Omicron is Surging, while Delta Continues to Rove

Key Points:

• In today’s Recommendations for Industry, we discuss the continuing saga of the Delta and Omicron variants – and where we stand now. Read more below.
• WHO warns world cannot ‘boost its way out’ of pandemic
  • Blanket booster programs in rich countries risk prolonging the battle with COVID-19, WHO chief says, warning that the rush in wealthy countries to roll out additional COVID vaccine doses was deepening the inequity in access to jabs that is prolonging the pandemic. “No country can boost its way out of the pandemic,” he said.
  • However, Israel plans to become first nation to offer fourth coronavirus vaccine dose, offering it to citizens 60 and older and other at-risk groups.
• Covid Omicron: European nations reinstate restrictions
  

• European leaders are reinstating coronavirus restrictions as the Omicron variant continues to spread across the continent.
  • Germany and Portugal have announced post-Christmas curbs and greater social distancing measures; The Netherlands has gone into lockdown; France, Cyprus and Austria are tightening travel restrictions; and Denmark has closed many indoor spaces. (CNBC)
• Omicron Severity
  • A December 22 report from Imperial College London found evidence of a reduction in the risk of hospitalization for Omicron relative to Delta infections, averaging 20-25% for hospital visits, and 40-45% for those admitted or hospitalized for at least one day.
  • While there is a larger risk of infection with Omicron, due to the reduction in protection provided by both vaccination and natural infection, the report stated that a previous infection reduces the risk of hospital visit by approximately 50% and of a hospital stay of 1+ days by 61%.
  • These findings are in contrast to a December 16 report from the Imperial College that found “no evidence (for both risk of hospitalization attendance and symptom status) of Omicron having different severity from Delta.”
• Omicron Symptoms
  • Data released last week from South Africa’s largest private health insurer suggest that symptoms include a scratchy or sore throat, nasal congestion, a dry cough and muscle pain, especially low back pain.
  • Other reports are showing only subtle differences between Omicron and previous strains, with one possible difference being that Omicron is less likely to cause a loss of taste and smell.
    • Original strain:  48 and 41 percent respectively reporting loss of smell and taste
    • Omicron:  An analysis of a small Omicron outbreak in the Netherlands found only 23 (smell) and 12 (taste) percent loss in vaccinated persons. It’s unclear, though, whether the differences are because of Omicron or some other factor, like vaccination status.
  • Many symptoms vary depending on vaccine status. One report shows that vaccinated patients with Delta or the original coronavirus tend to present with headache, congestion, sinus pressure and sinus pain, while unvaccinated patients are more likely to have shortness of breath and cough, along with flulike symptoms.
• Case drop may show South Africa’s omicron peak has passed –
  • South Africa’s noticeable drop in new COVID-19 cases in recent days may signal that the country’s Omicron-driven surge has passed its peak.
  • After hitting a high of nearly 27,000 new cases nationwide on Thursday, the numbers dropped to about 15,424 on Tuesday. In Gauteng province of South Africa, the decrease started earlier and has continued.
• FDA authorizes first pill to treat COVID-19
  • FDA authorized Pfizer’s antiviral pill, Paxlovid, to treat COVID-19 in high-risk individuals age 12 and older who weigh at least 88 pounds and have a positive SARS-CoV-2 test.
  • Pfizer’s updated results showed the treatment cut the risk of hospitalization or death by 88% if given within the first five days of symptoms, the efficacy was similar.
  • Paxlovid combines a new antiviral drug named nirmatrelvir and an older one called ritonavir and is administered as three pills given twice a day for five days.

Recommendations for Industry

Omicron Is Surging, while Delta Continues to Rove

As shown in TAG’s weekly COVID-19 matrix, as well as many articles in the news, Omicron is here. TAG sees the U.S. as being in a transition period, with the Delta variant still working its way through some communities, while other communities are solidly in the grip of Omicron with cases rising dramatically. If your community is not yet in this rise, be prepared – you will be. And at the rate it is being seen in other countries – you will be very soon.

