#16,531
The sudden and sharp quadrupling of COVID cases over the past 8 weeks (see chart above) has been due to the emergence of the Omicron variant - which while far more transmissible - has turned out to be less severe than its predecessor Delta.
As a result, while hospitalizations have risen markedly in some regions, deaths have not.
Although it was always a possibility, we needn't have been so lucky. Two months ago, on the day that this new variant was announced (see South African NICD Statement On B.1.1.529 Variant), I wrote:
What comes after Delta may be more, or possibly, less dangerous than our current strain. Change isn't necessarily bad. As disruptive as the 2009 H1N1 pandemic was, it replaced an increasingly antiviral resistant H1N1 virus, and that likely saved lives over the long run.
The take-away from today's report isn't that a new pandemic threat has appeared, only a reminder that evolution is a process, and another global public health threat will emerge at some point.
Omicron could have easily been more severe, or deadlier, than Delta. But we got lucky, and it wasn't. And while this attenuation of virulence is hopefully a trend, the above passage still applies.
What comes after Omicron could be more - or possibly less - virulent than our current variant.
While COVID has been the worst pandemic in 100 years, and has killed millions, it is far from the worst that nature can throw at us. When this crisis eventually ends - and it will - we will simply be in an interpandemic period, waiting for the next global health crisis to arrive.
Five months ago, in PNAS Research: Intensity and Frequency of Extreme Novel Epidemics, we looked at a paper that suggested that the probability of novel disease outbreaks will likely grow three-fold in the next few decades.We squandered the last such period (2010-2019), preparing for something far less severe, and allowed public health to languish and our strategic stockpiles to wither. While the virus gets the blame, our own hubris claimed a great many lives.
Which means the next public health crisis may be closer than we think.
For now, even though Omicron is `milder' than Delta, it is far from benign. There is still much we don't know about `Long COVID' and Omicron, and of course, people are still dying - even from the Omicron variant.
The following MMWR report pretty much confirms what we already know from anecdotal reports, and other sources. These findings are based on the BA.1 Omicron variant, and while we have no information to suggest the BA.2 variant is more virulent, it is still early days.
Trends in Disease Severity and Health Care Utilization During the Early Omicron Variant Period Compared with Previous SARS-CoV-2 High Transmission Periods — United States, December 2020–January 2022
Early Release / January 25, 2022 / 71
A. Danielle Iuliano, PhD1; Joan M. Brunkard, PhD1; Tegan K. Boehmer, PhD1; Elisha Peterson, PhD2; Stacey Adjei, MPH1; Alison M. Binder, MS1; Stacy Cobb, PhD1,3; Philip Graff, PhD2; Pauline Hidalgo2; Mark J. Panaggio, PhD2; Jeanette J. Rainey, PhD1; Preetika Rao, MPH1; Karl Soetebier, MAPW1; Susan Wacaster1; ChinEn Ai, MPH4; Vikas Gupta, PharmD4; Noelle-Angelique M. Molinari, PhD1; Matthew D. Ritchey, DPT1 (View author affiliations)View suggested citation
Summary
What is already known about this topic?
The SARS-CoV-2 B.1.1.529 (Omicron) variant became predominant in the United States by late December 2021, leading to a surge in COVID-19 cases and associated ED visits and hospitalizations.
What is added by this report?
Despite Omicron seeing the highest reported numbers of COVID-19 cases and hospitalizations during the pandemic, disease severity indicators, including length of stay, ICU admission, and death, were lower than during previous pandemic peaks.
What are the implications for public health practice?
Although disease severity appears lower with the Omicron variant, the high volume of hospitalizations can strain local health care systems and the average daily number of deaths remains substantial. This underscores the importance of national emergency preparedness, specifically, hospital surge capacity and the ability to adequately staff local health care systems. In addition, being up to date on vaccinations and following other recommended prevention strategies are critical to preventing infections, severe illness, or death from COVID-19.
Emergence of the Omicron variant has resulted in a rapid increase in COVID-19 cases. Concurrent increases in ED visits and hospital admissions appear to be driven by high case counts and not by increased disease severity following acute infection. Although patients hospitalized during the Omicron period have shorter stays and less frequent ICU admissions, the high volume of hospitalizations resulting from high transmission rates during a short period can strain local health care systems in the United States, and the average daily number of deaths remains substantial. This underscores the importance of national emergency preparedness, specifically, hospital surge capacity and the ability to adequately staff local health care systems when critical care needs arise and before the system is overwhelmed. Previous studies have identified increased risk for severe outcomes among unvaccinated persons (4,9). Thus, being up to date with COVID-19 vaccinations and following other recommended prevention strategies are critical to prevent infections, severe illness, or death from COVID-19.
