Dr. Scott Gottlieb meets with the USA TODAY Editorial Board to discuss the new omicron variant and what the future might hold for the pandemic.
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The new study from South Africa’s largest private health insurer shows that two shots of the Pfizer-BioNTech vaccine is just 33% protective against omicron.
Full vaccination against COVID-19 continues to provide 70% protection against severe disease, according to the Discovery Health study.
Omicron also appears to be able to reinfect people who had an earlier disease variant, with those infected longer ago at higher risk of reinfection.
The new omicron variant of the coronavirus is substantially more contagious and reduces the effectiveness of COVID-19 vaccines, a study from South Africa released Tuesday found.
Even though the variant so far seems to produce mostly mild disease, world health leaders warned it could bring a wave of illness that crushes health systems
“Omicron is spreading at a rate we have not seen with any previous variant,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.
“We underestimate this virus at our peril,” he said in a press conference Tuesday from Geneva. “Even if omicron does cause less severe disease, the sheer number of cases could once again overwhelm unprepared health systems.”
Early data from South Africa appears to show that people who are fully vaccinated are still largely protected against severe disease, according to early data released Tuesday by Discovery Health, South Africa’s largest private health insurer.
The omicron variant, which was first identified in southern Africa, appears poised to take over the world, as delta did before it. Omicron accounts for 90% of COVID-19 cases in South Africa and is a growing problem in Europe.
It has now been found in 77 countries, Ghebreyesus said. It has been seen in at least 30 U.S. states, though the delta variant still dominates the American outbreak.
Formally identified the day before Thanksgiving, information on omicron’s characteristics – including how contagious and dangerous it may be – are just emerging.
The new study from Discovery Health shows that two shots of the Pfizer-BioNTech vaccine, which provided more than 90% protection against the original virus, is only 33% protective against omicron infection.
Full vaccination continues to provide 70% protection against severe disease, which seemed to hold up across high-risk groups, though it declined somewhat in people over 60 and even more in those over 70.
“This is the first time we’ve had any data on that,” said Dr. Eric Topol, vice president for research at Scripps Research in La Jolla, California, and a national expert on the use of data in medical research.
“Seventy percent is definitely a dropdown. It isn’t great,” he said. “It was 95% effective severe disease when it was delta variant and then about 85% after six months of waning,” he said.
Whether those numbers will continue to hold as more patients with omicron are studied isn’t yet clear, he said. “This is all still so new.”
“The Omicron-driven fourth (wave) has a significantly steeper trajectory of new infections relative to prior waves,” Dr, Ryan Noach, CEO of Discovery Health, said in a statement. “National data show an exponential increase in both new infections and test positivity rates during the first three weeks of this wave, indicating a highly transmissible variant with rapid community spread of infection.”
Mild but dangerous
WHO officials chided nations that are focusing on offering boosters to their citizens while ignoring the lack of vaccines globally.
“The priority in every country and globally must be to protect the least protected, not the most protected,” Tedros said.
Vaccine for poor countries has dealt with many setbacks over the past year, brought on by export restrictions, vaccine hoarding and regulatory delays, COVAX, the global vaccine alliance, said in a statement Tuesday. However, supply has increased since September.
Even if mild, omicron could easily overwhelm health systems even in highly developed nations said Dr. Michael Ryan, Executive Director of the WHO Health Emergencies Programme.
“If you have a huge wave of cases, you will see a lot of severity and you will see hospital systems coming under pressure,” he said.
He warned already stressed heath systems may fail, and urged they prepare now.
“Make sure you have the health workers in place, make sure you have the clinical trials in place. Make sure you’ve got oxygen supplies in place. Make sure that you’re vaccinating the unvaccinated,” Ryan said. “Make sure you’re taking every opportunity individually and at the community level to stop transmission where you can.”
Omicron appears able to reinfect people who caught an earlier variant of the virus, and those infected longer ago are at higher risk of reinfection.
People infected in South Africa’s first wave early last year, have a 73% chance of reinfection, while those infected with the beta variant have a 60% chance of reinfection and those infected in its most recent delta wave face a 40% risk of reinfection with omicron, the new study showed.
That fits with findings from a preliminary briefing released by the United Kingdom on Friday showing an approximately three- to eight-fold increased risk of reinfection with the omicron variant, Topol said.
There has been some hope that omicron would cause fewer cases of severe disease than its predecessors, but that remains unclear.
The rate of hospital and intensive care unit admissions is lower than with other variants – 29% lower than with the first wave of infections early last year, according to the study. But that may be because so many South Africans recently recovered from infections with delta, Noach said.
Children continue to show a relatively low rate of infection with omicron, as they have with earlier variants, the study showed.
Children infected with omicron have so far had a 20% higher risk of hospital admission for complications than they did with earlier variants, according to Shirley Collie, chief health analytics actuary at Discovery Health.
“This is early data and requires careful follow up,” Collie said in a company press release. But the finding lines up with an earlier warning from South Africa’s National Institute for Communicable Diseases of an increase in hospital admissions for children under 5.
COVID-19 omicron variant is spreading quickly. Here’s what we know.
South African scientists identified a new COVID-19 variant which has now been reported in Belgium, Botswana, Hong Kong and Israel.
Anecdotal reports from South African hospitals suggest that most young children hospitalized with COVID-19 tested positive on routine screening, after going to the hospital for an unrelated reason.
“It’s a peculiarity that hasn’t been explained,” Topol said of the high rate of hospital admissions for children. “It hasn’t yet been seen in the United Kingdom, Denmark, Norway and other places hard hit by omicron.”
Collie said, “Children were 51% less likely to test positive for COVID19 relative to adults in the Omicron period, and overall, the risk of children being admitted to hospital for COVID19 complications remains low.”
The world shouldn’t focus only on the early data coming out of South Africa and the United Kingdom showing omicron might be milder, because when omicron gets to different populations it might behave differently, said Dr. Abdirahman Mahamud, WHO COVID-19 incident commander.
Even if omicron does prove to be milder, delta remains a threat.
“We are caught between two elephants, the delta and the omicron,” he said. “These are massive, angry elephants.”
Contact Elizabeth Weise at eweise@usatoday.com
Contact Karen Weintraub at kweintraub@usatoday.com.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
