Deep data dive: is Omicron the end of the pandemic?
Pieter Streicher makes the case for cautious optimism in South Africa
Since its discovery in the Gauteng province of South Africa in November, a new Covid variant has set off a spiral of harsh restrictions, travel bans and questions about the efficacy of the existing two-dose vaccines. Dr Angelique Coetzee, the scientist who first raised the alarm in Gauteng, has repeatedly assured the public that early observation of symptoms suggests that Omicron could be milder than the Delta variant. Despite some reassuring signs on the ground, reaction to the new variant has been dramatic, with Boris Johnson warning of a ‘tidal wave’ of cases in the UK and Joe Biden predicting an ‘explosion’ of cases in the US.
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To unpick some of the data coming out of Gauteng, Freddie Sayers sat down with researcher at the University of Johannesburg, Pieter Streicher, who has been following the developments of the Omicron variant in his home country.
Pieter is clear that, like all waves of the virus, there will predictably be a sharp increase in cases in the coming weeks in South Africa and beyond. But cases are not, he says, the best metric by which to measure the threat of Omicron. When measuring the virulence of any variant, it is more important to study records of hospitalisations and excess deaths.
By these measures, Omicron is resulting in hospital admissions well below the previous wave in South Africa, and needing far less interventions like ventilation or supplemental oxygen. Excess deaths look likely to follow this pattern. With Delta, Pieter explains, patients were often coming into hospital with low blood oxygen levels and severe symptoms. Reporting from South African hospitals suggests that a higher percentage of positive tests are ‘incidental’ with the Omicron variant, with patients often asymptomatic or unaware that they were harbouring the virus.
Pieter appreciates that the initial exponential growth rate for Omicron does look dramatic. But scientists ‘make the mistake to project that [exponential growth rate] well into the future, well beyond even a plausible peak date.’ According to his observations, Omicron’s growth rate appears to already be slowing in Gauteng.
If symptoms are less severe and numbers slowing, could this new variant actually be good news? Pieter is cautiously optimistic. If Omicron ‘outcompetes’ the Delta variant, then it could spell the end of the pandemic as we know it, putting coronavirus in the same category of disease as the common cold. Pieter is keeping a close eye on the newer numbers being recorded in Europe, as are we.
I was at the University of Cape Town Heart and Lung Institute today visiting a specialist pulmonologist – this centre is affiliated with the Groote Schuur teaching and research hospital – the first hospital in the world that did a heart transplant (for those that don’t know).
The pulmonologist I visited has been intimately involved with and weathered the storms of Covid throughout (of course) and he is also cautiously optimistic that Omicron is going to be milder – echoing what other doctors and specialists have said. He feels end of December would be the marker to declare categorically that this variant is not nearly as deadly and could usher in the end of the pandemic.
Being a Greek Virus, as it were (Xi being skipped over and Omicron being chosen, Pythia like) then rather than Niel Ferguson and these number crunching technocrats like above – we need to turn to Delphi and learn from that Oracle; who, when Croesus asked the Oracle, what it had been doing that day;the Oracle replied:
“οἶδα δ’ἐγὼ ψάμμου τ᾽ ἀριθμὸν καὶ μέτρα θαλάσσης, καὶ κωφοῦ συνίημι, καὶ οὐ φωνεῦντος ἀκούω. ὀδμή μ᾽ ἐς φρένας ἦλθε κραταιρίνοιο χελώνης ἑψομένης ἐν χαλκῷ ἅμ᾽ ἀρνείοισι κρέεσσιν, ᾗ χαλκὸς μὲν ὑπέστρωται, χαλκὸν δ᾽ ἐπιέσται. [Translation: I count the grains of sand on the beach and measure the sea; I understand the speech of the dumb and hear the voiceless. The smell has come to my sense of a hard shelled tortoise boiling and bubbling with a lamb’s flesh in a bronze pot: the cauldron underneath it is of bronze, and bronze is the lid”
Indicated they were able to understand and figure out complex things deeply, although cryptically- and then gave their actual Prophecy in answer to if Croesus should attack Persia:
“ἀλλ᾽ ὅταν ἡμίονος βασιλεὺς Μήδοισι γένηται, καὶ τότε, Λυδὲ ποδαβρέ, πολυψήφιδα παρ᾽ Ἕρμον φεύγειν μηδὲ μένειν μηδ᾽ αἰδεῖσθαι κακὸς εἶναι. [Translation: Whenever mule shall become sovereign king of the Medians, then, Lydian Delicate-Foot, flee by the stone-strewn Hermus, flee, and think not to stand fast, nor shame to be chicken-hearted.”
