Omicron growth in Norway

well welcome to today's talk it's thursday the 9th of december i want to do a bit of an omicron update still reasonably optimistic but let's let's go into some detail straight away on this now this one is the louise restaurant bar and the night of the 26th of november so this is oslo and it's a christmas party pretty early christmas party i would say but nevertheless uh scar tech solar power company one or two return travelers from south africa there was actually two travelers returned from south africa only one of them turned out to be positive though for saskarona virus too had returned a few days earlier so had been knocking around as normal in norway after his return where there was fairly limited restrictions actually at that time now there's 120 people went to this party 120 all doubly vaccinated from the from the san tek um solar power company group and they uh they had their own christmas dinner and everything then about half 11 when there was a it was a bit later on they started mingling with people outside later on from uh other guests from the hotel now there were 70 of the 120 tested positive the day after or in the days after and 50 others from the hotel as well so that's a total of 120 people testing positive so 120 in the original uh company group 70 of those tested positive but they also infected 50 others in the hotel at the same at the same in the same evening the 26 november by the way was the evening or the 26th of november was the day where the world health organization named the omicron variant as a variant of concern half have tested positive for omnicom it's more than half as we said it's 70 70 out of 120. 13 have been confirmed with sequencing the others are assumed to be omicron from the um from the s gene dropout that we know about so it looks like most of those are are in fact uh omicron variant uh dr teeny ravo oslo infectious diseases they have symptoms like fever cough headache muscle pain fatigue interesting so they have got symptoms as quite a lot of people are symptomatic in the group but uh but now and this was as of yesterday actually this was yesterday's report none of them have become severely ill and none of them have been treated in hospital so of the 120 uh so far zero have become uh zero have become ill which is uh it's encouraging and this is actually uh this is actually uh 15 days ago now i think so the time is ticking on so uh the next day one of the two employees recently turned from south africa tested positive and then the other ones were found as well now norway state epidemiologist fraud foreign a sheer number of people infected at a single event omicron considerably more infectious than the delta so the sheer number of people that are infected 120 people are all together infected in that one evening it shows that this is a highly transmissible variant the omicron is more transmissible than the delta and when we look at what happened to norway this is really quite telling as well where are we there we are so this is norway throughout the pandemic so pretty low cases what we might call first second and third wave enjoy but but low numbers all the way through really until we get to the end here where we see uh this sudden increase here and it looks like a lot of this is now omicron driven so way more numbers in norway than there ever have been probably originating many of them originating in that in that particular party uh so this this professor forlander norwegian institute of public health he says there's one one of the three scenarios for omicron is that it would be both very mild and very transmissible so that was a possibility and he says that is the hope that is the best scenario we can have that it's getting uh that says minded but it should be should that should be getting milder that most people will get it most people probably just about everyone is going to get it and they will get a natural immunity so the professor cl here is clearly saying that this will be associated with a natural immunity which of course is absolutely brilliant if it's minimal symptomatic disease it might be that it is now replicated and mutated so many times that this is the optimal position from the viruses point of view to spread widely and not kill the host so what the virus wants to do is to reproduce as much as possible and if it goes around killing people it's going to reproduce less because if it kills someone it's not going to carry on reproducing from that person so it's natural that viruses do evolve to become milder it looks like this process has been accelerated as we saw yesterday when we said omicron quarter cold in other words it got a particular genetic sequence from a common cold corona virus and the professor in norway goes on to say um that's what we've seen with other diseases beforehand so this is a pattern he's familiar with and of course it then gets into more like an endemic phase and this is me speaking so this is not the end because we know it's not the end because there's still a lot of delta going on in the world and uh the delta is not finished yet but but i've said here nor is it the end of the beginning because i think we're past the beginning we're past the end of the beginning and i think really this this could well be the beginning of the end so if you'll exclus excuse the melodrama there i think that's probably roughly where we're at but it's not it's not to the end yet and i want to tell you why there's things i'm still concerned about so delta is still ravaging many many countries so here we have the new daily confirmed covered cases per uh per million people and we go look at japan where the numbers are very low and india the numbers are still pretty low uh australia canada south africa has increased of course and we know this is all omicron in south africa the united states quite high but