Are you prepared? For continued wellness checks? For increased labor shortages? For back-ups for essential personnel? If not, we highly recommend you set a plan now so you’re not caught short. Because of the seemingly reduced severity of Omicron, one idea coming out of the UK that TAG sees as a practical approach for US businesses is the retesting on days 6 and 7. If a person who tested positive tests negative on days 6 and 7, UK is allowing the early release from isolation.

There also seems to be a silver lining to the rapid increase of Omicron – that is, the S. Africa case rate trends seem to be showing an even faster decline than other variants. Additionally, while data is still being studied, it seems to be showing reduced severity and hospitalizations. So, while 2022 appears to be coming in like a lion, we can hope that it takes on the idiomatic characteristics of the month of March and quickly softens to those of a lamb.

Risk Matrix:

Omicron is now the dominant variant in the U.S.

In case you missed it

• In Tuesday’s Recommendations for Industry, we discussed the possibility of a “twindemic” and how businesses can prepare. Read more here.
• The Omicron variant is now dominant in the U.S., accounting for 73% of all new COVID-19 cases. However, the Delta variant does continue to spread. In Canada, Quebec “became the latest region to implement restrictions, closing bars and schools and mandating remote working, as COVID-19 cases rise.”
• As has been noted in the news, the WHO has announced that the “Omicron variant of the coronavirus is spreading faster than the Delta variant and is causing infections in people already vaccinated or who have recovered from the COVID-19 disease.” 
• The New York Times breaks down how you can best utilize an at-home test, prior to the holidays and before meeting others in large gatherings.
• As individuals debate whether to receive a COVID-19 vaccine or not, recent research has found that “a positive [COVID-19] test [is] tied to much higher odds of” myocarditis (Inflammation of the middle layer of the heart wall) than from actually receiving a COVID-19 vaccine. Another study has found that 1 in 10 pediatric COVID-19 patients may develop sever GI issues. A third study has also found that there is “very low risk of death” with multi-inflammatory syndrome in children (MIS-C) with COVID-19. Finally, additional research has also found that Pfizer’s COVID-19 antiviral medication, Paxlovid, is promisingly effective against the Omicron variant. However, as with most things, more data is needed.
• In Europe, leaders are weighing implementing tougher measures and preventive controls as Omicron cases surge. As part of this, the Netherlands has entered a lockdown to limit spread while the UK and Germany are considering next steps. German leaders will be meeting to discuss further preventive measures including “limiting public venues to vaccinated or recovered people, capping gathering size, and speeding up the booster shot campaign.” In fact, cities like London, Paris, and Rome are canceling New Year’s Eve events.

Influenza:

• In the US, according to HealthMap and the CDC, influenza numbers are increasing with almost all of them being the H3N2 strain (Influenza A). Cases are increasing as identified through indicators, including hospitalizations. Although early activity had focused on those ages 5 to 24, the proportion of illnesses in older age-groups has risen in recent weeks.
  • Several states are starting to report low numbers of deaths due to flu and cases are approaching where they were 2 years ago. Unfortunately, the “twindemic” of flu and COVID-19 that public health leaders wrongly predicted last year might happen this year.
  • However, it should be noted that testing for flu is likely unusually high this year because that is the only sure way to differentiate between flu and COVID-19.  
  • According to the CDC, “Influenza activity is increasing, with the eastern and central parts of the country seeing the largest increases and the western part of the country reporting lower levels of influenza virus circulation at this time.”
• According to the WHO, “Globally, influenza activity continued to increase but remains well below levels observed in previous seasons.”

Food Safety & Public Health:

• The FDA has released its annual summary report on antimicrobials sold or distributed in 2020 for use in food-producing animals. To add to this, Brazilian restrictions on antibiotics sales has been linked to a decline in antimicrobial resistance (this is good news!)