And so Croesus, acting on his interpretation of this, attacked Persia and lost his Kingdom because the ‘Mule’ actually meant Cyrus as he was half Greek and half Persian…..
Unfortunately I think the last and final Prophecy is the best for the Omicron question, and maybe Boris can use it in figuring the Nation’s Policy tomorrow, although it is tricky as sometimes it works well, sometimes not:
““Tell to the king that the cavern wall is fallen in decay;
Apollo has no chapel left, no prophesying bay,
No talking stream. The stream is dry that had so much to say.””
Preventing a virus from spreading and infecting a whole lot of is and killing some of us is a bad bad idea.
It feels like we are going against the natural curve of interaction between viruses and its hosts. ( our evolution is taken lightly). Hence such a severe meddling by modern medicine to unnaturally protect a species from natural deaths (culling!)appears to have consequences of even worst proportions. The hubris, the fear, the manipulation and subsequent dystopia with mandates and passports are all unmeasurable on charts and graphs.
As the disease mutates & progresses it is moving to turn us all into a stronger & hopefully more fortified species. We have perhaps misunderstood it’s intention and have been our own worst enemy. We perhaps misunderstand death too, it is salvation for the old & diseased and should perhaps be looked at more kindly.
There are no scenarios in which there could have been no death from covid and even “with” omicron. As for hospitals being overwhelmed, it reeks of western hubris, face saving, while delaying the inevitable but not kindly at all. The tearing down of nightingales soon after being built speaks volumes in itself.
No pandemic lasts forever.
On the whole I found this a rather heartening interview, however, the one thing not addressed here, and I wish had been, was the differing age profiles for SA and the UK. Is the fact that the UK has a larger number of older people going to give a vastly different outcome here or will it have a negligible effect? We may just have to wait for the answer.
On a different note why are the medical authorities reluctant to let us know the circumstances of the death? I understand that there is medical confidentiality involved, but if the person was 99-years old with severe COPD it’s a different matter from the person being a fit 25-year old; telling us that would not breach anyone’s confidentiality.
The champagne stays in the cellar
Maybe they are reluctant to say anything about the patient because the fear factor must be ever present. You don’t threaten a raft of calamitous restrictions without reason, do you? So this one poor soul is mentioned.
They cannot release the details till the court of inquiry makes charges, as the patient who died had been shot 9 times during an armed holdup 4 hours previous.
I can’t work out if you’re being sarcastic or not. This worrying, am I now believing anything?
My thoughts on this yesterday were…
The daily cases are doubling every 2-3 days, like 2, 4, 8, 16, 32, 64, 128, 256, 512, 1024, 2048, 4096, 8192, 16384 in 4-6 weeks. The small fatality rate is roughly fixed.
If deaths are only 0.1%, then 16 people die per day after 4-6 weeks (16384/1000), but deaths keep increasing 32, 64, 128, 256, 512, 1024, 2048 per day over the next 2-3 weeks, continuing upwards until we run out of people to infect. *edit: he says that deaths are likely to be 25 times less than delta*
*edit: he says that these sorts of numbers are for do nothing scenarios; in reality, small behaviour changes make big differences*
Either we batten down the hatches, or let it become endemic. I still don’t know which is the best choice if it’s “mild”
This interview seems to suggest that something may cause it to peak much earlier, which would be great news. What is this mechanism? *edit: he is suggesting that the threshold for herd immunity is 20-30% of the population*
I have also been wondering on UnHerd if a mild Omicron could signal the end of the pandemic. If it comes to dominate, does it prevent a more virulent variant coming along? In which case, should we stop vaccinating?
Any experts out there?
Seems to me there is a new flu variant every year to supplant the previous one and you can be vaccinated every year. It reduces severity and deaths but never eliminates them. Why should covid be different ?
Could the 1919 flu virus return ? Where did it go and why doesn’t it come back ?
Could a democratic government decide on no restrictions, see fatalities and survive ? No. They need to be seen to have tried.
Too many people see themselves as an expert. The result is the anti-vax ‘hoax’. Sad.
I can think of no fundamental difference from flu, except this started off being much more virulent.
The 1919 flu must have mutated into something mild.
Governments have to be seen to be in control, or they don’t get elected. In reality, they turned out to be fairly powerless.
Yes, we are all armchair experts.
