Latest data, looking good

well welcome to today's update it's sunday the 5th of december now i've just been preparing today's talk and i must say i felt a really quite a palpable sense of relief at the material i've been uh going through and it's largely from south africa now i'm going to give you a very quick pre-save for you sound like people that need to dash off and do something else so just just the first few minutes and you'll get the gist and then we'll go on to the to the full detail with references of course as we always do so the summary of this situation here is uh there's there's been an examination of 166 patients admitted with covered or not admitted with cory but found to have covered in hospital in south africa since the omicron variant arrived and there's also data from a snapshot of 42 patients on the covered wards in the steve biko hospital in uh pretoria in in south africa this is where the abs this is the absolute epicenter of where this started so this is really the sentinel information we're getting here what is happening it what is happening here what is happening here in south africa will be happening all around the world in six seven eight nine weeks time that that kind of time frame so this is this is this is a an anticipation of what's going to happen everywhere the proviso is that as we said yesterday there's quite a lot of hiv in south africa but i think this data is looking good um and in fact if anything the data looks better because of because of the hiv in south africa strangely enough so it's these two things 166 patients and a snapshot of 42 patients on on the covered wards at steve biker hospital the majority of hospital admissions are for diagnosis unrelated to covered 19. so most of the patients in hospital with covered 19 were diagnosed for something different they were just picked up the tsar's coronavirus ii positivity is an incidental finding in these patients and is largely driven by hospital policy requiring testing of all patients to be all admitted patients to be tested of course because you need to know if they're going to spread it to everyone else so they've found a lot of people who admitted for other medical reasons who hey they seem to have size coronavirus too as well 76 of the patients are incidental covered admissions so 76 of the patients with covered were just found to have covered in hospital that they were admitted for covered related complications this is this is really very reassuring news and the south african authorities are saying this is a very unusual picture and it's also occurring at other hospitals in the guten region which is again the region where this all started in south africa even though it probably came from botswana the high proportion of covered incidental admissions may reflect higher rates of community transmission compared to previous waves now i haven't got full data on this but i've been looking at this this morning and the sewage surveillance in south africa the the prevalence of uh new infection has just gone off the scale it just seems to be absolutely huge this omicron variant is just completely exponentially taken off in south africa and in it most provinces now it's absolutely huge number of community incidents now the good point about this of course is that means we're going to get massive herd immunity really quickly really quickly and that's why this is so one of the reasons this is so encouraging but anyway getting back to the to the direct communication from the south african authorities so it's absolutely taken off reflect uh may reflect higher rates of community transmission compared to previous variants so the first three waves it wasn't the fast as fast as this this was absolutely taken off this massive transmissibility of omicron but that's not translating into higher commission rates for a primary covered 19 diagnosis this is just brilliant news so there you go that's that's the main that's the main points of today's tour give you a short time so prevalence absolutely taking off in south africa no question about that um we know it's omicron from various sources the actual hospital concerned here the steve biko facility that they can't actually detect whether it's omicron or not directly but we we we know that the south africa uh fourth wave is is omnicron from numerous other sources so let's get down to the detail now because the bottom line is that people aren't being hospitalized with this anything like as much as would fear therefore there's going to be rapid herd immunity at minimal hospitalization and this could be the same all over the world this is what we've been hoping for and sort of predicting on this channel to be fair um for for the the last week now and it so far it it's coming to fruition so far it's looking good now it could change this could change in the next two weeks tens of thousands of people all over south africa could start getting ill tomorrow but it's not looking like it so far so far it's looking remarkably promising and i'm hopeful that this is going to be maintained and we're going to get massive herd immunity all over the world at minimal cost in morbidity and mortality right let's get down to the detail now so um tishwani district omnicon variant patient profile early features so this is what they report now this was reported yesterday fourth of december so this is straight from the south africa medical research council do check it out for yourself there that the article i've got this from is absolutely brilliant that's it there click on it it's completely 100 readable to anyone i i i just read through it with ease and and any any anyone could read through it with these it's not in technical jargon is at all so omicron in south africa is what this is about now there's been a significant rise in new size coronavirus 2 infections in gutang province in the last four weeks no question about that that's a simple statement of fact it's absolutely taken off in that area now just for orientation here i've just given us a quick map um because i i'm not that familiar with south africa geography so this is all of south africa here of course and and here's gutang province here it's where pretoria is there's a lot of people live there in cities so that's that's where we are and there are the other provinces in south africa um then the increase has been attributed to omnicron variant which was announced on the 24th of november 2021 not too long ago but yet so much has changed in that short time the first cases of omicron were detected in the the tisch wayne district and i'm sorry about my pronunciation so we'll get them better in the tisch wayne district so this really is the sentinel the rest of the world is going to follow in the same trajectory as this i don't think there's any question about that there's no question in my mind that omicron is going to spread around the world and become the dominant variant so the city of this is just background information the city of tesco metropolitan municipality is the metropolitan municipality that forms the local government of northern ghoutan province in south africa so so tish1 is in this gutang province the metropolitan area is there is centered on the city of pretoria with surrounding towns and localities population 2.7 million so that's a lot of people we're getting a representative small sample of patients from this population of 2.7 million and the the relatively low numbers of hospitalizations for the size of the population and the prevalence of the disease already is in itself reassuring and what i'm going to tell you now is he's getting even more reassuring than that um so this is where the fourth wave started so where where where this area has led the rest of the world is going to we believe the rest of the world