Omicron COVID Cases May Already Be Peaking Where Outbreak First Started

Omicron COVID-19 cases may have already peaked in South Africa's Gauteng province less than three weeks after the new variant was first identified there.

Cases in Gauteng—which has seen the fastest rise in Omicron infections in the world since the variant was discovered in mid-November—appear to be leveling off. On December 8, it recorded 11,703 new cases, but on December 14, there were 8,685. Gauteng, home to the cities of Johannesburg and Pretoria, is South Africa's most populated province.

Shabir Madhi, a professor of vaccinology at the University of the Witwatersrand in Johannesburg, told Newsweek: "Most recent data does indicate a plateauing of the 7-day rolling average of the case rate in Gauteng, but not elsewhere where it is still on the rise and will probably continue for the next two or three weeks.

"That being said, the steeper incline in case rate in this wave than any of the previous three waves has possibly resulted in large number of people getting infected over a shorter period of time, hence peaking sooner than with previous waves," he added.

Another scientist noted that the average number of new cases for the past seven days in Tshwane, one of the early epicenters in Gauteng, is now "relatively flat."

"Case growth is steeper than last week but still has slowed down versus November," Louis Rossouw, of the COVID-19 Actuaries Response Group in South Africa, told The Telegraph on Sunday. "In Gauteng, cases are still levelling off. Tshwane cases are relatively flat, with a slight increase in the most recent days."

Despite the emergence of the new variant in South Africa that has proved to be highly transmissible, the country's deaths and case fatality rate are extremely low.

Between November 14 and 16, when the first case of Omicron was found in South Africa, the average daily death rate was around 20. On December 14 it was 24, showing no significant rise, despite Omicron surging and becoming the dominant strain in South Africa in a matter of days.

The Our World In Data website shows the case fatality rate—the ratio of deaths divided by the number of cases—was 2.81 percent on Tuesday. This is the lowest it has been in South Africa since January this year. It was as high as 3.44 percent in May 2021 when the Delta variant was dominant.

However, some experts have warned that the reason why Omicron appears to be less virulent so far is that many of the people infected are either vaccinated or have had the virus previously, meaning that they still have enough antibodies to respond to it. A recent recent study in Gauteng found that 72 percent of the population had been previously infected with COVID-19.

Madhi agrees, saying that although Omicron is antibody evasive, there is "a large amount of underlying cell-mediated immunity that is possibly playing a role in shortening the duration of shedding of virus."

"Also, the uncoupling of high case rates but low hospitalization and death rates is likely due to the cell-mediated immunity preventing progression from infection to severe COVID. This might well herald a turning point in the COVID-19 pandemic, where infections may continue unabated but severe disease is greatly diminished, hopefully not to any larger number of deaths than occurs with season influenza each year before the pandemic started," Madhi said.

Matthew Snape, a professor in pediatrics and vaccinology at the University of Oxford, said in a press briefing in London on Monday: "In areas where we know omicron has been circulating for a bit longer, such as in South Africa, they are not seeing severe disease, maybe because they actually still have enough cross-reactive antibodies."

Only one person is known to have died from Omicron so far, among tens of thousands of cases of it. Although there is a lag of a few days or weeks between case reporting and deaths, there has been no sign yet that Omicron leads to significantly more hospitalizations or deaths. As a result, South Africa has not imposed tighter restrictions since the new variant was discovered.

In a tweet on Friday, Madhi praised the South African government for not imposing more COVID-19 restrictions with the outbreak of the Omicron variant.

"[Government] response correctly remains measured by not increasing restrictions and not panicking with increase in cases, but seem to rather focussing on COVID (excluding coincidental Ix) hospitalisation and health facility capacity," Mahdi said.

Omicron peak quicker SA
A patient gets vaccinated against COVID-19 by the Witkoppen clinic at the Kya Sands informal settlement in Johannesburg on December 8, 2021. Omicron COVID-19 cases may have already peaked in South Africa’s Gauteng province, where the outbreak first started, less than three weeks after the new variant was first identified. Emmanuel Croset/Getty