Should we break out the champagne? (I’m still a little concerned that it could mutate to be more virulent because it can spread without symptoms, despite what the guy said)
Maybe to be a successful virus you should not kill or even incapacitate your host otherwise they will die or not move around and you won’t spread.
Ideally you would be beneficial or even essential to your host, as many germs seeme to be.
In the distant future our descendants might rely on a covid descendant to keep us breathing in an over-rich CO2 atmosphere (?)
Yes, but if it’s virulent enough, and can spread before you get incapacitated, then it may as well kill you once you’ve passed it on.
Oh, how does a coronavirus help you breathe more easily?
Why did we evolve to rely on bacteria in our gut ? There must have been a time when we didn’t need them , now they are essential.
.The covid that keeps its host alive will spread more than the one that kills.
The covid that evolved to make our lungs more efficient would previal over those that didn’t.
I like the way you’re going with this, but currently CO2 is only about 0.4%
Actually, its oxygen which is poisonous
He said that this is the mistake that all the forecasters have made… that they assume that everyone is susceptible to the disease and that it must move its way through the entire population if no measures are put into place.
The epidemic curves that are as ancient as time, show that they rise… and then fall.
South Africa had very limited restrictions last summer (we cannot count some nonsensical restrictions like beach bans – duh) – and yet the curve rose – and then plummeted. At this time they banned indoor shouty places but allowed the bulk of the population to move around in minibus taxis jammed to the hilt – nary a mask in sight – good for them).
Exactly,HART have deduced that around 15 to 20% of the population are susceptible to each variant of a virus.Thus it runs out of fuel eventually
“Either we batten down the hatches, or let it become endemic”
Which hatches were battened that made any difference to the arc of covid infection? Florida and Sweden, Michigan and UK – the most battening has coincided with the greater harm to the place.
The highest rate of Vax inevitable leads to the highest amount of cases in the West – wile across the world places like (Worldometers)
China, 3 Deaths per Million
Japan, 146 Deaths per Million
Taiwan, 36 Deaths per Million
Vietnam, 290 Deaths per Million
Kenya, 96 Deaths per Million
India, 340 Deaths per Million
are not much bothered, AND THEN:
UK, 2146 Deaths per Million
Notice any pattern there?
Yes…..an armchair one :))
The Spanish flue mysteriously disappeared after 2 years and as an open minded armchair specialist I can tell you this will become the same……when ? I have no clue, but omicron is surely showing something very different from what we’ve experienced since the start of the pandemic. The time frame seems to match the Spanish flue.
Should we continue vaccinating ? you bet…..targeting the vulnerable and certainly not mandating for the others making a chunk of the population social nobodies. In short….just like the flue shot we get each year. The point Freddie made about health passes is going to make some politicians sweat and people like Lord Sumption’s point finally recognised.
The tab is going to be very high in social costs……family abuse, school closed, lost education years, business going tilts up, psychological scars. Not one politician will want to pick it up…….not me…..will be the phrase.
In the meantime, soooo many people made insane amounts of money. Sounds like pretty much deja vu.
This is UK All-cause mortality, and this is the one to watch. You don’t need to distinguish between ‘of covid’ and ‘with covid’ if you just watch total deaths.
Useful data for us data addicts.
I should have fetched the champagne from the cellar in week 13, 2021
You should drink it now.
If the pandemic is over; celebrate!
If you’re about to die; drink it while you can!
I feel the need for some emojis other than 🙂
13:21 Dr. Streicher’s 100% right here. SAGE, especially Neil Ferguson(who BTW has ZERO degree or training in virology, epidemiology, evolution biology OR public health policy-making), has got it way off far to many times made things a whole lot worse than it needs to be. It’s way overdue that they get disbanded and be replaced by far better scientific advisors like Profs. Sunetra Gupta & Carl Heneghan!
Ferguson has consistently failed to understand the way and the rate the covid viruses infect people. It is amazing that after 2 years of this, and I assume this is the only thing he works with, that he still uses a naive mathematical model without any resemblance to reality. They use the same model who has been proven beyond reasonable doubt to grossly inadequate.
