As the fourth wave of Covid spreads, South Africa is seeing a considerable increase in positive cases. Just as the Delta variant became part of our daily vocabulary, the Omicron or BI.I.529 strain has too. Omicron has more than 30 mutations (double those carried by Delta) that may have an impact on how it behaves. This includes how easily it spreads and the severity of the illness it causes. The Omicron variant was found in 74% of the 249 Covid-19 samples that were gene-sequenced in November in SA. It appears with more than double the mutations carried by Delta, Omicron is virulent enough to take over from Delta.
Current international data shows that there are far more positive cases, meaning that Omicron appears to be highly transmissible. However, although more people are testing positive, they are presenting with mild symptoms with fewer hospital admissions. Medical professionals believe this is a direct result of the immunity acquired through vaccinations.
The first wave of Covid-19 took the world by surprise but globally everyone is better prepared for this new wave. This includes a sustained effort to vaccinate as many people as possible. What the World Health Organization (WHO), the National Institute for Communicable Diseases (NICD) and most people involved in the healthcare sector agree on unanimously, is that the best form of protection from serious disease is vaccination.
Lee Callakoppen, Principal Officer, Bonitas Medical Fund says, “We have been proactive in urging our members and the public to be vaccinated. Our statistics show that, of our members over 60, there are 90% fewer admissions to hospital after full vaccination and 56% fewer after one vaccination. Research across the public healthcare environment has shown the same results. With this information freely available it is disturbing that only 16 944 413 people living in SA have been vaccinated. This is only 35.5% of adults and 23.7% of the total population.
‘The cost of hospital admissions too, especially ICU, are very high. Our figures show that up to November 22, the Bonitas Covid-19 costs totalled R1.75 billion. 80% of this (R1 399 181 922) was hospital costs, while only 4.9% (R85 669 068) was for vaccinations.
‘The average cost of admission to ICU, per patient, was R533 969. There is no doubt that vaccinations not only save lives but also reduce the burden on the public healthcare system, as well as save the country billions in costs related to treating Covid. Vaccinations are a fraction of the cost of treating Covid.’
Both in the public and private sector, the unvaccinated are filling our hospitals. Dr Waasila Jassat, from NICD, announced at the end of November that ‘unvaccinated patients suffered more severe symptoms than vaccinated ones and were most likely to face hospitalisation if infected by the new Covid-19 variant.’ She said that 90% of patients admitted to hospital in Pretoria (one of the current hotspots) are unvaccinated. ‘Not only is there a higher incidence of hospital admissions but also that the chances of death amongst unvaccinated are considerably higher.’
Callakoppen says there is enough clinical evidence to show that the vaccination reduces the severity of Covid and he encourages everyone to be vaccinated. He urges those who have been vaccinated to encourage others to do the same. However, this doesn’t mean you can forgo following the Covid protocols: Wearing a mask; sanitising your hands, maintaining social distancing; staying in well ventilated spaces; coughing or sneezing into your elbow or a tissue.
Bonitas has reported the following Covid related figures for 2021 as of 22 November.
- Total lives older than 18 estimated to have received at least 1 jab 66.4%
- Total tests performed: 441 929
- Total Covid-19 hospital admissions: 20 376. (12 264 during 2021)
- Bonitas lives currently in hospital: 0.3%
- Admission rate: 25%
- ICU Admission Rate: 22%
- Total Covid deaths: 3 515 (2 292 in 2021)
- Total Bonitas membership vaccinated: 70%
- Highest number of people vaccinated is in the 35-49 age group followed by the over 60s
‘I must reiterate that our best defence against Covid-19 is to be vaccinated,’ says Callakoppen. ‘It won’t necessarily stop you from getting the coronavirus but it will reduce the severity of the disease. I contracted Covid in September but thankfully because I was fully vaccinated, my symptoms were mild which meant I was able to heal and recover at home. My experience is not unique.’
Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund answers some common questions around Omicron
What is it?
It’s a new, heavily mutated Covid variant known as BI.I.529.
When was Omicron first detected?
The earliest sample was detected on 11 November in Botswana.
Is it more transmissible?
Circumstantial evidence indicates it is. Within two weeks of its detection, it has outpaced Delta to become the main strain in Gauteng.
Will vaccines work against it?
Yes, most likely. A crucial objective remains to increase vaccination rates. Current vaccines remain critical to reducing severe disease, hospitalisation and death. Should updated vaccines be developed, they will be rolled out globally and used as guided by WHO.
Will prior infection provide me with immunity?
Preliminary evidence suggests there may be an increased risk of reinfection with Omicron but information is limited. More information on this will become available in the coming days and weeks.
What about treatment?
Currently Oxygen and Dexamethasone have been saving lives. There is however very exciting data coming from two antivirals.
What about the current tests?
The widely used PCR tests continue to be the global standard to detect infection including Omicron. Studies are ongoing to determine whether there is any impact on other types of tests including rapid antigen tests.