is going to follow on now just one has become the global epicenter of the omicron outbreak cases rising exponentially over several weeks 41 921 cases by the 3rd of december now we do know from sewage and other data that the real number is not probably 10 20 times this way way higher than this these are just officially diagnosed cases so the real number is way higher than this this is absolutely taken off in this area and other areas of south africa um 9929 new cases reported on the day in the 24-hour period i think that was for for friday i think uh anyway steve biko academic hospital tichuan the district hospital complex in pretoria is where this information is coming from now these are the uh let me get rid of me a minute these are the uh these are the new daily uh cases there we go uh tischwani daily cases so this is the increase in the cases but of course these are officially diagnosed cases and represent only the tip of the iceberg we can still see a clear uh rapidly increasing trend day on day first second and third of december and this is this is in the heart of the tisch wayne district so the steve baker hospital really in other words is the epicenter of the epicenter it's the hospitalization hub for the epicenter of the disease statistics presented by the uh grouting district health or authority department of health on the 2nd of december 2021 written up as we said on the 4th for the province as a whole with emissions across all public and private hospitals so this this is collecting all of the data really that's available in that area uh sharp increase in admissions yes there is a sharp increase in emissions now between the 14th and 29th of november 20 2166 of these admissions that were found to be uh covered positive so there's a lot of people being admitted but most of the people with covered it's an incidental finding of cover these are being admitted with other conditions now is is there something about the um is this is interesting is there something about the um the omicron variant which is stimulating or triggering exacerbations in previously existing conditions causing the increased admission that that could could well be but what we know is that the majority of people that are being diagnosed are incidental diagnoses when they're admitted for some other medical uh condition is what we know so 166 new admissions with with comet patient information presented here only represents the first two weeks of the omicron wave in uh tisch wayne so we we this could change as we said this could change the clinical profile of admitted patients could change significantly over the next two weeks direct quote that that could happen but we'll look at reasons why i'm reassured as well uh but but by which time we can draw conclusions about the spirit of the disease with greater precision of course but um there are reasons i'm optimistic already the main observation that we have made over the last two weeks is that the majority of patients in the covered wards have not been oxygen dependent not been oxygen dependent now the reason i am quite optimistic about this is that these patients are already being treated with steroids now of course the south african doctors know that you absolutely absolutely don't give steroids in the first part of the illness and the viral illness you give steroids to suppress the inflammatory reaction caused by the body's immunological reaction to the virus that causes the covered pneumonia and the adult the acute respiratory distress syndrome and the other complications so the fact that these doctors are giving steroids means that the doctors are happy that they are not in the initial stages of the disease therefore i would not expect this patient this group of patients to suddenly relapse they they are in their danger period now let's go on with it with information um majority of patients have been uh not oxygenated pencils so these patients are not needing lots of oxygen they are not needing lots of oxygen really good news sars coronavirus ii has been an incidental finding in patients that admitted to the hospital for other medical or surgical or obstetric reasons now here's the here's the list that they've got here so uh on this is patients on room air this is patients are on oxygen and these are the covered warts so the male ward uh 17 patients with covered four on oxygen female wards 16 patients with copper five on oxygen the rest on room air the higher deprived dependency care intensive care uh as you would expect three on non-invasive ventilation they're obviously on oxygen so but but to be fair these are the other figures that you would expect on any medical ward in in any hospital these sort of number of people being oxygenated is not out of the way not by any means a snapshot of 42 patients on the ward on the 2nd december this data so um 29 of the patients 70 are not oxygen dependent so we have hospitalized patients here diagnosed with sas coronavirus 2 and they are most of them are not oxygen dependent these patients are saturating well on room air now what what this means is that their blood is saturating with oxygen they are getting good oxygen saturations as we've looked at with the meters they're getting good oxygen saturations just on room air the same as you and i are now they're just breathing normal room air in fact we write that we're right the percentage or if the patient isn't on oxygen we're just writing room air um it's this again this is this is sort of international hospital sort of standard policy they're saturating well on roommate they're doing absolutely fine on roommate and do not present with any respiratory symptoms so most of these patients are not presenting with respiratory symptoms they're incidental admissions having another hand another reason for admission 13 patients are dependent on supplementary oxygen so some are of which 9 21 of a diagnosis have covered 19 pneumonia so there is some covered pneumonia here but it's much much much less common than previous waves all are being prescribed steroids as the mainstay of their therapy indicating they are already in this inflammatory phase already in already in their dangerous phase which is is good news well it's good news because it means they're not likely to relapse because they're already on steroids they're already in the complicated dangerous part of their illness the remaining four patients are on oxygen for other medical reasons just just happen to be on it anyway this picture was not seen in previous waves so they're being quite clear this is based on talking to the nurses and doctors around this hospital okay you could say that's anecdotal it is anecdotal but these are people that of course lived and suffered and uh worked phenomenally hard during the first three waves and they're saying this is noticeably different in the sense that it's noticeably better right so uh past three waves there's only been a sprinkling of patients on room air in the coffee wards so in the past three waves it was very unusual for the covered wards to not be on oxygen most so there's only a sprinkling of patients on room air in the past number of patients in high care on double oxygen high flow nasal oxygen or non-invasive ventilation were noticeably higher in previous waves this is anecdotal but confirmed by numerous clinicians who have previously worked in the covered wards in the hospital complex these are not inexperienced clinicians of the 38 adults in the covered ward on the 2nd of december interesting now looking at vaccination status 6 were vaccinated 24 and vaccinated 8 were unknown of nine patients with cover pneumonia eight are unvaccinated one is a child and only a single patient on oxygen was fully vaccinated but the reason for oxygen was chronic obstructive pulmonary