South African scientists believe Omicron causes more reinfections even though vaccines prevent the most severe cases

The omicron variant of COVID appears to be reinfecting people at three times the rate of previous strains. That’s what South African experts have said, as public health authorities and scientists around the world closely monitor the variant’s evolution in the country where it was first identified.

“There is no panic in South Africa because the local scientific community was expecting a new variant.”

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The European Union’s public health agency has warned that in the coming months the omicron variant could be present in more than half of the new cases of COVID in Europe. But on the other hand, evidence is already emerging that vaccines continue to protect against the progression of the disease from becoming severe.

The latest epidemiological evidence collected in South Africa by the country’s National Institute of Communicable Diseases (NICD) suggests that omicron can evade the immunity provided by having been infected with another variant before and that the rate of reinfection with omicron is three times higher than previously reported.

The South African Centre for Epidemiological Modelling and Analysis, together with the NICD, said the latest findings “provide epidemiological evidence of the ability of omicron to evade the immunity provided by previous infection”. “We believe that a previous infection does not protect against the omicron variant,” said Anne von Gottberg, NICD expert.

As of mid-November, South Africa was reporting about 300 cases of COVID-19 per day. On Wednesday, it reported 8,561 new cases, after reporting 4,373 on Tuesday and 2,273 on Monday.

Describing the early investigations into the newly emerged variant, von Gottberg said that doctors were seeing “an increase in omicron reinfections”. “We believe the number of cases will increase exponentially in all provinces of the country,” he said. “But we believe the vaccines will continue to protect against severe disease progression; the vaccines have not stopped protecting against severe disease, hospitalization and death.”

According to other scientists at the same agency, early evidence suggests that the disease caused by omicron may be less severe than that caused by earlier variants, although this may be biased by the fact that early cases of omicron include many young individuals and travellers tested in the early stages.

Rush to vaccinate

The emergence of the Omicron variant has led to a sharp rise in the number of people asking to be vaccinated. After South African President Cyril Ramaphosa warned on Sunday that tighter restrictions could be imposed if immunisation rates did not improve, South Africans have been rushing to get immunised.

According to Aslam Dasoo of the Progressive Health Forum, the recent increase in vaccination rates may not be enough. “The test positivity rate was 1% last Monday and now it’s in double digits; we’re on the crest of wave four; everyone you know is a potential risk to you,” he said.

According to doctors in Gauteng province, COVID-19 patients are presenting with flu-like symptoms, including a dry cough that can be treated at home. Epidemiologist Salim Abdool Karim said on Tuesday that current vaccines continue to provide high levels of protection against hospitalisation and death.

In addition to an exponential jump in the number of cases, South Africa has experienced a sharp increase in the positivity rate (the number of people testing positive for COVID-19) over this period, rising from 10.7% to 16.5%, and reaching 19% in Gauteng province. Even more worrying has been the increase in Gauteng’s hospitalization rate, which shot up 144% in the past week, almost doubling every six days.

South Africa has recordedo nearly 3 million COVID-19 infections during the pandemic and more than 89,000 deaths, the highest number in the entire African continent.


So far, most of the attention on the omicron variant has focused on Gauteng province, but there are signs that it is already taking hold elsewhere in South Africa. This Thursday morning in Cape Town, the head of the Western Cape Department of Health, Dr Keith Cloete, announced that a new wave of COVID had arrived in the country’s southernmost province.

“The weekly percentage change in the moving average of new cases per seven days has been above 20% for more than a week, indicating that we have now officially entered a phase of resurgence,” he said. “For the next few weeks, a very large increase in absolute numbers is expected,” he added.

Only 16 cases of omicron have been directly identified in the province, but the indicator of PCR testing leads Cloete to claim that the omicron variant could be the predominant one and present in up to 80 per cent of cases in the last week.

Much has been written about vaccine shortages in developing countries but in South Africa that has not been the main problem. Vaccine supply has been outstripping demand for several months to the point that, in late November, the South African government asked pharmaceutical companies Pfizer and Johnson & Johnson to delay shipments of doses because of overstocking.

The latest figures show that 36.3% of adults are fully vaccinated (although in the over-60s, the percentage of people with at least one dose rises to 64%). But vaccination is lower among younger people: only 26% of South Africans aged 18-34 years, the group with the highest rate of omicron infection, have received at least one dose of the vaccine.

Translation by Francisco de Zárate

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