Why Omicron is more likely to kill Americans

The new Omicron variant of the new coronavirus is continuing its march around the planet. It is now the dominant lineage in the United States, much of South America and Europe, and much of Asia.

The new variant is a nasty one. But some countries have Omicron do not have recorded any significant increase in morbidity or mortality. Cases are on the rise. Serious cases are not. Singapore and South Africa are great examples.

But other countries – the US – did not see an equally high degree of “separation” between infections and deaths. Now, epidemiologists are trying to figure out why. Differences in vaccination rates is an obvious explanation, but demographic factors also seem to play a role.

Irwin Redlener, founding director of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast: “Countries with middle-average ages and healthier populations are to be expected. would be better in terms of hospitalizations and deaths.

“Another big question,” he added, “is vaccination rates.” Younger and fast-growing countries seem to be leaving Omicron for the most part. But limited countries – especially those with older populations – could struggle for several months as the new variant works its way through.

Omicron raised alarm among health authorities around the world in late November after officials in South Africa reported the first cases. Compared to older lines, Omicron has about 50 major mutations, about 30 of which are on mutant proteins that help viruses enter our cells.

Some mutations are associated with the virus’ ability to evade antibodies and thus reduce the effectiveness of COVID Vaccine. Others are associated with higher transmittance.

The genetic makeup of lineage has fueled a massive spike in infections among unvaccinated individuals as well as an increase in milder breakout infections in vaccinated individuals. World Health Organization report a weekly record of 15 million new COVID cases in the first week of January – a number the WHO has warned is almost certainly a low figure due to incomplete data.

Many of these cases are mild or completely asymptomatic. Virologists partly attributed the relatively mild Omicron in many cases to the fact that it tends to infect the throat rather than the lungs, where pathogens can do more damage.

But external factors are also important. It goes without saying that countries that have vaccinated nearly all of their populations have better outcomes than countries with lower vaccination rates. Consider Singapore, one of the most affected countries in the world.

Singapore authorities detected the first case of Omicron locally in early December. A month later, this lineage accounts for most of the new Southeast Asian city-city cases, population 5, 7 million.

Cases of spike in Singapore after Omicron arrived. In mid-December, there were about 250 new infections per day. Now it’s 800 a day and growing – tripling in just one month. But the mortality rate is unchanged. On average, one person died of COVID a day in Singapore in December. In January, the exchange rate remained one death a day.

Paul Ananth Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infectious Diseases in Singapore, told The Daily Beast: “We are still early in the Omicron outbreak. “However, there is no reason to believe why Singapore would not be like most of the other countries in the world, with the number of cases and the number of deaths separated.”

Experts have pointed to Singapore’s excellent vaccine absorption capacity. About 90 percent The population was fully immunized, most receiving two doses of the first-line messenger RNA vaccine. Half have returned for the booster dose.

Yes, Omicron somewhat reduces the effectiveness of the vaccine. But even with the ability to evade vaccine-induced antibodies, this lineage still encounters an immune wall in Singapore.

South Africa also overcame Omicron – and did it without widespread vaccination. More than a quarter of South Africa’s population is fully vaccinated with one or two doses of the vaccine. Very little has been enhanced.

Even so, infections and deaths are still falling – although not as severely as in Singapore. From the end of November to the end of December, cases spiked by a factor of 40, from 500 cases per day to more than 20,000 cases. The death toll has only increased eightfold from about 20 people a day to 170 or so.

Many South Africans have natural immunity left over from a previous infection in the summer. But those antibodies wear off quickly, so they alone cannot explain South Africa’s relative luck with Omicron.

Age is probably a factor. South Africa, population 59 million, is a young country. The median age is just 27, compared with an average age of almost 40 in Singapore. Younger people tend to be less vulnerable to all COVID variants than their parents and grandparents — and Omicron is no exception.

But not many countries can count on their very young populations to save them from the worst outcomes as Omicron spins around the world. The United States, whose median age is 39, certainly cannot. The US is on the list of aging countries with poor average childhood immunization rates.

That puts Americans at particular risk. “The worrying thing is that once the contagion occurs between the older segments [of the population]Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast.

Only 63 percent of Americans are fully immunized, 37 percent enhanced. That leaves 122 million people with compromised natural immunity to COVID. It’s no surprise that Omicron is ripping through this large, mostly unprotected group.

The US has registered 760,000 new COVID cases a day in recent days, a fivefold increase from the worst days of the Delta wave in the fall and triple the previous record of 230,000 new cases a day a year. before.

There have been some splits in the United States, but nowhere as many as in Singapore and South Africa. About 1,700 Americans die each day — slightly less than the daily death toll at the peak of Delta waves in the fall.

America is not alone. brazilian, average age 34, has fully immunized about two-thirds of its 212 million people and increased by 15%, making the country roughly similar to the United States in those respects.

No wonder Omicron is hitting it hard. Cases spiked by a factor of 10 this month to a record 44,000 a day. The death rate is increasing rapidly — from a low of less than 50 people a day in early January to a whopping 600 in a single day on January 9.

Experts warn that the numbers coming from Brazil are most likely a low number. Under President Jair Bolsonaro’s denial of COVID, the Brazilian Ministry of Health no longer reliably reports COVID data. “The Ministry of Health doesn’t want people to know the truth,” Pedro Hallal, an epidemiologist at the Federal University of Pelotas in Brazil, told The Daily Beast.

Inconsistent data forces epidemiologists to round off official COVID figures with educated guesswork. Hallal for someone who has witnessed the impact of Omicron firsthand. Only a few of his family caught Delta. More than a dozen have captured Omicron. “It’s exploding,” he said of the new variant.

Since Omicron’s impact is uneven across the planet, experts agree it could be even worse. Imagine a lineage capable of dodging vaccines and Omicron’s extremely infectious and also attacking the lungs like Delta. “We could say we dodged a bullet,” Stephanie James, head of the COVID testing lab at the University of Regis in Colorado, told The Daily Beast.

The world is fortunate that, almost everywhere, there is a separation between Omicron cases and deaths. To a large extent, people can decide the width of that split. You can’t choose your country’s average age, but you maybe choose vaccinations.

The more people vaccinated, the larger the gap between the case rate and the death rate. Vaccinate almost everyone in your city, state, region, or country, and you’ll most likely weather the Omicron surge with very few serious consequences.