![\"\"](\"https:\/\/drbannonsblog.aprendo.co.uk\/drbannonsblog_wp\/wp-content\/uploads\/2021\/12\/SA-admissions-1024x769.png\")
<\/figure>Early signs that the third South African Wave might be less deadly than the first two.<\/em><\/strong> <\/p><\/div><\/div>\n\n\n\n There are also suggestions that South African ITU’s are not filling up; so when patients are admitted with the Omicron variant, they are staying three times shorter, signifying less severe illness. However, things are changing rapidly and in the last few days it seems there have been significantly more admissions in a country where most infections are with the Omicron variant. Also, gloomily for us, they are in the middle of summer.<\/p>\n\n\n\n BIG BUT….data from elsewhere shows that admissions are increasing as the Omicron wave crashes, so caution is needed.<\/em><\/strong> <\/p><\/div><\/div>\n\n\n\n In the USA there have been 40 cases so far, with mild symptoms and one hospital admission. One in 40 is not especially good news, but numbers are too low to make any conclusions. That is why, over here, we are less sanguine; we are facing winter, the public sector is already struggling and any increase in cases and admissions will make life difficult. <\/p>\n\n\n\n So back to the labs; what is the latest on the big issues of transmissibility, virulence and immune escape?<\/p>\n\n\n\n Transmissibility<\/strong>; Yes it does seem significantly more transmissible, being able to infect 3-6 times more people than Delta, according to this analysis<\/a> in Nature. In the UK the HSE expect that at least 50% of all infections<\/a> will be with the new variant within the nest few weeks – in other words, over Xmas.<\/p>\n\n\n\n Severity of illness: <\/strong>So far it does not seem to cause more severe illness, but this is based on very preliminary data from the South African population<\/a> where the climate, season and age of patients are very different from Europe. Given that this is very early days, it is too early for optimism on this, even if there is some to hang on to. <\/p>\n\n\n\n Vaccine evasion:<\/strong> Yes it does partially evade the vaccines and immunity from previous infection. This paper<\/a> shows you need many times more antibodies to neutralise it, but vaccine escape is not complete. Over here HSE stated half the early cases were in people who have been vaccinated – in other words, half the cases are in the 10% of people who are unvaccinated – again the numbers are too small to be reassured by, but they suggest that the vaccines continue to have a positive effect. <\/p>\n\n\n\n For those who have had boosters, or been double jabbed with an infection, early news from Pfizer is encouraging – in a press release Pfizer have said<\/a>;<\/p>\n\n\n\n By way of hedging their bets, Pfizer add:<\/p>\n\n\n\n “The companies continue to advance the development of a variant-specific vaccine for Omicron and expect to have it available by March in the event that an adaption is needed to further increase the level and duration of protection \u2013 with no change expected to the companies\u2019 four billion dose capacity for 2022<\/em>.”<\/strong><\/p>\n\n\n\n In summary, it looks certain that Omicron will become dominant, and it is still hoped that it causes less severe infections, and a booster dose of vaccination is really useful, countering the immune escape of Omicron. So, for those vaccinated, a booster dose makes sense, as it does against other viruses like Hepatitis B. <\/p>\n\n\n\n With new and better treatments coming along, we will have more options as this winter rolls on, The newer protease inhibitors continue to look promising and should be OK with the new variant – they will be available early next year. Some however, will fall by the wayside:<\/p>\n\n\n\n Ronapreve, a combination of spike protein specific antibodies, shows little effect against Omicron<\/em><\/strong><\/p><\/div><\/div>\n\n\n\n For anyone with vulnerabilities more options are available to prevent severe disease, and cell based immunity from previous vaccines will also have this effect, so Im keeping my fingers well crossed. <\/p>\n\n\n\n![\"\"](\"https:\/\/drbannonsblog.aprendo.co.uk\/drbannonsblog_wp\/wp-content\/uploads\/2021\/12\/world-in-data-1024x723.png\")
<\/figure>The three big questions:<\/h3>\n\n\n\n
Treatments<\/h3>\n\n\n\n
![\"\"](\"https:\/\/drbannonsblog.aprendo.co.uk\/drbannonsblog_wp\/wp-content\/uploads\/2021\/12\/ronapreve.png\")
<\/figure>What next?<\/h3>\n\n\n\n