That’s the omicron way

THE EDITOR: Minister of Health Terrence Deyalsingh must have been quite pleased with the reception to his sardonic response to the opposition query of the January rise in covid19 cases. Not only was he able to successfully switch the topic on the rise in cases to the decisive drop in hospitalisation for the same period, but to attribute this latter success to his Government’s vaccination policy, and the use of new spokespersons in getting the message across.

People who studiously track the global covid19 scenario would know that the phenomenon of rapidly rising case rates with associated drops in hospitalisation is in fact not uncommon and quite prototypical of the omicron variant, now dominant in 171 countries including TT. Fortuitously, the latest covid19 strain, omicron, is not as virulent or intense in symptoms as alpha or delta.

A study published in the January 25 Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report in the US found that despite the lofty spike in covid19 cases, the percentage of hospitalised patients admitted to ICUs during the current omicron wave was about 29 per cent lower than during last winter’s surge, and some 26 per cent lower than during the delta surge.

Deaths in the period December 19 to January 15, when omicron peaked, averaged nine per 1,000 covid19 cases, compared to 16 per 1,000 during last winter’s surge and 13 per 1,000 during the delta wave, the study showed. The findings were consistent with previous data analyses from South Africa, England and Scotland, where infections from omicron peaked earlier than the US.

The Health Minister’s cause-and-effect claim is somewhat baffling when one considers that from December 1, 2021 to January 27, only 42,739 more people could boast full vaccination, a mere three per cent improvement, or an average of less than 1,000 people a day achieving full vaccination.

Paradoxically, because omicron is 2.7 to 3.7 times more transmissible than the delta variant, and infects more hosts because of its ability to evade full vaccination and boosters, it has become the dominant strain in many First World countries. Local statistics are beginning to show that such will also be the case in TT. The implications of such trends are both good and bad.

On the good side is the fact that in the US, as in Britain and South Africa before it, omicron has crested and cases are dropping rapidly, and low spread is expected in many countries by the end of March; drop in hospitalisation and deaths (which usually lag by two weeks) are expected to follow. TT may have already advanced to this phase.

Even more encouraging is the fact that new research is showing that serums from vaccinated people with confirmed breakthrough infection, in particular, showed very high levels of protection against all strains, including omicron. Studies to show whether uninfected and unvaccinated individuals develop such effective cross-neutralising antibodies are ongoing.

The bad side is that omicron’s extreme transmissibility means many more people will be infected with bad consequences for the immunocompromised: mainly older people and those with comorbidities. Statistics indicate that although covid19 cases in TT rose through January, seven-day moving averages being 596 on January 7, 530 on January 14 and 783 on January 21, figures for Barbados and Estonia show that these are on the lower side.

For Barbados (population 287K but similar indices re climate, health system, comorbidities, etc), the figures for the comparative periods were 348, 488 and 535; and Estonia (near identical size of population that is biostatistically healthier, in a temperate zone, etc): 1,169, 1,841, and 2,928; not an unsurprising diversion, given our poor test-and-trace system.

The consequences of this last transgression means many more people in households with identified infected people are not being quarantined, or isolated, and, worst of all, older people with comorbidities are not being singled out so that they can be taken to safer environments. The seven-day moving averages for covid19 deaths in TT were 20, 21 and 18 for the foregoing periods; for Barbados: 1, 1 and 1; and Estonia: 3, 3 and 4. I don’t think I need to say more.

KENWYN NICHOLLS

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