Including nonCOVID admissions who test positive for SARS-CoV-2 would make severity among hospitalized look lower as suggested by this account from SA https://www.samrc.ac.za/news/tshwane-district-omicron-variant-patient-profile-early-features … .
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Bottom line we are far from having evidence that severity is low enough to make this not a worry at the societal level, especially with already-stretched hospitals. Evidence that vaccines, especially when boosted, offer protection against severe disease is more consistent.
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Marc Lipsitch Retweeted
Already learning from the responses, thank you. Two sets of data suggesting modest contribution of "incidental" SARS-CoV-2 diagnoses among hospitalizations, one in Tshwane, Gauteng, SA https://twitter.com/enjoyingthewind/status/1472329401585045518?s=20 …
Marc Lipsitch added,
This Tweet is unavailable.2 replies 15 retweets 89 likesShow this thread -
Marc Lipsitch Retweeted Criostal Ó Conghaile
And one in London, UKhttps://twitter.com/cripipper21/status/1472328298025869314?s=20 …
Marc Lipsitch added,
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Marc Lipsitch Retweeted Prof. Christina Pagel
which shares this https://twitter.com/chrischirp/status/1471900266811244547?s=20 …. A constant proportion of hospital admissions over time that are incidental SARS-2 findings vs. admitted for COVID is indeed consistent with similar severity per infection to the past variants, as
@chrischirp notes.Marc Lipsitch added,
Prof. Christina PagelVerified account @chrischirpHosp admissions by primary diagnosis show increase in *both* admissions for Covid and more incidental admissions (e.g. trauma or caught covid while in hospital for something else). This is consistent with no evidence that Omicron milder. Critical care already v busy. 13/18 pic.twitter.com/3lhVwG9Y4UShow this thread13 replies 22 retweets 117 likesShow this thread -
This presentation from yesterday is illuminating https://www.youtube.com/watch?app=desktop&v=e4Y2sXkt-cw … ht to a responder whom I can't find any more, twitter fail...
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Several lines of evidence here suggesting a lower hospitalization proportion than in previous waves, limited to first 25 days. Caveats 1) this is growing faster, so higher proportion of recent cases makes bias (missing not-yet-hospitalized) worse even when compare first 25 days
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2) the proportion vaccinated is going up, as is the proportion previously infected, so a more immune population. So hard to compare but declining in-hospital severity measures here as in Discovery Health are hopeful signs.
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Replying to @mlipsitch
I think given its age structure and high seropositivity from prior outbreak+infection, South Africa could only give us the signal to *really* worry, but not to relax. Asymmetrical in its ability to inform us. Denmark and UK, similar age pyramid but healthier and more vaccinated.+
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Replying to @zeynep @mlipsitch
I think we have little idea what Omicron might mean for the yet-to-be vaccinated population of Vietnam or Hong Kong, or many countries in Africa without prior outbreaks. Also not clear on breakthrough outcomes for unboosted elderly, imo—too little time yet. Seems wise to act.
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(Also: 65+ in SA is not only smaller proportion of the population, likely healthier compared to same-age peers here—survival bias, frankly. Don’t think we have strong signal about that age group yet, plus they need antibodies more than younger people away from immunosenescence.)
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Replying to @zeynep @mlipsitch
All this was easier to figure out, when world was more uniform, everyone immunonaive. Now with such varying levels of prior infection and/or vaccination, not easy to disentangle all this from looking elsewhere, especially at the speed with which it is spreading…
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Replying to @zeynep @mlipsitch
Anyway, I think that’s frustrating for everyone but we don’t know what we can’t know, and it is what it is.
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