I first looked at Omicron just under one week ago. The data since that time has already been sufficient to rethink my origin viewpoint.
- Recap: Previously.
- What Has Changed? S. Africa Cases!
- The Norway Party.
- The Big Hope: Less Dangerous Than Delta?
- Revised Summary.
- Conclusions(2 weeks later): Scary, But Not Earth Shattering.
I only recently took a first look at Omicron on 6 days ago on November 29th.
It was already astounding just how quickly it had become the dominant variant in South Africa, and it was clear it could infect people who should have immunity. Many people who should be immune have been infected, although the severity is now worse than expected for a breakthrough infection, resulting in a low number of severe cases.
So perhaps a new variant that result in a huge number of breakthrough infections, but as with most breakthrough infections, these should be less severe than cases in those without immunity. More breakthrough infections need not be bad?
What Has Changed? S. Africa Cases!
Update Dec 7th: At the time of writing, Dec 4th, each previous day had seen a rise in case numbers, but in the days since, the spike has already subsided, and the 7 day average in now just over 10,000, and could start falling.
To the left was the chart of case in South Africa back in November. Now check the cases to the right just one week later.
Tracking case numbers per day:
This is a disturbing rate of infection.
The ability to result in breakthrough infections as the sole “superpower” would alone, enable taking over as the dominant variant, but it would not explain this rate of spread.
Breaking thorough would result in the same rate of spread within a population with high immunity, as would occur with no immunity. However, this rate of spread appears unprecedented, even in outbreak where there was no immunity.
Some caution is required, as the highest ever daily cases number of 26,000 could reflect the limit of the system to detect cases. On the current trend, that limit could again be reached in days.
|Date||1 day||3 day||7 day|
- Dec 3 202: I first wrote this page on Nov 29, when cases were around 2,000 and now, just a few days later, things have skyrocketed, and I updated the table.
- Dec 14 Update: After Dec 3rd, cases dropped only to surge again on Dec 9, and then on Dec 12th smash the previous record for the pandemic of 26,645 with Delta to reach 37,875 cases. This may highlight just how much 1 day figures can fluctuate, so I am now adding 3 and 7 day moving averages, and will only add days that are noteworthy, or perhaps every 5th day. Note that Omicron at Dec 12 was already the record for 3 day average, but not 7 day yet (July 8 was 20,076).
The Norway Party.
“Our working hypothesis is that at least half of the 120 participants were infected with the Omicron variant during the party. This makes this, for now, the largest Omicron outbreak outside South Africa.”
“It is still too early to say whether the clinical picture of the disease is different in Omicron infections than in Delta infections,” Aavitsland said.
“None of the patients has severe symptoms; none is hospitalized. However, this is not unexpected given the young age of the participants.”CNN 2021 Dec 3: Omicron outbreak at Norway Christmas party
The party on November 26th, was open only to those with proof of vaccination, and a negative test. This would seems a high number of infections even for a party of unvaccinated young people. Although it would be surprising if there were severe symptoms in what are, after all, not only young people but also all cases of breakthrough infection, the normal level of infection for a party of young fully vaccinated people would be “undetectable”.
The Big Hope: Less Dangerous Than Delta?
The hope is that Omicron results in a lower percentage of severe cases. The problem is it seems difficult for a lower percentage or more cases to end up being less cases. What is the point of a lower percentage, it is a bigger number due to the increased cases? In the end, because every wave reaches a peak after which it declines. That decline effectively represent at least a brief period of herd immunity, a time when each person is infecting less than one other person. It could be that Omicron will just “burn out faster”, and in doing so, will have hospitalised less people. A faster rise, to a similar plateaux and a faster fall. That is the hope.
There are sill many reports that an Omicron infection prevents less of a threat than a Delta infection.
This could turn out to be true, but there is every reason that the typical case of Omicron appears less severe when in fact, this is only due to a flaw in our ability to collect data, and the ambiguous definition of infected.
Consider the party in Norway. We know that at least 60 people were detected as infected.
But what is infected? We do not count all people where the virus enters their body, but only those where having entered their body, the virus manages to take hold and then reach a level detectable by a test.
If we count ‘infected’ as when the virus enters your body, then as there is not even a suggestion Omicron flies through the air better, where be the same number of people would be ‘infected’ with Delta as with Omicron.
What is different is that with Omicron, a far higher number of infections presented some level of threat.
Consider the following hypothetical data.
|Variant||Infected/Exposed||Test Positive(case)||Develop Symptoms||Severe||Casualty|
If considering the ratio of severe cases and causalities to “test positive”, than Omicron would result in severs cases and casualties relative to the number of cases. However, this becomes academic given with Omicron, more people are in hospital and die.
So does the hypothetical data above match reality? While the Norway event has no data for the “severe or casualty columns”, it does the scenario where lower severity statistics would occur, even when there is increase in adverse outcomes. The whole argument of “less dangerous” may be constructed on a false premise that follows from our inability to detect low level infections. Include all those infected, and the outcome with Omicron already looks worse in terms of people who are symptomatic, and as far as severe disease and casualty, we just do not know yet.
Virulence Preliminary Analysis.
Omicron can defeat some layers of existing immunity, but not all, and this may become less significant as immunity from Omicron infections build and vaccines are adjusted.
Omicron is also spreads more effectively than any previous strain of the virus. This suggests it may be more virulent, but this is not clear. What is clear is that more effective spread results in a wave with huge numbers, and when there are huge numbers, many people who are infected have high viral loads, and that results in more serious infections and deaths. If this does happen, it may take several months to eventuate, as the large number of previously immune people infected will keep the ratio of infections high compared to the lower number of severe cases.
The ratio of severe cases to infections may always look better with Omicron, but both total numbers will most likely rise. So not as large of an increase in severe cases or deaths as the huge increase in cases, but still an increase.
Omicron represents a new phase of the pandemic. It seems unlikely this will be a good new phase.
What is not officially known about Omicron is:
- Any reduction in immunity as a result of vaccination.
- “It is not yet clear whether Omicron is more transmissible”.
- “It is not yet clear whether infection with Omicron causes more severe disease compared to infection with other variants”.
While nothing is official or proven, it does seem clear that:
- There is a reduced immunity at level 2 to Omicron from immunity acquired from previous infection and possibly also vaccination.
- Omicron is more transmissible.
- Increased transmission will lead to more virus in circulation, which will in time lead to infections with higher viral loads that seen previously, and higher viral loads result in more cases of severe disease.
It is still early, but the rate of new cases of Omicron emerging is far outpacing new cases of any previous variant. Yes, for example, in the US, there are 90,000 cases per day of Delta to less than 90 of Omicron, but if the pattern in South Africa replicated, that could change within two weeks.
It is likely that any increased severity of Omicron infections, if present at all, would be minor provided outbreaks are contained.
The ability to evade prior level 2 immunity, may be purely due to the virus looking different from previous strains, and be only a “one time” effect as full immunity to Omicron will result from infection with Omicron.
In summary. I suggest there is reason to be alarmed. There will very likely be a significant spike in infections everywhere Omicron reaches, but as all evidence is level 3 immunity will remain fully intact, there will potentially be only a far smaller rise in severe cases or hospitalisations. Infections from Omicron will increase overall immunity, potentially ending its own spike.
In fact the better ability to spread could be the Omicron Achilles heel, as it quickly exhausts potential spread targets. Nervous times.
Update Dec 16. It was only 2 weeks later that I had some conclusions. Cases in South Africa did not continue rising, and more data is available. The conclusions are in this update, but overall, it seems Omicron will be a bump on the road out of the pandemic, but we are on that road and hopefully deaths will continue to fall in most locations.