So we have a new covid variant omicron and there’s a huge spike in covid cases in the last few days. But, what is the real situation and the facts behind hospitalizations due to Omicron? Should we be worried? Well, that’s the million-dollar question! Let’s start with what we know so far about the omicron variant. It was first identified in South Africa. Why were we concerned about this variant? Well, firstly there are a lot of mutations in the spike protein, almost 30+ and most of our vaccines and treatments were targeted against this spike protein. Now the question is does this affect vaccine efficacy, well to some extent the vaccine efficacy has been reduced but they are still good at preventing severe covid disease. Does this change our treatment well yes again; some drugs have to be re-evaluated for treatment efficacy and some new treatment protocols have been introduced.

But the real question is how does this affect hospitalization risk?

What are the facts behind hospitalizations due to Omicron? Let’s begin by looking at data from other countries where the omicron variant has been prevalent. In South Africa, there was a sharp rise and fall in cases in fact as per the current data this wave of omicron did not last as long as the previous waves. Next in the International Journal of Infectious Diseases, it was reported that during the omicron wave in South Africa the mortality rate was 4.5 % as compared to 21.3% in previous waves. The hospitalization rate during the peak of the omicron wave in South Africa was half of that of the previous waves; in fact, interestingly 63% of the hospitalized patients were admitted due to other reasons and there was an incidental finding of omicron infection. Also, studies have shown a single dose of vaccination was associated with a 35% reduced risk of hospitalization against symptomatic omicron infection and 2 doses gave 51% reduced risk of hospitalization 25 weeks or more after the second dose. Preliminary data has also shown a probably reduced risk of hospitalization with the omicron variant for school-going children as compared to the delta variant. In the elderly with pre-existing comorbidities, there is still a higher risk for hospitalization as compared to other age groups. Kids’ hospitalization has hit a record high in the USA, but most children’s hospitalizations were in children with pre-existing health conditions.

What does this mean?

Firstly it’s very important you complete your 2 doses of vaccination and people eligible for a booster shot should get their third dose of vaccination. Booster shots are being shown in the initial data to be associated with an 88% reduced risk of hospitalization 2 weeks after taking the third shot. As per global data available on 7/1/2022 80% of the patients admitted to ICU were unvaccinated. So the most important takeaway from these data points is to complete your vaccination schedule and take booster shots whenever available. In India vaccination is available for children above 15 years of age. It is extremely important that we get our children vaccinated. This will reduce the risk of hospitalization in them if infected with the covid virus.

Indian Perspective

In India, there are certain factors that need to be taken into consideration. Firstly our population is around 1.4 billion people. Also until genomic sequencing is done we won’t know if covid positive patients are infected with the Delta or Omicron variant. In India though, the Omicron variant is slowly seen to be replacing the Delta variant. But to reduce the risk of hospitalization following a covid appropriate behavior is of the essence. Covid appropriate behavior will prevent the spread of this variant and as we all know the Omicron variant has faster transmissibility compared to previous variants; in fact, in India, the R naught value is 2.69 and can increase in the days to come this is higher than the previous waves of 1.69, this means the Omicron covid variant is infecting more people in a lesser amount of time. So, it’s important to know that our healthcare systems might very soon be overwhelmed by covid patients just by the sheer size of our population more than the severity of the illness. And that’s why it’s important to not take Omicron lightly.

What can we do as responsible citizens?

● Follow covid appropriate behavior, wear your face mask, maintain social distancing, wash your hands frequently, follow cough hygiene.

● Complete your vaccination and take booster shots whenever available and eligible

● If symptomatic, immediately get tested. It’s only by testing can we know if your covid positive and through genomic sequencing understand which variant you are infected with.

● If positive, follow government guidelines for isolation. Isolation when positive protects your family members from getting infected this is of the essence if you have elderly or young children at home. Especially elderly with comorbidities.

Follow these simple guidelines to prevent community spread of the Omicron variant. We need to flatten the curve, that’s the only way to protect our society from the threat of Omicron. We shouldn’t panic as most of the available data looks promising but it’s always tough to predict how a covid wave progresses in any country until we have passed it. So in conclusion don’t panic, stay calm, follow covid appropriate behavior, get vaccinated, and follow government guidelines; they are in place to protect us. Finally, we should protect our elders and children by following these simple protocols. Proactively monitor your vitals and consult an expert whenever in doubt. Stay safe.

Authored by:

Dr. Abhishtita Mudunuri is an Internal Medicine Physician Diabetologist with over 10 years of experience in treating lifestyle disorders like Diabetes, Hypertension, Dyslipidemia, etc. She has worked previously at Columbia Asia, Sunshine Hospitals, and Apollo Group of Hospitals. Currently, she is working as a Senior Manager and Diabetologist at MFine

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