Sunday, 22 May, 2022
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Omicron Wave – Can We Afford Indifference?

Dr. Md. Jamal Uddin Chowdhury

Omicron Wave – Can We Afford Indifference?
Dr. Md. Jamal Uddin Chowdhury

We are now encountering a wave of the Omicron variant of COVID-19. Our honourable health minister very recently revealed that 69 per cent of the infected are carrying the Omicron variant. He expressed his concern regarding the scarcity of hospital beds that may arise within the next one and half months, if the present trend of infection continues. Many of us may say why worry when Omicron in most cases shows mild symptoms. Is Omicron really less damaging? Let us visit the scenario around the world.

Omicron is the latest variant of concern (VOC) of  COVID-19 as recognised by the World Health Organisation (WHO). Although it was first detected by Botswana in the African Continent on November 11, 2021, it was first declared by South Africa on November 23. By then this variety of  COVID-19 had propagated extensively throughout South Africa, United States, United Kingdom and other European countries. Now most countries are affected by it. Although western countries, including Australia, and other developed countries have attained 'Herd Immunity' with vaccines, yet Omicron is spreading unabated, ignoring the herd immunity of the community. As Omicron is a hugely mutated COVID-19, so, it is capable of evading the immunity that protected the people from the previous variants of Alpha, Beta, Gamma and Delta.

To analyse the situation, let us explore the vaccination status of the various developed countries including India. In the UK, so far 70 per cent of the population have completed full dosage of vaccines, another six per cent are partially vaccinated. 60 per cent of the population got booster doses. On January 17, the number of newly detected COVID-19 patients was 84,429; the number of deaths was 85. Although so far the highest number of cases detected in a day was 2,18,376 and highest death recorded in a day was 1,824 in this wave.

In the USA, 63 per cent of the people got full dosage of vaccine; another eight per cent got the first dose. Booster dose was given to 25 per cent (nearly 8,00,000) of the population. In the USA, the number of newly detected on January 16 was 3,89,553 and the number of deaths was 468. Highest number detected in a day was 8,59,149; the highest number of deaths was 2,452. It may be alluded that in the USA, 95 per cent of COVID-19 infection is due to the Omicron variant.

In Denmark, 81 per cent of the population is fully vaccinated. Another three per cent received single jab. 55 per cent received Booster dose. On January 17, 2022, the number of newly detected COVID-19 infections was 26,965; the number of deaths was 11. During the previous Delta wave, the highest number of infections was only 1,085.

In South Africa, the highest number of infections was found on December 12, 2021, It was 37,875. Highest number of deaths in a day was 161. The death toll due to COVID-19 is comparatively low in South Africa. It may be because only six per cent of the population is above 65 years.

In the UK, total number of Omicron detected till December 29, 2021 is 6,49,834, of these, 25 per cent are unvaccinated, 43 per cent had full dose of vaccine and 23 per cent got Booster dose. In this period, among the Omicron infected, 815 were hospitalised, 57 died. So, it can be inferred from this data that presently used vaccines are not giving adequate protection against Omicron. So, the scientists are trying to develop Omicron specific vaccines.

A recent study conducted in UK revealed that, two doses of Oxford-AstraZeneca vaccine were found to be effective in 30 per cent cases after 12 weeks and in 18 per cent after 19 weeks in case of Omicron; whereas in case of Delta variant, It is 80 per cent effective after four weeks and 57 per cent after 19 weeks. In these cases, if Pfizer- BioNtech is given as Booster, in case of Omicron it is 62 per cent effective after four weeks and 40 per cent after 10 weeks ; whereas in case of Delta, it is 98 per cent effective after four weeks and 82 per cent after 10 weeks.

On the other hand, two doses of Pfizer-BioNtech vaccines are 60 per cent effective in case of Omicron after three weeks and 95 per cent effective after four weeks in case of Delta. In these cases If Pfizer-BioNtech vaccine is given as Booster, then it is 63 per cent effective after four weeks and 48 per cent after 10 weeks in case of Omicron and 97 per cent effective after four weeks and 92 per cent after 10 weeks in case of Delta. From this study it can be deduced that presently used vaccines are less effective against Omicron and the effect of vaccine wanes in a very short period. It can also be inferred that those who have taken two doses of AstraZeneca vaccine before six months and Booster is not taken yet, are going to be more vulnerable to Omicron infection.

In another study conducted in the USA on 52,297 Omicron infected and 19,982 Delta infected persons, 235 Omicron infected and 222 Delta infected had to be hospitalised. Amongst the Omicron infected, the need for ICU support and number of deaths were 1/4th of Delta and 1/11th of Delta cases respectively. So it may be said that the number of hospitalisations in Omicron is less than Delta in terms of proportion but in terms of absolute number it is more in case of Omicron than Delta. It is because the number of infections in Omicron is 3-4 times greater than Delta. We have to keep in mind that only patients of severe and moderate category with co-morbidities need hospitalisation. Most of these patients require artificial oxygen.

From the above study reports, we can deduce that the currently used vaccines cannot give full protection against any of the variants of  COVID-19, and much less in the current wave of Omicron. So, additional protection must be attained by wearing a face mask and following stringent COVID-19 protocol such as social distance, handwash, etc. South Africa’s COVID-19 situation has come under control within a month and a half. It has been possible due to the strict application of law regarding wearing masks and other COVID-19 protocols.

In Bangladesh, we are amid the Omicron wave. In the previous Delta wave, the doubling time of the virus was 10 days at the initial phase. Now it is only four days. So the magnitude of the crisis can easily be understood. Moreover, only 34 per cent of the population got two doses of vaccines, another 18 per cent got a single dose. Only 6,oo,ooo persons got Booster doses. The prevailing condition of our neighbour is also worrying. During the previous Delta wave, we were much affected by the rise of infection in West Bengal.

In conclusion, it can be said that the Omicron is not less harmful than Delta if its transmissibility is considered. In Bangladesh, as comparatively less people are fully vaccinated so we have to protect ourselves with face masks and other COVID-19 protocols. The Honourable Prime Minister has prudently collected vaccines for us in a crisis situation at a huge cost. If we do not wear masks or follow other COVID-19 protocols, huge pressure will be created in the hospitals, more valuable lives will be lost. It will be cumbersome for us to meet the extra expenses paid for such an indifferent attitude towards Omicron, which may weaken our economy as a whole. Let us become cautious before we lose any more.

 

The writer is a member of the National Clinical Management Guideline

Committee and Secretary General, Bangladesh Private Medical

Practitioners Association