Omicron’s hospitalization rates are lower than previous COVID variants—at least in the hotspot that is South Africa

While COVID-19 hospital admissions across South Africa have risen 70% over the past week, the percentage of infected people being hospitalized is a far cry from the first, second, or even third wave, according to the country’s health minister, Joe Phaahla.

The number of cases from the Omicron variant in South Africa exceeds those from any previous mutation of the virus, but only 1.7% of COVID-19 cases have been hospitalized during this wave, the country’s fourth—with an average of 350 new hospital admissions each day this past week. The third wave, which was dominated by the Delta variant, saw 800 people hospitalized daily, an average of 19% of those infected.

“In terms of absolute numbers we are still at a fairly low level,” Phaahla said Friday.

According to Phaahla, just over 7,600 patients have been admitted since the start of Omicron, which is around 40% of the peak in the second and third waves. Excess deaths, the number of deaths above historical average, are below 2,000 a week—an eighth of their previous peak—and 91% of those infected in the fourth wave have already recovered, Phaahla said.

The apparently mild infections from Omicron in South Africa contrast with its highly contagious nature, however. Although data has indicated that South Africa may be reaching its infection peak, Phaahla said that the variant is quickly spreading outside the province of Gauteng, which had been South Africa’s Omicron hub. While Gauteng accounted for 70% to 80% of all new infections in South Africa seven to 10 days ago, today the region accounts for only 25%. “All provinces have seen a rise,” Phaahla said.

U.K. hopes for the same hairpin turn

South Africa’s good news may not translate to the same story in the U.K., which just overtook South Africa as the world’s Omicron hotspot and is seeing new infection records on a daily basis. More than 88,000 people tested positive for COVID-19 in the U.K. yesterday.

Chris Whitty, England’s chief medical officer, warned that the rising wave of Omicron infections could lead to daily hospitalizations exceeding last winter’s peak, when on one single day more than 4,500 people were admitted.

The number of infections is expected to rise “incredibly fast, even if people are taking more cautious actions,” Witty said at a House of Commons health and social care select committee on Thursday.

“It is possible, because this is going to be very concentrated over a short period of time, even if it’s milder, you could end up with a higher number than that going into hospital on a single day,” Witty said. Complicating matters, the Omicron variant is spreading in the U.K. at a moment when hospital bed occupancy levels are above 93%, according to analysis done by the Financial Times.

The U.K. and South Africa could also see different trajectories because of the high number of previous COVID infections in South Africa. One recent study in Gauteng found that 72% of the population had been previously infected with COVID-19. These infections offer some natural immunity and may mask the severity of the Omicron variant outbreak, South African scientists said.

The U.K. is making a concerted effect to clamp down on Omicron, but it has not gone entirely as planned. The U.K. government’s plans to push booster shots and daily testing to curb Omicron have both been sabotaged, by hour-long queues for boosters and a nationwide shortage of rapid antigen COVID-19 tests.

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