we still believe that's mostly delta but causing quite a lot of hospitalization in the hospitalizations in the states that's the united kingdom there we see norway presumably delta presumably omicron driven has overtaken the united kingdom but of course we are getting daily more and more omicron cases in the united kingdom denmark we know there's quite a lot of omicron and ireland it's quite unclear why the cases are so high at the moment in ireland so that so that's the sort of demographic not demographic but the incidence at the moment or prevalence at the moment a number of new covered patients in hospital per million which is probably the most important this is the data that we have so denmark we do see an increase norway the numbers are are low there's a few days data missing but the numbers are still low um united kingdom higher ireland higher united states we know that in some areas of the states hospitals are under quite a lot of pressure actually at the moment although it is patchy around the country deaths well the united states deaths remain stubbornly high unfortunately indeed have gone up quite a lot with this current uh delta increase ireland the deaths have gone up as well united kingdom denmark norway thankfully low canada india south africa australia and japan so they're the deaths at the moment and what else have we got here this is the estimated reproduction rate so this is the r1 here this line here is one so below this is getting less above that it's getting more and we see the only country where cases are still reducing is japan uh denmark which has omicron is increasing the united kingdom which is omicron and delta was increasing ireland we don't have genomic data canada united states norway which is probably largely omicron driven is increasing and south africa which we know is pretty well entirely omicron driven well is entirely virtually over 90 omicron driven very high rate of increase indeed well over an hour value of over two now this is a bit out of date south africa is over 90 percent now united states that's probably about the latest we've got india japan australia canada norway we believe that omicron is much higher than this but we don't have the firm data yet denmark we believe it's much higher than that but we don't have the firm data yet united kingdom it will be higher than this but again not firm data yet an island uh sadly somewhat lagging behind in terms of um in terms of profiling and uh moving age case fatality rates so so the people dying per number of cases india is quite high at the moment which is sad to see but uh looking at the other countries so countries where there's more omicron like denmark and norway very low figures ireland not so many people dying united kingdom australia canada uh japan uh that's actually the united states uh there because these are all sort of compressed down a bit that gives you the order so countries where there's a lot of omicron spreading like south africa the death rate is actually pretty low in south africa so this is the south africa line here and we see that the death rate has actually come down as omicron has increased and of course this is this is really remarkably encouraging that we're hoping omicron is going to be very very mild now um we talked about the clinical features of omicron yesterday from doctor kotsir in in south africa and we've had some um interesting communications from you as well sally reported i've had delta this time last year pretty rough took six months to recover really sadly that is a long time it just shows it can be a long time and i i have omicron now the symptoms of vomicron are as you state which we'll go over in a minute and she is uh vaccinated so it looks like these symptoms are being consistent hellgaard in in gaotang in south africa in the epicenter have tested positive two days ago the symptoms is 100 correct as stated also after first symptoms three days and i don't even know that i was sick so symptoms only lasting feeling better after three days so sally and helgard both confirming the symptoms of omicron because they're both omicron positive and let's just look at what these are the symptoms that we know so far are um muscle aches and pains so achiness headache tiredness lasts one or two days slightly sore throat no cough and no runny nose so we are getting sort of collaboration that these do seem to be the main symptoms that are present and these ones do seem to be the ones that are absent we'll get much more data on that one tim once tim spector gets going of course he's he's the best at getting the data on this um but let's look at um let's look at some south africa data now because south africa as we've said really is the uh really is the sentinel on this now this first slide from south africa is the uh the number of hospital admissions and we are seeing an increase in the last couple of weeks this data week here week 49 is not yet complete so we are seeing some increase in hospitalizations in south africa now this doesn't tell us why these patients are admitted but it does tell us there's been an increase in hospitalizations although not a dramatic one it has to be said compared to where we were uh in earlier in the year now this is current uh ward these are patients in the wards in south africa uh 4.8 so 4 800 people actually in hospital and these are people that have been um diagnosed with sarcoma virus too we know in south africa it's basically all omicron now not necessarily because they're in hospital for saskarona coronavirus too in fact most of them were just discovered to be sars coronavirus too positive incidentally because everyone going to hospital gets tested so um they're the number of people so currently um these are in intensive care these are in high care and uh these are on the general ward and this is for the whole 40 million population of