Good fortune with omicron

and welcome to today's Talk Saturday the 11th of December a lot going on with Omicron at the moment so I want to stay with that now if you're in South Africa you're being sort of exposed to Omicron as we speak if you're in the United Kingdom you're going to be exposed to Omicron in the next few weeks if you're in the United States you're going to be exposed dramaicon in the next few weeks or certainly month or so the whole world we believe now is going to be exposed to this now thankfully so far it's only making a small minority of people ill but if lots of people get it all at the same time because it's so massively transmissible a small proportion of a lot of people could still be a lot of people ending up needing to go to hospital all at the same time and this is what we are worried about with Omicron this is why we're watching South Africa so carefully so on to South Africa the r value is 2.5 so each infected person on average infecting 2.5 other people this is giving us an exponential rate of growth in the UK at the moment the number of people with the Omicron variant is doubling every 2.5 days according to most estimates this is an incredible acceleration which means soon everyone's going to be exposed to Omicron vaccinated unvaccinated everyone this is just a a raging infection now but thankfully so far as we'll see not making people very ill just a very small proportion and we're hoping it's going to stay that way National Institute for communicable disease that's that's their figure equals 2.5 in South Africa really quite incredible the percentage of positive tests nationally so the positivity now remember the positivity is a good indication of the community prevalence at any one time so the positivity uh nationally it's 25 24.9 percent and again that's for the week ending the 4th of December so that's already out of date but it's the latest we've got 16.4 percent higher than last week so of all the tests being done a quarter of them are coming back positive this means there is a lot of Omicron in the population in South Africa at the moment and as we say everyone is being exposed as we speak now it does vary quite a bit depending on the states how Tang 35 Limpopo 32 other areas slightly less other areas even less free state Western Cape gazuli natal 10 to 15 Eastern Cape and Northern Cape lower but of course it is spreading in these areas but the fact that the community positivity prevalence is 10 is already pretty high and it's not going to take long for that 10 to become 25 because we've seen this higher high high r value so we know it's more transmissible we know there's a fair degree of immune Escape whether you've had the infection or whether you've had the vaccine you can still get it and we believe that you're going to get a lot less sick if you've been vaccinated and if you've had it but you're still probably going to what you're going to be exposed and many people are going to be symptomatic thankfully mostly minimally symptomatic let's put some proper figures here so here we have Dr Richard uh Friedland chief executive of Netcare now this is one of the big private insurers in South Africa Private health care insurers Omicron variant covid-19 symptoms are now far milder than in the first wave according to Dr Friedland which is good having personally seen many of our patients across how time hospitals so this is speaking from first-hand experience here their symptoms are far milder than anything we've experienced during the first three waves so we've ended up with this massively transmissible variant everyone's going to be exposed to unfortunately it's governing it seems to be producing mild disease now it didn't have to be like that it's probably more probable that it would be like that but this could have been like the the the MERS the Middle East Respiratory Syndrome which caused 40 mortality I I could have been sitting here saying well I'm afraid there's a 40 chance that we're all going to die in the next few months thankfully I'm not but it's not because humans have been particularly clever it's not because the vaccines have been so successful that it's eradicated the infection it's not because the lockdowns have worked it's not because we've been so clever we are just fortunate that this massive massively communicable variant that is going to bring about huge amounts of herd immunity is doing so at the cost of absolutely minimal disease Humanity has been indeed fortunate indeed fortunate because this variant could have been associated with extremely increased pathogenicity as as we said MERS is and uh this could have been a disaster for humankind but thankfully it's not thankfully it's probably going to be the end of the pandemic but it's not because we've been clever it's because we have been incredibly fortunate it's almost as if there's corrective systems looking afterwards I don't know how much philosophy or emotion to put into this but this could have been bad this really could have been bad and thankfully it looks like it's not but anyway enough of that let's stick to the figures in science approximately 90 of covid-19 patients currently in hospitals require no form of oxygen according to Dr Friedland so 90 percent don't require oxygen um and are considered incidental cases so about 90 of cases they just happen to have found that they're positive they're not admitted for those reasons this is indeed fortunate um if this trend continues so and of course we do have this Proviso it could be that this makes people sit with a much longer delay we don't know that yet it's unlikely but it is it's not totally impossible that this variant could make people iller after a month or two rather than a week or two I don't see why it should be but it's not impossible so until the time's passed of course we can't can't give up get any guarantees so so Dr Friedland correctly says if this trend continues it would appear that with few exceptions of those requiring tertiary care that's hospital care the fourth wave can be adequately treated with it's a primary care level in other words people can be managed at home because they're much less sick I mean wow isn't this fortunate in this first way in the first three waves Netcare across 49 acrylic hospitals in South Africa treated 126 000 coveted patients