disease this patient needed oxygen because they had chronic obstructive pulmonary disease which is the most common indication for giving oxygen we give masses of this in hospitals and indeed many patients with uh chronic obstructive pulmonary disease are maintained on oxygen therapy at home so not at all surprising so nothing like way way less oxygen requirement in the in this omicron wave compared to the previous three waves is what we are seeing but also important to note that the vaccine is providing a high degree of protection against severe disease albeit from that limited data set analysis of 166 patients admitted from the 14th to 29th of november 80 of the emissions were below 50. this is getting younger but it also reflects the fact in south africa that the vaccinations are more more of the older population is more heavily vaccinated so 80 of the emissions were below the age of 50 in the population where the vaccines are not as commonly uh taken up 19 with children aged not we looked at that as a concern but the children don't seem to be getting sick and uh we have no reports of deaths thankfully in children at all twenty percent of uh hospital admissions uh 30 to 39 year old so the 30 to 39 year old age group which has a low vaccine uptake in south africa was the most common age to be admitted so more people in the 30 to 39 year old age group were being admitted than in the older age groups and this really is a wake-up call for vaccine uptake in these groups around the world because omicron's coming you and me are going to be exposed to dramacon pretty soon in the next month or two you and i are going to be exposed to romichrom we have to be ready for it and this would indicate that vaccination is an important part of that preparation as is good health as is good nutrition as is vitamin d status of course but it is coming it's just a pity that the authorities in the states and the united kingdom aren't using aspiration routinely if that was happening i think we'd have a lot more vaccine uptake and a lot less complications subject to confirmationary data of course anyway that's my view so there you go younger age groups really need do need to be thinking about vaccination all over the world because that you are if you're between the ages of 30 and 39 watching you're going to be exposed to one micron in the next few months unless i am very much mistaken in hospital death rate 10 deaths in the steve eco complex um in the past two weeks uh 6.6 of 166 who were diagnosed with sars coronavirus 2 have died four deaths were in adults aged 26 to 36 but the thing is we don't know what they died of yet we don't know yet whether these deaths were covered related or not we simply don't know but given that most people were admitted for reasons other than covered it's reasonable to guess that at least a good few of these deaths were for non-covered related reasons but we simply don't know that yet um in fact you would expect the majority to be non-covered reasons but but we don't know so we'll leave that there but it's not it's still looking hopeful it doesn't doesn't distract from the general feeling of hope that i have from this data um four of the deaths are in adults yeah 26 to 36 f five decimal adults over 60 one death was in a child whom the cause of death was unrelated to covet so so here we go this is uh this is a really important point there's been no deaths reported in children from covered so far in the steep beaker hospital complex from omicron in south africa let's hope it stays that way but so far it's looking good um so the child tragically died but it was some non-covered related reasons uh there were no covered related deaths among 34 admissions in the pediatric covered wards over the last two weeks so brilliant no children have died that's good um guten province as a whole now here we have the let me get rid of me and show you this graph because this really is a pretty amazing graph so what we have here is the um these these are the previous waves so we can see the uh the first wave the cases went up and then with the delay of course the deaths went up second wave cases went up then with the delay of course the deaths went up third wave the line there is when vaccination started so cases went up massively due to vaccination even though the vaccination status in south africa is not that good not that high still the deaths were nothing like us high now the cases are going up cases are going up but the deaths are way down the deaths are way down at the moment i'm just going to show you that on the blow up so far so here here we have it the cases are going up now but so far the deaths are going down so it really is so far so good in this in this south africa situation of course it could change but there's no indication that it is going to change dramatically at this stage so that that's the really reassuring graph cases of omicron going up even more than this is saying and uh but deaths which we know about the deaths are definitely definitely uh low even though the cases are much higher than we are are officially reported so um neither done for this data level of care only two patients in the uh covered icu in the last 14 days so not many people needing high levels of care neither of whom had a prior diagnosis of covered pneumonia so again looking really good much shorter average length of stay on the omicron fourth wave so far the average length of stay is 2.8 days for sars kova positive patients admitted to covered wards over the last two weeks compared to and look at this difference this is spectacular 8.5 days for the past 18 months so the average for the first three waves is 8.5 days of hospitalization and the average for the omnicron wave so far is 2.8 days of hospitalization this is remarkably encouraging and i think that's probably about enough there so [Music] so far this data from south africa is very encouraging we are seeing um non-respiratory symptoms um we are seeing patients who are not most patients who are not requiring additional oxygen most patients are not oxygen dependent the oxygen demand is way way lower than in the previous waves the patients are getting out of hospital quicker the patients are not requiring high levels of care and most of them were picked up incidentally so what this means is our initial hope that omicron while it's massively contagious and is taking off in south africa will take off around the world that is happening but our hope was that because it's so good at a lot of the genetic variation it's kind of used up as it were to make it more transmissible there's less left for um for making it more pathogenic and that is looking like it is it is looking like it is the case it's looking promising now what this means is the omicron variant will i believe spread all around the world as people are exposed to it they will generate immunity that is specific to the omicron variant it looks like people are going to have very minimal disease now because there's so many because there's going to be so much omicron everywhere all at the same time over the next few months that could mean that of course a proportion of people as we saw in south africa will be admitted hospital so there could be increased hospitalizations in the united states in the uk and europe canada australia everywhere over the next month or two but this should be within manageable levels and the patients we are hoping are not going to be too sick and we'll expect mortality while it might not be absent uh we would expect it to be much lower but that would be the price that would be paid for massive herd immunity developing really quickly which would essentially be the end of the pandemic so there we go that's the what the data is telling me at the moment thank you for watching

