News from the epicentre of Omicron transmission.
The news from the Epicentre of the Omicron transmission is very positive. The current global epicentre of the Omicron variant is in the city of Pretoria which is in the Tshwane District just north of Johannesburg, South Africa. What the hospitals in this district are experiencing currently varies distinctly from the effects of previous variants over the past 18 months.
Information released this weekend by the South African Medical Research Council is very positive and there is very good reason to believe that our battle with Coronavirus could be tailing off. It must be noted that we are two weeks into this “4th wave” driven by the Omicron variant. It is early days yet and the situation may still change substantially over the next two weeks by which time the scientists and medical researchers can draw conclusions about the severity of disease with greater precision.
The scientists are quietly confident that the Omicron variant should follow the path of massive transmissibility with lower disease impact that is manifesting itself now at the health facilities of Steve Biko Academic Hospital and Tshwane District Hospital Complex in the city of Pretoria. This is a metropolitan area with a population of 2,708,702 people (official figures). This is significant when you look at the very low number of hospital admissions to date.
What are the facts emerging? Here is a summary;
This report from the SAMRC is an examination of 166 hospital admissions since Omicron arrived and below is a snapshot of the clinical profile of 42 patients on 2 December.
The majority of hospital admissions are for diagnoses unrelated to Covid-19. A total of 76% of the patients are incidental Covid admissions as they were admitted for another diagnosis but it is policy to test all new admissions for Covid and these new cases were detected.
A total of 41,921 cases were reported by 3rd December. In Tshwane, a total of 9,929 cases were reported from 29 November to 3 December.
Sharp rise in new cases
- We have seen a sharp rise in admissions at the Steve Biko Academic and Tshwane District Hospitals (SBAH/TDH) Complex with 166 new admissions between 14 and 29 November 2021. This makes up 45% of all Tshwane District Admissions in the public sector and 26% of all admissions in both public and private sectors for the same period.
- SARS-CoV-2 has been an incidental finding in 76% of patients that were admitted to the hospital for another medical, surgical or obstetric reason.
- The main observation made over the last two weeks is that the majority of patients in the COVID wards have not been oxygen dependent.
- This is a picture that has not been seen in previous waves. The COVID ward in previous waves was recognizable by the majority of patients being on some form of oxygen supplementation with the incessant sound of high flow nasal oxygen machines, or beeping ventilator alarms.
|Ward Type||Patients #||On Room Air|
|Ward 1 Male||17 (4 on oxygen)||13|
|Ward 3 Female||16 (5 on oxygen)||11|
|Stoltz HighCare||4 (3 on NIV)||1|
|Stoltz ICU||1 (intubated)||0|
|Stoltz Paeds||4 (1 on HFNO)||3|
|Patients on Oxygen||14 (33%)|
|Patients on oxygen for COVID||9 (21%)|
|Table 1. Snapshot of Patient Profile on 2 December 2021|
Comparison of Death rates to Case rates
The figure below shows the absence of any significant increase in in-hospital deaths in relation to the dramatic rise in the case rate for the Gauteng Province as a whole. This may be due to the usual lag between cases and deaths and the trend will become clearer over the next few weeks.
Other basic indicators of the severity of disease include the level of care required in the hospital (ICU, high care, general ward), oxygen requirements (nasal prongs, face mask, high flow, non-invasive or invasive ventilation) and length of stay in the hospital.
There were only 2 patients in the COVID ICU in the last 14 days, neither of whom had a primary diagnosis of COVID pneumonia. Sixty-three patients were admitted to high care, but our anecdotal information is that the majority of high care admissions were for a diagnosis other than COVID.
Reduced hospital stays
A significant early finding in this analysis is the much shorter average length of stay of 2.8 days for SARS-CoV-2 positive patients admitted to the COVID wards over the last two weeks compared to an average length of stay of 8.5 days for the past 18 months.
This is very good news for the world. We look into our crystal ball and see the clear picture of unrestricted travel to Africa in the near future. The team at Africa Explore Safaris eagerly wait to be of service to you all.