of whom 46 required hospitalization sorry 44 required hospitalization 26 required high that should be high care uh High care or intensive care significantly overcovered patients admitted were sick and required some form of oxygen therapy so all of the patients that admitted in the previous wave required oxygen therapy in the current wave approximately 90 percent of patients in our hospitals require no form of oxygen therapy I mean what a relief in me in me the high admission rate as well as the high percentage of patients requiring ICU or high care is uh care is indicative of the severity of cases during the first three waves so the first three waves are bad 44 required admitted to hospital 26 required intensive care virtually 100 required oxygen where I was now 90 now 10 require oxygen now again again this is just in this group this is in this this Netcare group so this is not talking about the whole country this is the patience he's personally responsible for 337 coveted covid-19 positive patients admitted uh whereas in the other previous waves it amounted to 126 000. to 72 of these patients are in hautang Area 18 in kwazulu in a towel so still fairly Regional it will be spreading out to all of South Africa well it is now as we speak so most hospitalizations in this area of the 337 hospitalized approximately 10 are on some form of oxygenation not a hundred percent about 10 percent of on some sort of oxygenation dear me that's such a difference 100 in the first three waves wow aren't we fortunate eight out of the 337 two percent are being ventilated and of these two are primary traumication so that they were patients who've been had accidents and other traumas came in and just found to be positive so we could change that to six who actually required it for medical or covered related reasons incredibly low number during the first three ways during the overall Community positivity rate breached 26 across South Africa so similar positivity rates uh first wave they didn't have 337 admissions in this particular Hospital group they had 2 000. second wave two and a half thousand third wave three thousand what a difference fourth wave Omicron wave so far 337. patients hospitalized if the pages admitted to Netgear hospitals and Facilities since the 15th of November 75 not vaccinated seven deaths I due to covid-19 complications so it's not gone away altogether it's just massively massively less age distribution of patients covid-19 Pages admitted since that since since the 15th of November on average younger than those seen during the first three waves 71 being 50 years of age or less average age of pages admitted to this particular Hospital group 38.5 years no question is younger people but also no question that vaccination rates are lower in this younger age group in South Africa doesn't tell us cause and effect but those two facts are facts presentation mild to moderate flu-like symptoms as we know now this is different to what we have been seeing and this seems to develop later perhaps because it's not what we have been saying but blocked or runny nose headache scratch your sore throat uh he the Dr Friedland here doesn't mention the um the body aches which we have been talking about so body X we know we know our future but it's not mentioned here so it blocked overly knows headache scratchy throat only 10 of people admitted on oxygen so only 337 as opposed to several thousand admitted and only 10 of those on oxygen I'm just free I can actually feel a palpable relief here this could have been this could have been bad but it's so far it's looking it's looking okay as I've considered view that at this early stage that this trend should continue so Dr Friedland in the heart of it there he does admit it's an early stage but he thinks this trend should continue direct quotes 19 may be effectively managed at a primary care level iie by GPS District nurses at home with the exception of certain cases requiring a mission to a tertiary facility so the minority still seeing people are going to be required and this is as I said this is my concern that many millions of people in the UK for example get it all at the same time and that could result in a hospital pressure for a short period of time until the herd immunity develops so that that's that's possible but we do know that vaccines are providing about a 70 people that are fully vaccinated we're probably looking at about a 70 protection much less than it was much less than it was but still a good degree of protection We Believe from the severe hospitalizations and deaths as the South Africa data is showing where we did find out that 75 75 of patients who were actually admitted to hospital were not vaccinated office of agent TB research South Africa medical research Council he says nationally it's 80 of emissions that are below the age of 50 so even higher nationally oh no sorry that's throughout the gutang province in the last two through in the last um two weeks so that's that's private and state hospitals in the last two weeks the best indicator of disease severity is measured by the in-hospital death rate uh There Were Ten deaths in the past two weeks from a cohort of 166 patients that he personally followed up that's uh 6.6 percent of people died but of course that was in the ones that were actually admitted which were the vast minority vast majority of people being treated at home now the death rate amongst people that have been emissions and admitted in the previous ways were 23 so for all previous waves of all the patients who admitted 23 didn't go home so far it's 6.6 of a much lower number of admissions four deaths so far tragically in the younger age groups aged 26 to 36 we don't know if these were vaccinated we believe they weren't five deaths over the age of 60. so younger age group certainly more at risk probably because they're unvaccinated and another sigh of relief although children have been infected there were no covid-19 related deaths among 34 admissions in the Pediatric Ward over the last two weeks so in the gautang area 34 children have admitted of course the vast majority of children that are infected were not admitted but of the 34 that were admitted there have been no uh no deaths so just breathe aside relief on that it could it didn't have to be like this we we have been so so