Channel: Dr. John Campbell

Views: 1,484,325

Rating: 4.9105921 out of 5

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

Id: 1Paq17X6ucQ

Length: 25min 29sec (1529 seconds)

Published: Sun Dec 05 2021

Reddit Comments

[u/Pretend_Summer_688]

I've read everything from this is fabulous news and the way out of all this to everyone hide, we're all fucked, it hits kids under 5 even worse they'll be dead in the streets, and never ending infections for the rest. The incredibly huge swing is unbearable. If this turns out to be good news in the long term, I hope the doom fans saying that this is truly the Thanos virus now fall off a cliff. It's just unbearable.

[u/Zekusad]

76% of Sars-Cov-2-positive patients are not in the hospital for Covid. This makes me think. What about other hospitals, which are allegedly overwhelmed by Covid? What is their criteria?

Besides that, good news really. From now on, the governments who don't abolish SA/other African bans are tyrant or racist in my eyes.

[u/stalematedizzy]

SS:Full summary in the first few minutes of this video, its good news

examination of the 166 patients admitted since the Omicron variant arrived

snapshot of the clinical profile of 42 patients

currently in the COVID wards at SB

The majority of hospital admissions are for diagnoses unrelated to COVID-19.

The SARS-CoV-2 positivity is an incidental finding in these patients and is largely driven by hospital policy requiring testing of all patients requiring admission to the hospital.

76% of patients are incidental COVID admissions.

This very unusual picture is also occurring at other hospitals in Gauteng.

The high proportion of COVID incidental admissions may reflect higher rates of community transmission compared to previous waves (variants)

that is not translating into higher admission rates for a primary COVID-19 diagnosis.

Tshwane District Omicron Variant Patient Profile - Early Features

4th December: https://www.samrc.ac.za/news/tshwane-district-omicron-variant-patient-profile-early-features

[u/AutoModerator]

Thanks for your submission. New posts are pre-screened by the moderation team before being listed. Posts which do not meet our high standards will not be approved - please see our posting guidelines. It may take a number of hours before this post is reviewed, depending on mod availability and the complexity of the post (eg. video content takes more time for us to review).

In the meantime, you may like to make edits to your post so that it is more likely to be approved (for example, adding reliable source links for any claims). If there are problems with the title of your post, it is best you delete it and re-submit with an improved title.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.