south africa patients in hospital with uh covered 19 or corona cyclone vibes to positivity at the moment and this shows the intervention so there's 148 people that are positive in south africa that are being ventilated and 662 for the whole country that are receiving oxygen so we see a continued very low rate of oxygen requirement and this was live as of about an hour ago this is from the live reference which i'll give you so very few people being oxygenated requiring oxygen in south africa who were hospitalized with sars coronavirus ii confirmed infection and of course this is this is omicron infection so that this remains this remains encouraging now this is the number of uh deaths in south africa um this is for the uh the these are these are the weeks so this is uh 2021 this is halfway through the year week 25 deaths went down quite nicely and we see that so far is there an increase well in in that week there was 102 up from 55 so there is a slight increase a slight increase and this shows the weekly reported deaths in south africa all together and this actually is the most um concerning slider i'm showing today um it does actually show that there is an increase in overall deaths in south africa now it doesn't tell us why this increase is there but that's above the uh the upper and lower average for the time of year so there is a slight increase in deaths in south africa but as i say we don't know why that is we just know that it is the case at the moment and this shows the way that delta's taken over in in south africa but so sorry that's delta taken over this is the shows the way that omicron's taken over so first of all we had beta which was the original south africa variant here and that was out computed by delta and now delta is being out computed by omicron so that's the the pattern in south africa at the moment we see that virtually everyone at the moment who's positive in south africa is coming up positive for omicron having replaced delta and this is an important point the the the omicron from south africa is replacing delta it's not as well as it's instead of so here's all the references we've just looked at uh there so do do click on those for yourself just check them out uh they're all there a click away now sir patrick valance speaking in from downing street uh yesterday uh chief scientific officer for the uk from pandemic to endemic where this becomes a more regular infection like flu over time so there's a movie seeing this move to becoming more endemic so that is good this virus has mutated a lot quickly and that is sort of what you would expect at this stage so again this is consistent with his experience the good news is that so far and again of course he's hedging his bets here as we all are but i'm i'm quite optimistic it looks as though when you get very high antibody levels with the booster vaccine it's definitely having some effect against it in laboratory studies so he's seeing that saying that the booster vaccine works there which we looked at data for that yesterday but i'm also optimistic which is not really commenting on is that people aren't getting sick but he's not he's keeping his powder dry on that at the moment boris johnson is incl british prime minister so again working from home on monday this is the so-called plan b or aspects of the plan b are now being implemented to prevent spread work from home on monday face masks in public venues uh covered mandates for passes for night clubs and other crowded areas daily testing instead of isolation for omicron variant so here we can see that they're expecting so many omicron contacts that they've gone over to um to um daily testing as opposed to isolation because it means that no one will be available to go to work so it's looking like apart from that slight increase in the overall deaths in south africa it is looking remarkably promising for omicron being a very mild disease and the omicron should replace delta as delta replaced alpha um and and as delta replaced alpha in in the uk and as as delta replaced beta in in south africa which was quite originally called the south africa variant so um we see that clear evolution of south africa which is really really quite encouraging so it could be that the the pandemic is is well and truly on its way out in terms of causing people to get sick if it is that the um the omicron variant continues not to make people sick the big proviso is of course it can be sometimes two three or four weeks before people get sick but we're not seeing it yet apart from this slight increase in deaths in south africa but as i say we don't know why there's an increase in deaths in hospitalizations in south africa even though they're not marked we do know that most of the cases of sars coronavirus 2 positivity in hospitals in south africa have been incidental findings so still fairly frustrating still on tenterhooks really seeing how this is going to go but it's looking it is looking promising now i'm just going to do a quick uh talk about this uh plant-based corona virus vaccine from canada galaxo smith klein and uh med medi medi cago i'm not going to pronounce that uh primary endpoints are secondary endpoints in the trial uh have been met and the trial here is dominated in the variance phase now it's not it's pre-omicron days but it's post-wild type of virus days so this is invariant days presumably alpha beta and delta waves this was mostly trialled in efficacy demonstrated against all variants seen in the study so this seems to be this particular vaccine seems to be working against all variants 75.3 efficacy again covered 19 of any severity caused by the delta variant so looking good for the delta variant now it's so interesting this because it's a plant-based plant it's brewed up in plant cells which is fascinating vaccine candidate was well tolerated with no serious related serious