Omicron variant more resistant to vaccine but causes less severe covid, major South African study concludes
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OMICRON appears to cause less severe illness than earlier variants of the coronavirus but is more resistant to the two-dose Pfizer-BioNTech vaccine widely used in South Africa, according to the first major private study since omicron was first detected last month.
The study by Discovery Health, South Africa’s largest health insurer, of 211,000 positive coronavirus cases, of which 78,000 were attributed to omicron, showed that risk of hospital admissions among adults who contracted covid-19 was 29 percent lower than in the initial pandemic wave that emerged in March 2020.
However, the study, released Tuesday, found that the vaccine from U.S. pharmaceutical giant Pfizer and German partner BioNTech provided just 33 percent protection against infection, much less than the level for other variants detected in the country.
At the same time, the vaccine may offer 70 percent protection against being hospitalized with omicron, the study found, describing that level of protection as “very good.”
The protection was maintained across all age groups, Ryan Noach, Discovery Health’s chief executive, told a news briefing. He said the disease may be less severe in South Africa because more than 70 percent of the population had already been exposed to the coronavirus.
He cautioned, however, that it was still early days and hospital admissions could rise sharply as the variant evolves further.
“The omicron-driven fourth wave has a significantly steeper trajectory of new infections relative to prior waves,” Noach said in a statement. “National data show an exponential increase in both new infections and test positivity rates during the first three weeks of this wave, indicating a highly transmissible variant with rapid community spread of infection.”
“What is encouraging at this stage is a flatter trajectory of hospital admissions indicating likely lower severity of this wave,” he told a news briefing later.
Noach said anecdotal evidence gathered from doctors treating omicron patients outside hospitals showed a high reinfection rate and multiple breakthrough infections in vaccinated people that emerge after a short incubation period of three to four days.
Most infections are described as mild, with recoveries usually within three days, he said. The most common early symptom reported is a scratchy throat, followed by nasal congestion, a dry cough and myalgia, or aches, manifesting in lower back pain.
He said private hospitals reported that most patients were unvaccinated and many were initially admitted for non-covid-related illnesses. There was less evidence of respiratory infections in omicron-infected patients, compared to the other variants, with fewer patients requiring oxygen, Noach added.
Shirley Collie, chief health analytics actuary at Discovery Health, said doctors were reporting a higher number of children testing positive with omicron, but cautioned that closer examination of the issue was needed. Discovery Health’s data indicated that children under the age of 18 have 20 percent higher risk of admissions for complications when infected with omicron compared to the other variants, she said.
Most children infected with omicron complained of a headache, sore throat, nasal congestion and a fever, that was usually over within three days, Collie said.
The study comes as omicron has become the dominant variant in South Africa less than three weeks since its existence was confirmed on Nov. 25. The World Health Organization warned Monday that omicron, now detected in 63 countries, poses a “very high” global risk.
In a separate briefing Tuesday, Matshidiso Moeti, the World Health Organization’s director for Africa, declared that Africa was now officially in the fourth wave of the pandemic primarily driven by omicron, with an 83 percent surge in new cases this week compared to the previous week.
“This is the fastest surge recorded since May last year,” Moeti said. “We are cautiously optimistic, as we are seeing fewer deaths during the early weeks of this current wave when compared to previous surges.”
In South Africa, the drop in the protection of two doses of the Pfizer-BioNTech vaccine against any symptomatic infection is similar to what a British preprint study released late last week showed, namely that it dipped below 40 percent.
The British study, however, could not answer pressing questions about whether vaccine protection against severe disease would erode just as steeply. The South African data provides a first hint, showing that protection against severe illness requiring hospitalization after two doses was diminished from its more than 90 percent protection against the delta variant but remained relatively robust, at 70 percent.
As the world watches South Africa closely for signs of how omicron could evolve elsewhere, there are a lot of questions around population differences and how much previous infection protects people.
Glenda Gray, president of the South African Medical Research Council, said it was hard to answer those question right now.
“South Africa has a quite high seroprevalence of prior infection, particularly after delta, and in some parts of South Africa up to 80 percent of people were exposed to previous infection,” she said. “We don’t think it’s a question of virulence, but more a question of exposure to vaccination and prior infection, so we would be cautious to try and interpret that this is a less virulent strain. We’ll have to see what happens in other parts of the world before we make a call on this.”
CREDIT: Y. Johnson contributed to this report in Washington Post.
