Wednesday, December 15, 2021

Good news at last! Omicron is causing up to a THIRD fewer hospitalisations than Delta and two Pfizer jabs still slash death risk of severe disease by 70%

Omicron is causing milder disease than Delta in patients in the epicentre of the new Covid variant, the first major real-world study in South Africa confirmed today.

Officials who analysed 78,000 Omicron cases in the past month estimated the risk of hospitalisation was a fifth lower than with Delta and 29 per cent lower than the original virus.

As a crude rate, Omicron is currently leading to a third fewer hospital admissions than Delta did during its entire wave — 38 admissions per 1,000 Omicron cases compared to 101 per 1,000 for Delta.

The findings lend weight to the theory that the ultra-infectious variant is weaker than previous strains, something which doctors on the ground in South Africa have been claiming for weeks.

But the reduction in severity is probably not solely down to Omicron being intrinsically milder, according to the South African Medical Research Council which led the analysis.

Around 70 per cent of South Africans have recovered from Covid already and 23 per cent are double-vaccinated, which has created high levels of immunity.

The finding will raise hopes that the UK's Omicron wave will be less severe than previous peaks, despite having an older and denser population. Unlike South Africa, the UK is rolling out booster jabs on a mass scale.

The study also found two doses of Pfizer's vaccine still provide 70 per cent protection against hospital admission or death from Omicron, compared to 93 per cent for Delta.

While this is more protection than many scientists initially feared, it still leaves 30 per cent of people vulnerable to severe Omicron disease, four times as many as Delta. Waning immunity from two Pfizer doses was found to offer just 33 per cent protection against Omicron infection, explaining why the country has seen a meteoric rise in case numbers.

Against Delta, two Pfizer jabs initially offer more than 80 per cent protection against symptomatic infection before falling to around 60 per cent within six months.

Today's study, co-run by private health insurance company Discovery Health, was based on more than 211,000 positive Covid test results from November 15 to December 7, 78,000 of which were attributed to Omicron.

Overall, four in 10 of those who tested positive had received two doses of the Pfizer/BioNTech vaccine.

The 70 per cent protection from severe disease figure still puts two doses well above the World Health Organization's efficacy threshold of 50 per cent.

But the researchers said that efficacy was reduced further in older age groups, falling to just 59 per cent in the 70 to 79 bracket, for example.

That could be because older people were vaccinated first in the initial rollout and there has been more time for immunity to wane than in younger people.

Protection against admission was consistent across a range of chronic illnesses including diabetes, hypertension, hypercholesterolemia, and other cardiovascular diseases, the study said.

Children appeared to have a 20 per cent higher risk of hospital admission with complications during the fourth wave than during the first, despite the numbers still being tiny.

'This is early data and requires careful follow up,' said Shirley Collie, chief health analytics actuary at Discovery Health.

She cautioned that children were still 51 per cent less likely to test positive during the Omicron wave and the risk for them remains low.

As a crude rate, Omicron is currently causing a third fewer hospital admissions than Delta did — 38 admissions per 1,000 Omicron cases, compared to 101 per 1,000 for Delta.

However, South Africa is only a month into its Omicron outbreak and Covid admissions are steadily rising, with 422 admitted yesterday, a rise of 141 per cent compared to last week.

A total of 6,198 people are being treated for the virus now compared to the 5,562 who were in hospital on Sunday — the biggest single-day rise since the new variant took off.

Yet, despite the increasing case and hospital numbers, there were just 11 deaths attributed to Covid in the last 24 hours, up only marginally on last week.

Doctors in South Africa's Omicron ground zero maintain that Omicron patients are coming in with milder illness and being discharged quicker.

Official figures suggest the number of Covid hospital patients with severe illness is a third of the level at the same point in the country's Delta wave.

The South African doctor who first raised the alarm about Omicron last month endorsed the study today, telling MPs that it confirmed what doctors were seeing on the ground.

Dr Angelique Coetzee, chairwoman of the South African Medical Association, told the Commons Science and Technology Committee that 'we don't have all the answers' but the clinical picture so far is that people are mostly suffering mild illness from Omicron.

Dr Coetzee said some people are getting breakthrough infections if they are vaccinated or if they have had Covid before, but cases seemed to be milder, especially for the vaccinated.

'The breakthrough infections we are seeing are mild... (and) the symptoms we are seeing in (vaccinated) people are less severe or intense than in the unvaccinated,' she said.

'On a hospital level... between 88 per cent to 90 per cent (of people) are unvaccinated.'

She said that in hospitals it is hard to differentiate between those patients with the Delta variant and those with Omicron, but that intensive care units 'are still not overwhelmed'.

Pfizer's Covid pill slashes the risk of hospitalisation and death by up to 90 per cent and will work against Omicron, the vaccine maker claimed today.

A study of more than 2,200 at-risk adults found the drug, called Paxlovid, reduced the risk of severe outcomes by 89 per cent.

And a separate trial of the pill, which the UK has already ordered 250,000 doses of, on healthy unvaccinated adults found taking it within a few days of suffering Covid symptoms cuts the chance of being hospitalised by 70 per cent, Pfizer said.

Meanwhile, laboratory tests suggest Paxlovid will still offer a 'robust' response against the Omicron variant, which is due to become dominant in the UK tomorrow.

Pfizer's boss Dr Albert Bourla said the emergence of Omicron has ‘exacerbated the need for accessible treatment options for those who contract the virus’ and the pill could be a ‘critical tool to help quell the pandemic’.

The UK's medicines regulator has so far approved one at-home pill in the fight against Covid. But molnupiravir, made by US-based Merck and Ridgeback, will only be given to older and at-risk people within 48 hours of catching the virus as part of a pilot that is expected to launch by the end of the year.

He added: 'For example, the narrative around South Africa is that Omicron may be much milder, whereas reports out of Denmark broadly suggests the opposite.

'This reflects the uncertainty of new data. Within that, factors include the different levels of exposure to Covid-19 and previous infection, levels of vaccination and potential waning of immunity, and also age ranges infected thus far.

'We know that Covid-19 is very adept at moving from younger to older populations within a few weeks.


Irish firm collaborating on delivery of world’s first inhaled COVID-19 vaccine

After months of collaborative work in the lab, China's CanSino Biologics and Irish drug delivery specialist Aerogen are taking their inhaled COVID-19 vaccine pact to the next stage.

CanSino and Aerogen are teaming up to develop and market an inhaled version of CanSino's recombinant COVID-19 shot Convidecia, which is already approved in China as a one-and-done injectable. Because aerosol delivery requires a "considerably smaller volume of vaccine," the partners' inhaled prospect could help stretch capacity and enable more patients to access the inoculation, the companies said.

Outside of China, Convidecia boasts emergency authorizations in countries such as Argentina, Chile, Ecuador, Indonesia, Hungary and Pakistan. The shot is around 63.7% effective against COVID-19 two weeks after vaccination, and 96% effective against severe disease over that same time frame, a CanSino representative said during an October World Health Organization presentation. At 28 days, overall efficacy dropped to 57.5%, while efficacy in severe disease hovered around 91.7%.

As for the inhaled candidate, CanSino's vaccine will leverage Aerogen's vibrating mesh aerosol drug delivery technology, the companies said. The aerosolized vaccine is directly inhaled through a cup dispenser into the patient's airway, mimicking the respiratory virus's natural infection pathway. This delivery route could further help patients, thanks to the potential for mucosal immunity, the partners said.




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