Like I said Rickard: Neil Ferguson has ZERO degree or training in virology, epidemiology, evolution biology OR public health policy-making before he entered his current field- His bachelor degree was in arts, his masters degree unknown(if it actually relates to what he’s doing now it would’ve been known to the public by now) and his PhD in philosophy in theoretical physics(math models and stuff). This alone should’ve set LOADS of alarms bells ringing and disqualify him from his current field already, and his math models predicting previous pandemics & epidemics all failed spectacularly by making Mount Everest out of a mole hill, and caused bizzare consequences(eg mass-culling of shiploads of livestock), and the very same thing happened to this pandemic. Perhaps the gravest failure of Boris Johnson isn’t the trivial things hyped up by the media, BUT rather him even listening to Ferguson in the 1st place, plunged millions in the world into chaos(Fauci & Birx in the US, although nefarious themselves, didn’t push for lockdowns until they saw Ferguson’s math models!) let alone enabling him to spew more bollocks and keeping him in the sub-committees of SAGE after his scandal with ZERO repercussions(his resignation from the main SAGE was merely an act), not to mention dissenting scientists magnitudes more credible than he ever will be were shunned and even scapegoated in favor of him!
Another master interview especially toward the end on Freddie’s and Peter’s part.
When people realise this……particularly in France where health pass is to be turned into vaccine pass beginning of January, this is going to make them feel extremely cranky and cheated…….months from a presidential election. Marine Le Pen and Zemmour would be mouth watering if they had access to your interview Freddie……just like the AFD in Germany.
As to Bojo, I was going to say he will look like a fool…..but this is something he has made a profession of…..no harm done then.
As per my overlong post below, in South Africa natural deaths are the thing to watch.
The latest report which takes us to 18 December shows that natural deaths under 60 remain within normal prediction bounds, while deaths over 60 are only slightly elevated. You can access it here:
Unfortunately the next one will only be available on 5 January.
I am convinced that Omicron is milder (I currently have it myself; would not have known it if I hadn’t gone for a travel PCR) however there are important things to note about South Africa vs the UK.
Contrary to the “South Africa is much younger and therefore is less at risk” mantra, South Africa (RSA) has a very unhealthy population with approximately 7 million HIV-positive with 3.5 million on ARVs; and high rates of TB, diabetes, hypertension and obesity. Some 74 000 die of HIV/AIDs every year.
Furthermore, in some parts of the country, there is a weak public health-care system, such that people are not much helped by any care which might be available.
RSA’s estimated excess natural deaths since March 2020 are approximately three times the official Covid-19 death toll (270 000 vs 90 000).
What this means is that two-thirds of people died during epidemic waves in RSA without interacting with the health system in a way that their death could be recorded as a Covid-19 death. By contrast, in the UK, excess deaths are lower than the official Covid-19 death toll, due to the with/from Covid issue. Three-quarters of excess deaths in RSA are over the age of 60.
In South Africa, far from being a lag-indicator, a rise in excess deaths seems to come before the “official” rise in cases and hospitalisations. What this could mean is that vulnerable populations not accessing health care are hit first and start showing up in excess deaths. Indeed excess deaths jumped to 1389 from 807 in the week of 31 October. The first Omicron specimen was from 9 November. Cases starting rising in the of week of 16 November. So excess deaths are the thing to watch in SA. However, there is a lag in the sense that the data is only available 2 weeks after the deaths occurred.
The rate of increase in excess deaths reduced in the week of 5 December, unlike 2020, when it simply carried on increasing. In the last available week (week of 5 December), it is at around 2000 per week, drawn almost entirely from 60+ population, and compared to 3500 in the equivalent week last year (prior to that excess deaths were closely following the previous year). The divergence suggests something different may be happening now.
At the height of the peak last year in the week of 10 January there were 16 000 excess deaths.
The magnitude of total excess deaths in RSA suggests an IFR of around 0.5 percent, assuming the entire population has been infected. This means that either, the IFR is higher than the 0.3 percent often thought, in an uneven treatment context OR people have been infected multiple times OR many more people have been infected than we can imagine (I suspect a combination) .
The data on cases and hospitalizations in RSA reflects what is happening among the cohort of the population accessing care. The data from private hospitals in particular reflects the employed, relatively wealthy population, which is probably broadly comparable to the UK population. (Incidentally, the median age of Covid death in this cohort in RSA is around 55). Anecdotally, many more of this cohort are being infected now than they were previously (presumably with Omicron) such that the Ministerial Advisory Council has called for an end to quarantine for contacts, as it is simply no longer feasible and has great social and economic cost. This much higher infection is not translating into hospitalizations and deaths – neither official nor excess deaths.
Watching excess deaths which are usually released on a Thursday will tell us which way the wind is blowing.
The latest SA natural deaths data is available to 1 January 2022. Almost no excess for people under 60 and slight rise overall.
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