events reported in the vaccine group 24 000 adults again phase 3 placebo control trial and this is this is the the canadian plant-based vaccine now this is the world's first ever vaccine where the the antigen is actually brewed up in plant cells this is just absolutely a a brilliant uh a brilliant step forward for vegetarians and vegans and probably for the entire world as well um because it's brewed upon potato cells and corn cells it's uh it really is a major new way to make vaccines and the british galaxy smith cline pandemic adjuvant is going in it now the adjuvant is something which increases the the immune reaction to the uh to the vaccine to the actual antigen so in other words the canadian group are producing the antigen which is the bit that the the human immune system will actually recognize as being foreign and the adjuvant is making the antigen more antigenic if you like generating a better immune response brian ward medical officer at uh medicare mega cago plants that are used simply as uh bioreactors to produce the antigen so they produce in bioreactors with plant cells health canada us fda uk medicines and healthcare products regulatory agency and the world health organization have all been approached for approval so interesting what will happen there world health organization point out produced cheaply in very high amounts uh carrier plants such potatoes and corn antigen created are fridge stable so the antigen is the actual vaccine the part the part of the vaccine that the immune system will recognize as being foreign fridge stable so you can ship it all around the world in a normal icebox can be stored for long periods of time don't know how long probably talking months likelihood that a plant virus will get in the way is minimal so that is good because plant viruses don't generally affect i don't i don't i've never heard of a plant virus infecting any animal actually vets and botanists out there correct me by all means but i've never heard of a plant virus jumping to a animal virus like particles for protein vaccines so they're producing virus-like particles but but they're empty shells with no rna so we're going to end up with something that's kind of i don't know what it's like yet but it's going to it's going to look like a bit like a it won't be shaped like the vice it'll have the proteins the same protein construct constituents i would imagine but of course there's no rna inside it so it's not it's not transmissible it's not going to make the person sick so keep an eye on that but plant plant-based vaccines wow that really is a new thing it's not new it's it's been on the go for they've been developing it for about 20 years it's just i've come to fruition at the right time and then finally sally who we saw had typical symptoms before asked this question can you explain how one variant replaces another uh does the other variant just fade out so can you play explain so the in in this case the omicron variant uh is more transmissible more able to survive more likely to reproduce than the delta variant so it simply outcompetes it this is natural evolution it's the survival of the fittest and the less fit and in this case thankfully very very thankfully the less fit variant is the delta variant so it's it is simply out competed by a fitter variant does the other variant just fade out well it goes away but it doesn't fade out it's out competed it it it is denied the ecological niches that is in you and me it is denied the ecological niches in which to reproduce so it has nowhere to reproduce so it dies out yeah it does fade out it's out competed in this case by the omicron variant so it's a simple darwinian survival of the fittest situation so and as we saw in that graphic basically there's no delta reproducing now in south africa it's all omicron and that is my hope for the world um it really we really are you know you know the next couple of weeks is going to be pretty tense pretty tense and uh but so far it's looking like omicron could be um our way out of this pandemic not human beings being clever it's just the natural evolution of the viruses so uh cause for human humility there i think so i remain optimistic i'm gonna report on this until we've got something definite and uh but it really is it really is so far so good um oh just before i go um we um put the thing on yesterday for free downloads of the of the books not my books lots of people have done that and i was actually talking to my um these are free in pdfs of course um i was talking to a technician about it and he says that he thinks that since the middle of last year we've downloaded about 90 000 copies so i'm just so pleased you know you sit there you know write writing books and you know your whole life ends up going into these flipping books it takes ages and then sometimes you you'll you'll spend all day writing you think you know i'm really tired after a day's writing do you think anyone is ever going to read this and the idea that 90 000 people have downloaded and and hopefully are reading it really is um it really is great justification for all the uh all the happy days but they weren't that bad but all the days i spent writing these two books and there were quite a few of them so absolutely delighted that they're being read and hopefully the diagrams are being uh colored in and uh all that kind of thing so i drew all the diagrams i'm not artistic but i just um i just sort of can draw simple diagrams like that and uh put the labels on and kind of explains hopefully what's going on so um free downloads help yourselves and uh let's get to a hundred thousand that would be that would be brilliant okay thank you for watching

Channel: Dr. John Campbell

Views: 598,990

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

Id: 5r0AA41dgLU

Length: 26min 0sec (1560 seconds)

Published: Thu Dec 09 2021