December 20, 2021 – Omicron is here in the United States.
This emerging variant, which accounted for less than 1% of Covid cases in the U.S. on December 1, now represents more than half of the new infections in New York. By the end of this week, it will overtake Delta as the predominant strain in the U.S.
This much is clear: Omicron spreads rapidly. What remains uncertain is how well the available vaccines protect against infection and, more importantly, against severe illness. Early studies from South Africa and Europe hint that the vaccines lose some effectiveness against an Omicron infection but maintain significant protection against severe illness, including hospitalization and death.
Moderna reported this morning that a booster dose of its vaccine is effective against the Omicron variant. Compared to a two-dose regime, the company reported a 37% increase in neutralizing antibodies against the Omicron variant.
Reports from the Gauteng province of South Africa further suggest that the Omicron infection surge may be short-lived compared to prior variant-induced waves. These reports show infection rates peaking near Delta-level peaks but reaching this peak (and then receding) four times faster than with Delta. On an age-adjusted basis, hospitalization rates were half that experienced with Delta. Death rates were even lower under Omicron.
Omicron made its presence known in the United States late last week. Twenty-five of the 64 largest counties and municipalities saw new cases double from Wednesday to Thursday then double again on Friday. (Complete case data for Saturday and Sunday will not be available until late this evening.) At least 415 counties and municipalities across the country – from New York City to tiny Green Lake, Wisconsin – experienced this consecutive day doubling of new cases.
The consensus of an expert panel convened by Andy Slavitt on his In the Bubble podcast (“What 11 Top Scientists Expect in 2022”) points to explosive growth in Omicron cases in the United States in the next few weeks. However, the consensus also suggests an early rapid peak then rapid decline in these cases – beginning as early as mid-to-late January.
With this pronounced spike in new cases late in the week, we might expect a corresponding surge in hospital admissions. Fortunately, one did not materialize – yet. New Covid admissions have been dropping for at least 10 days on a day-of-week-adjusted basis. Despite the surge in new cases late last week, the decline in new admissions continued into the weekend.
This pattern of declining admissions repeated itself in hard-hit New York.
Covid infection rates are highest in Europe, southern Africa, and the United States. Due to Omicron, infections are exploding across the African continent, especially southern Africa. Malawi suffered from an eight-fold spike in new cases last week, the highest of any large country. Other countries near South Africa saw a doubling to a seven-fold increase, including Angola, Botswana, Eswatini, Lesotho, Mozambique, and Namibia. South Africa, where Omicron struck early and hard, saw “only” a 52% increase in new cases week-over-week – down significantly from the prior two weeks’ spikes.
By comparison, cases in the United Kingdom rose 39% from a week ago; cases in the United States increased 9%.
As Omicron cases swell in the United States – we should expect explosive growth this week – we must pay close attention to our overwhelmed health care providers. At the end of the week, Covid patients occupied one of every five hospital beds in the United States. In Arkansas, Delaware, Michigan, and New Hampshire, Covid occupancy has swelled to 40% or more of all inpatient beds.
Still, as mentioned above, Covid admissions on a day-of-week adjusted basis have declined for ten consecutive days.
Seasonal flu also can strain health care resources. Here too, the trends are somewhat encouraging. Now is the time of year when flu visits explode, taxing healthcare resources. Fortunately, flu cases have not swelled as quickly as during prior flu seasons in the past several weeks.
Contributing writer:
Mark A. Van Sumeren, strategic advisor, Medical Devices & Integrated Delivery Networks
Health Industry Advisor LLC, provides a regular report on COVID-19 numbers for the health care industry.
For more information, or to sign up for the report, contact Mark at Mark.VanSumeren@HealthIndustryAdvisor.com; or visit www.HealthIndustryAdvisor.com.