COVID-19: Omicron updates from John Campbell, RN, PhD
Campbell is a nurse-trainer in the UK, and I've been following his updates on Covid since early in the pandemic. He tends to be frank but accurate in his assessments, neither overplaying nor underplaying the disease, and his past assessments and advice have proved highly accurate and applicable.
Note that Campbell has a Doctor of Philosophy in nurse training. He's often styled as "Dr. Campbell". Given the potential for confusion with a medical doctor (M.D.), I choose to style him as "RN, PhD" instead for clarity.
Highlights:
- Omicron cases are mostly mild.
- Effective R value is 2.5 in South Africa. Each person infected with Omicron infects 2.5 others.
- Doubling rate in the UK is 2.3 days. That is insanely high. Even in the earliest phases of the outbreak in Wuhan and the US, doubling times were on the order of 5--7 days, and rapidly fell to weeks. The effective doubling rate for much of 2021 has been months in most countries (averaged over time, higher during specific outbreaks.)
- Vaccination does not completely protect against Omicron, rate is about 70% for fully-vaccinated, however ...
- Vacinnation greatly reduces severity of illness.
- Rate of spread and total number infected at the same time is a concern because a small number of a very large number is still a large number. That is, the few severe cases from a large population simultaneously infected will likely overwhelm hospitals.
- We got very lucky. It's not human intelligence, technology, or medicine that gave us an infectious-but-mild variant, it's dumb luck and random mutation. MERS had > 40% mortality, and we could well have been facing a "you're likely to be infected with a variant with a 40% chance of killing you" scenario. That we're not is sheer chance.
- "This really could have been bad."
- 90% of COVID-19 hospitalised do not require oxygen. This compares against all previous-wave patients in South Africa (SA) requiring oxygen therapy. 2% of hospitalised patients in SA require ventilation (much lower than previous waves).
- Omicron is infecting and affecting younger populations than earlier strains. 71% are age 50 or lower (SA). Dr. Fareed Abdulla, Office of Aids and TB Research, SA Medical Research Council.
- SA hospital admissions for Omicron are 337 as compared with 2,000--3,000 at 26% positivity rates in testing for earlier waves. Again: far lower severity / milder symptoms.
- Symptoms: like mild/moderate flu, headache, blocked/runny nose, scratchy/sore throat.
- SA study: "It is our considered opinion that this trend should continue." Again: mild cases.
- Best indicator of disease severity is measured by the in-hospital death rate, 6.6% of admissions (0.66% overall, if my maths are correct). Compares to 23% mortality amongst admitted for previous waves. Of 10 deaths observed, 4 aged 26--36, 5 aged 60+. No deaths among 34 pediatric admissions (< 18 years).
- Discussion of prospects that Omicron will act as a "natural vaccine", by Eleanor Riley, University of Edinburgh.
- Omicron does invoke an immune response.
- Still questions on whether or not Omicron will prove milder, and on applicability of SA data to UK.
- In drawing cross-national comparisons, South Africa has a much younger population than the UK, US, or EU generallly. SA also has a very large immunocompromised population (HIV/AIDS is endemic through much of southern Africa). This may affect exerience and its transferability elsewhere.
Interesting end discussion about viral evolution and whether the virus "cares" about severity. Given the long period of latent infection during which the disease is transmissable, pressure for low-severity may be only slight. That is, selective pressure on a virus is for reproduction and spread, and so long as the virus can do so in the short term, it's evolutionarily indifferent to whether it makes the host mildly or severely ill, or if the host even survives. Keep this in mind as SARS-COV-2 will continue to mutate so long as it is endemic.
In all likelihood **you will be exposed, in days or weeks within the UK, in weeks or months in the US.**
That said, "Omicron might be our way out of this pandemic," per Campbell. If that's the case, we've been fortunate.
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