obesity leading the co-morbidity list   Both hospital admissions and deaths will likely show increases, due largely to the greatly increased number of people exposed, (to Omicron) with new cases, hospitalizations, and death peaking in the late-February to mid-March, 2022 period. Treatment modalities developed for earlier COVID variants seem to work for Omicron, greatly reducing the need for hospitalization, supplemental oxygen, or intubation; and a growing body of studies is identifying alternative prevention and treatment techniques.

 

Other pieces of good news include reports that past Delta or Omicron infections and vaccinations seem to confer some degree of protection from serious complications from either, the need for hospitalization, and death; that vaccines are capable of being much more rapidly developed; and that the rapid rate of Omicron infection is likely to attain a degree of herd immunity not yet reached for Delta.

 

New News

 

Data from South Africa suggests T- and B-cell behavior is moderating the seriousness of the Omicron variant, and preventing further Delta infection. In an as yet non-peer reviewed paper released last week, antibodies developed from prior vaccinations or Delta infections do not confer immunity from the Omicron variant, allowing it to spread rapidly and out-compete, and therefore replace, the Delta variant. In another paper, a possible mechanism, through a jump from humans to mice and back again, very early in the history of COVID-19, is described.

 

Finally, the US Supreme Court on January 13 ruled in two cases involving the authority for administrative agency mandatory vaccination orders for all employers of more than 100 employees (overturned), and for health care organizations (allowed to proceed). Hearings and decisions are likely to be heard and reached on a third issue (and probably several others which have not yet reached the Supreme Court) the next few weeks or months.

 

Bottom Line

 

Cautious optimism that Omicron may out-compete and replace Delta as the dominant COVID variant in Washington State, the US, and the world, with vaccination, previous infections, and rapid attainment of herd immunity ending the COVID crisis, and reducing it to endemic proportions, such as the common cold, another COVID variant.

 

Recommendations

 

Continue social distancing, masks, and full vaccination encouragement. Increase focus on young peoples’ exposure, prevention, and treatment.  Relax non-traditional prevention and treatment protocols.