incredibly fortunate that this is not a bad pathogenic variant because nothing we've done stopping it spread around the world it was in England already before we introduced the flight bands now last last thing for consideration today this is interesting just to get a bit of backup opinion Omicron variant could act as a natural vaccine interesting idea this is Professor Eleanor Riley immunology and infectious diseases Edinburgh University in a few popular press Outlets it was actually on a radio 4 interview I believe um Omicron variant could act as a natural vaccine in the unvaccinated direct quote from the professor britons are very likely to contact the variant in the next couple of weeks very likely direct quote in the next couple of weeks direct quote if you're in the states as we said it could be a month or two but we are all going to be exposed to this variant I believe virtually all of us unless you want to go and live in a cave in the desert or on a desert island somewhere or a small uninhabited island in the outer Hebrides you're going to be exposed to this variant from what we know so far everyone's very likely to experience it in the next few weeks we're hoping that most will be asymptomatic if it's Milder and we know infection induces an immune response so if it's Milder and so if it's murder as a question mark but we do know that it induces an immune response so does Omicron induce an immune response yes Omicron invokes an immune response and that's going to give ongoing immunity for a period of time this could be a natural vaccine we know the infection induces an immune response fantastic it is possible that this could act as a natural vaccine she says get into those people who have so far been unwilling to be vaccinated foreign profound really um but I think we have to exercise a huge degree of caution with that because she's a scientist so she has to hedge her bets on that of course because there's a huge if about if it's Milder but I believe I've given evidence that shows in South Africa it most definitely is milder and they've had a fair bit of time now for people to start getting sick hospitalizations are increasing but the death rates and the severe illness rates and the oxygen demand are all very low yesterday we looked at oxygen demand South Africa got the population wrong yesterday sorry about that it's about 60 million 65 million people in South Africa and from memory there was about 700 800 on oxygen who were hospitalized with a positive diagnosis many of those who were had a positive diagnosis for SARS coronavirus 2 they're there for other reasons the oxygen demand is really quite minimal thankfully foreign and I think it's very dangerous to compare data from South Africa to the UK okay Professor fine of course we agree it's just the best guide we've got in the South African population there's been so many waves of infection they've gone through true but there again we know that the antibody positivity rate in the UK is about 95 percent so it's not as if we're inexperienced or unexposed in the UK so maybe that's not as dramatic a a difference between the two populations as that statement might intimate lots of immunity in a much younger population well lots of immunity in South Africa yes but there again a lot of immunity in the UK 95 people having some form of antibodies whether it's through natural exposure or vaccination so we're not in an exposed population nor is the states um certainly a much younger demographic in South Africa that is absolutely true we accept that advisors Professor advisors act to uh people to act on the basis that anyone they come into contact with could have a coronavirus Omicron over the next few weeks so there we are um we're going to be exposed personally I'm trying to optimize my immune system with good nutrition inadequate amounts of vitamin D and so vitamin K2 hopefully another video coming up on that shortly from the experience in Israel so that's us for today uh we're just going to carry on with a slightly academic debate though Michael pointed out yesterday that the virus doesn't care if it makes people really sick because by the time the people die from the virus um the uh the vice will they'll no longer be infectious and the wife doesn't care whether they die or not but we have counter argument again to the counter argument this is from a good you can look him up on the uh although up indeed I don't know uh the first name is good um it's in the comments murder disease will be a positive selection pressure for viral proliferation interesting so so what good is saying is having milder symptoms allow the infect the the infected people to be out and about and pass the virus on to more people beyond the household as opposed to knocking out the host immediately and the virus never getting a chance to get past the immediate contact so it's a good point so with his milder disease then people will still be out knocking around with their usual Life In the infective period therefore they will be infecting many more people therefore that will be a positive selection pressure for the uh for the uh for the virus and in this case for the Omicron variant um interesting that uh this is following darwinian Evolution which sounds very simple in principle but in actual fact when you get into it is quite complicated and more nuanced but no question that the virus has evolved into the shape of the Omicron and of course evolve just means change the virus has changed from a Delta to an Omicron in actual fact the Omicron probably doesn't come from a Delta it's probably someone affected with another variant other than Delta that became that the genetic material became mixed up with a common cold coronavirus that resulted in the Omicron mutation but either way it looks like Omicron might be our way out of this pandemic from what we know so far not human beings being clever uh but um these natural creative processes um helping out humanity and it didn't have to be this way we are fortunate thank you for watching

Channel: Dr. John Campbell

Views: 878,735

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: m2vI4XczqZ8

Length: 21min 19sec (1279 seconds)

Published: Sat Dec 11 2021

Reddit Comments

[u/SaltMagician]

Yh he seems to be a pretty decent voice when it comes to Covid, what do you think?