A healthcare worker collects a COVID-19 test swab sample from a girl at a market area in the old quarters of Delhi, January 7, 2022. Photo: Reuters/Adnan Abidi
“It would be extremely surprising if India does any worse” than South Africa under the impact of the omicron variant, Shabir Madhi, a professor of vaccinology and dean of the faculty of health sciences at Witwatersrand University, has said.
Madhi also shared a series of reassuring details about South Africa’s experience of infections of the omicron variant, the mildness of its disease, its impact on hospitalisation and deaths, all of which he said suggest that it is very different from the beta and delta variants of concern.
“It’s completely worlds apart.”
In a 28-minute interview, Madhi said that the omicron variant’s wave in South Africa proved to be extremely short. In less than eight weeks, after the first clinical diagnosis on November 18, cases rapidly shot up, peaked and then fell as quickly.
In contrast, the outbreaks of the delta and the beta variants lasted 12 to 16 weeks each.
Madhi also said that illness caused by an infection of the omicron variant is mild and lasts between three and five days, for people across all age groups. He also said 40-50% of those who got omicron infections were asymptomatic.
On hospitalisation, Madhi made two important points. First, he said a large fraction of those who had tested positive were only incidentally infected: that is, they had gone to the hospital for reasons other than because they had COVID-19, and were found to be positive after testing. A third of pregnant women admitted to hospital, for example, turned out to have COVID-19 without their knowing it.
Second, he said the overall hospitalisation rate due to infections of the omicron variant was a “world apart” from the rate earlier established by the alpha, beta and delta variants.
According to him, 80-85% of people in South Africa who had severe COVID-19 and needed ICU treatment or died because of the omicron variant were either unvaccinated or inadequately vaccinated.
In addition, of all COVID-19 deaths in South Africa, the omicron variant accounted for less than 5%. The delta variant has accounted for 50% and the beta and the alpha variants for 20% each. “There has been a complete decoupling of infections and deaths,” Madhi said.
What can India learn from South Africa’s experience?
“It would be extremely surprising if India does any worse,” Madhi said. According to him, there are two reasons why the Indian experience could in fact be better: higher seroprevalence and a larger fraction of the population that’s vaccinated.
Recently, the head of vaccines at the European Medicines Agency, Marco Cavaleri, said that because the omicron variant is highly infectious but causes milder disease, its spread could be pushing the world towards some form of endemicity.
Madhi agreed with Cavaleri’s view and added that we have “reached a turning point in terms of severe illness and death”.
However, he disagreed with India’s current COVID-19 restrictions (night curfew, weekend lockdown, work from home, and closed schools, restaurants, cinemas, etc.).
Finally, he said with the advent of the omicron variant, the time has come to change our strategy: to closely monitor hospitals, ICU and ventilator use instead of focus on testing, tracking and tracing.
“It’s naïve to believe [testing, tracking and tracing] has had any impact on the pandemic when up to 90% of infections were not identified.”
Watch the full interview here.