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Does Omicron have what it takes to fill hospitals? | Coronavirus


Omicron is spreading at a rate that we have not seen with the other variants. […] We are concerned that people will assume that Omicron is less severe. We should have understood that we underestimate this virus at our perilWorld Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus said Tuesday.

While early information from South Africa indicates that Omicron does not appear to cause more severe symptoms than previous variants, experts say more data is needed to confirm this fact.

For example, South Africa has a relatively young population. So what will be the impact of Omicron in countries like Canada, where the population is older?

In addition, very high infection levels (New window) in recent waves in South Africa, may partly explain the relatively low levels of hospitalizations and severe illness.

It is also difficult to compare the impact of Omicron between countries, in particular due to different populations (eg: average age), different vaccination schedules and the type of vaccine used. For example, Canada has one of the highest vaccination rates in the world and has adopted a longer interval between doses, which appears to offer better protection in the case of the Delta variant. What will happen with Omicron? Hard to say.

But already, we are starting to see indications that the number of hospitalizations is increasing in other countries where Omicron is spreading rapidly.

In the UK, hospital admissions are on the rise; same thing in Denmark. France has warned that its hospitals will soon be at maximum capacity.

A memo from the UK Health and Security Agency sent to the British government warned that the number of hospitalizations could exceed the peak of last winter, even if Omicron turns out to be less severe than Delta.

In Quebec, cases began to increase exponentially in early December; the number of hospitalizations began to follow on December 13. We pay the price for the 2000 cases [par jour], said Quebec Health Minister Christian Dubé.

If the number of hospitalizations continues to increase at this rate, the impact on hospital capacity could be very large, especially after the holidays, warned the Minister of Health.

Hospitalizations usually start to increase about two weeks after the upsurge in cases, so the increase may just start to be felt.

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Elsewhere in the country, new modeling in British Columbia estimates that the province’s hospital capacity could be exceeded within a month.

Manitoba is already considering canceling more surgeries due to a rapid rise in hospitalizations. Ontario estimates the number of people in intensive care due to COVID-19 could hover between 250 and 400 by mid-January, double the current situation.

Can vaccination reduce hospitalizations?

There are signs that the vaccination seems to partially protect against the severe symptoms caused by the Omicron variant, but that this protection is not as effective as for the other variants.

The efficacy of Pfizer-BioNTech’s vaccine against severe symptoms thus increases from over 90% to 70% when confronted with the Omicron variant.

The vaccine’s effectiveness in stopping an infection with the Omicron variant is almost zero for people vaccinated with the AstraZeneca vaccine and less than 40% for those who have received the Pfizer-BioNTech vaccine. A booster dose, however, would increase protection against infection to 75%. It should be remembered that less than 5% of the world population has received three doses of the vaccine.

A preliminary study shows that the antibodies of people who received two doses of Moderna are about 50 times less effective in neutralizing the Omicron variant than other variants. A booster dose would be needed.

Johnson & Johnson has yet to release data on the efficacy of the vaccine against Omicron.

Pfizer has also indicated that its experimental pill against COVID-19 seems very effective in reducing the risk of hospitalization. However, no country has yet authorized this treatment.

Omicron also appears to be able to further re-infect those who have been infected in the past. People infected with the Delta variant are said to have a 40% risk of being re-infected with Omicron, and those infected in early 2020 have a 60% risk of re-infection with Omicron.

A study of Germany (New window) (not yet peer-reviewed) shows that young Germans who received three doses of the vaccine were still infected. However, their symptoms were mild: runny nose, sore throat, shortness of breath and a dry cough. But again, we’re talking about younger participants, who are generally less likely to develop severe symptoms of COVID-19.

Considering all these uncertainties, the WHO warns that we must use the precautionary principle and try to prevent as many infections as possible.

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Omicron doesn’t have to be tougher to make an impact

For now, one thing seems certain: Omicron is at least two to three times more contagious than the Delta variant and appears to infect people who have already been infected or vaccinated. The number of cases seems to double every two or three days.

Omicron is so contagious that it is estimated by the Ontario government to be the predominant variant in the province before Christmas. Omicron was detected in Canada on November 28.

In comparison, the Delta variant, which appeared in December 2020 in Canada, became dominant only seven months later.

This is why experts warn that this variant, due to its ability to infect a large number of people, could affect as many people as possible belonging to vulnerable groups such as the unvaccinated people, the elderly and the immunocompromised. However, these people are more at risk of developing serious symptoms and of being hospitalized, which would be enough to have a major impact on the health system.

Remember that in Canada more than 8 million people are not adequately vaccinated (including those who are not yet eligible for the vaccine). Even before Omicron, unvaccinated Canadians aged 12 to 59 were 32 times more likely to be hospitalized with COVID-19; in unvaccinated Canadians aged 60 and over, the risk is 16 times higher.

In addition, 27% of Canadians have at least one comorbidity (e.g. diabetes, hypertension, asthma, etc.) that makes them more vulnerable to COVID-19.

Mike Ryan, the WHO’s emergency manager, said on Tuesday that governments around the world need to prepare for a wave of infections and make sure hospitals have enough staff and equipment. Health systems are weaker today than they were a year ago, in reality, he recalled.

As the holidays approach, the Quebec Minister of Health has asked people to be extremely careful, considering the fragility of the health system, which we struggle to support at arm’s length.

Mike Ryan called on people to protect themselves to slow the transmission of the virus and not cause health systems to collapse. Vaccines do not replace masks. Vaccines are not a substitute for distancing. Vaccines are not a substitute for ventilation or hand hygiene. Do all of these things. Do it consistently. Do it well.

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