Looking at South Africa (SA) which has seen the biggest outbreak of Omicron: cases are starting to peak (at highest ever levels) while hospitalizations are much lower than previous Delta wave and deaths are at a very low level.

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United Kingdom (UK) news cases have gone absolutely parabolic however hospital admissions and deaths remain quite a bit lower (compared to previous waves).

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As seen in past waves hospitalizations to some extend and deaths are a “lagging indicator” but as seen in SA which has seen Omicron effects for over 4 weeks is not showing any spike in deaths.

UK is also similarly not showing any massive spike in hospitalizations and deaths so far (though some critics would say that current wave is not showing any signs of topping so far).

Real world data from these 2 countries and some others shows that while cases have outpaced previous waves this variant is milder/not as bad as the previous ones (bit more on the milder part below).

Now there remains a healthy debate on whether Omicron is milder or not (compared to previous strains). Some including @nataliexdean have argued that the % of folks getting re infected makes the % of folks with milder disease lower while the raw number might remain the same.

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If the graph above holds true it must mean that previous infection does not provide as much “protection” vs re -infection as in the past

Omicron largely evades immunity from past infection or two vaccine doses | Imperial News | Imperial College LondonThe Omicron variant largely evades immunity from past infection or two vaccine doses according to the latest Imperial modelling.https://www.imperial.ac.uk/news/232698/omicron-largely-evades-immunity-from-past/

Now it has been well known that Omicron does evade Antibodies (Abs) and also some monoclonal Abs treatments (to a certain extent) which has lead to sort of panic due to the headlines in the media

How Omicron Evades Natural Immunity, Vaccination, And Monoclonal Antibody TreatmentsThis is the third in our series that outlines what we know about Omicron. We summarize the finding of recent experiments by Cameroni et al. in a bioRxiv preprint from December 14th.https://www.forbes.com/sites/williamhaseltine/2021/12/17/how-omicron-evades-natural-i

The good news is that “T cell responses remain broadly robust against Omicron variant”. So Omicron will be in most folks (very crudely put by me here) “dealt with 2nd level of defense” in T Cells

T cell responses remain broadly robust against Omicron variant of SARS-CoV-2A new study highlights the significance of robust T cell responses in preventing severe omicron infections.https://www.news-medical.net/news/20211216/T-cell-responses-remain-broadly

Omicron might evade Abs but T Cells dealing with the infection might result in severe COVID/death in immunocompromised/older individuals (hence the rush to push boosters for them) but for rest should result in milder disease in comparison. Looking at the spike in cases in many nations across the world it is inevitable that India will see a another spike in cases.

I have argued countless times in the past about weather driven surges in covid cases and now see that India will see a spike in cases in February or possibly March as the weather starts to warm up.

@agrawalmanindra (Prof at IIT-K) & his colleagues have developed a fantastic model SUTRA which predicts cases in the near future (P.S. Their modelling was accurate even during the 2nd wave even predicting the top of the 2nd wave in early May)

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Based on the prediction above even the most optimistic scenario has 1 lakh new cases per day. Looking at the surge in other nations right now the number could well exceed 1 lakh news cases per day at top the new wave.

That leaves now a couple of months on how to prepare for the oncoming Omicron induced wave. Best for Indian authorities to speed up vaccinations for the remaining adults including addressing the thorny questions of boosters for adults and vaccinations for kids.

Even highly vaccinated nations have seen Omicron surges (as seen so far) so higher vaccination in India is more to prevent way too many severe cases and deaths (i.e. will not prevent a Omicron surge itself)

States have to be pushed to not shut down “surge” faculties like they did before the 2nd wave earlier this year .

Just before 2nd Covid wave hit India, ICU beds decreased by 46%, oxygen ones by 36%Hospitals in India have been facing an acute shortage of oxygen/ICU beds and ventilators ever since the second wave of coronavirus infections hit the country with rampaging ferocity. Government data sā€¦https://www.indiatoday.in/coronavirus-outbreak/story/just-before-2nd-covid-wave-hit

While the milder Omicron might not hopefully require as many hospitalizations but even a small % of large number of cases might stress the medical facilities in certain places across the country.

Now that we are on the 5th variant of SARS-CoV2 (Alpha, Beta, Gamma, Delta & now Omicron) it would be good to take a step back and look at how viruses evolve, given how the media coverage has been over these variants: the less said the better šŸ™‚

Virus as a pathogen needs a host to survive. Kill a host too quickly and it does not enough time to replicate to increase it’s numbers.


How Viruses Evolve
Pathogens that switch to a new host species have some adapting to do. How does that affect the course of a pandemic like COVID-19?https://www.smithsonianmag.com/science-nature/how-viruses-evolve-180975343/

Some of the most lethal viruses like avian flu: 60% mortality rate don’t spread as much as it is not airborne like COVID. But another minor secondary factor (P.S. of course not being aerosolized like COVID is still main reason!) is that many times a person falls sick and dies quickly before having an opportunity to spread it to other people.

Eventually all viruses as part of their natural revolutionary process mutate (as a sort of “self preservation method” for a lack of better term) to spread a lot (vs mutating to becoming more lethal which by killing the host would mean lesser numbers) Covid with Omicron variant seems to following a similar path by becoming less lethal. The million dollar question of course is whether this is the last variant before it becomes very less lethal similar to regular flu.

Omicron variant could potentially signal the “beginning of the end” for this pandemic.

Content curated from Twitter and republished with permission from Mr Mohal Joshi

Credits: Mohal Joshi

Twitter @MohalJoshi

Host: @indiarisingmk podcast. Columnist/Podcaster. Interests: GeoPolitics/Defence/Politics. Tweets are personal. RT’s/Like’s not endorsements.

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