Winnie the Flu? Omicron Symptoms Mild So Far

Initial clinical data out of South Africa suggest that patients with the Omicron variant of COVID-19 don't have severe illness.

Don’t bet the house just yet. There hasn’t been any official proclamation that the worst Omicron could do is give us sniffles as it pushes the Delta variant—which has killed thousands—offstage making Omicron the dominant variant of COVID-19. But as Infection Control Today® reported last week, some frontline scientists in South Africa think that Omicron may be a way to end the pandemic.

Giving that scenario some credence is a report issued over the weekend by the South African Medical Research Council (SAMRC) which says that while cases of COVID-19 are spiking in the Tshwane District of the country, the symptoms are either very mild or the patients are asymptomatic.

“The main observation that we have made over the last two weeks is that the majority of patients in the COVID wards have not been oxygen dependent,” the report states. “SARS-CoV-2 has been an incidental finding in patients that were admitted to the hospital for another medical, surgical or obstetric reason.”

The authors of the SAMRC report looked at patient experiences at the Steve Biko Academic and Tshwane District Hospitals (SBAH/TDH) in Pretoria, in the heart of the Tshwane District, an area where Omicron was first seen to be spreading rapidly, with 10,000 reported cases from November 29 to December 3.

“It is essential to recognize that the patient information presented here only represents the first two weeks of the Omicron wave in Tshwane,” the authors state. “The clinical profile of admitted patients could change significantly over the next two weeks, by which time we can draw conclusions about the severity of disease with greater precision.”

South Africa’s National Institute for Communicable Diseases (NICD) confirmed that almost all of the new cases were caused by Omicron.

“The first impression on examination of the 166 patients admitted since the Omicron variant made an appearance, together with the snapshot of the clinical profile of 42 patients currently in the COVID wards at the SBAH/TDH complex, is that the majority of hospital admissions are for diagnoses unrelated to COVID-19,” the report states. “The SARS-CoV-2 positivity is an incidental finding in these patients and is largely driven by hospital policy requiring testing of all patients requiring admission to the hospital.”

“Encouraging” is the word Anthony Fauci, MD, used to describe the initial clinical data coming out of South Africa. However Fauci, the director of the National Institute of Allergy and Infectious Diseases and the chief White House medical advisor, tells CNN that “we really got to be careful before we make any determinations that it is less severe or really doesn’t cause any severe illness comparable to Delta. But thus far, the signals are a bit encouraging regarding the severity. But again, you got to hold judgment until we get more experience.”

Last week, the Centers for Disease Control and Prevention, recommended that adults 18 and older get a COVID-19 booster shot. Fauci and most medical experts say that vaccinations and booster shots are the best way to end the pandemic.

Meanwhile, though, public health officials in Australia, South Korea, Singapore, India, and Hong Kong are all reporting that patients infected with the Omicron variant display mild symptoms.

The SAMRC report states that “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. The NICD reports a similar shorter length of stay for all hospitals in Tshwane in its weekly report. It is also less than the Gauteng or National average length of stay reported by the NICD in previous waves.”