So let's see where things are at with Omicron post-Christmas....
The information regarding Omicron is still evolving and we are in the early stages. So far Omicron appears to be more infectious than Delta and other variants. Some estimates show that Omicron is now the second most infectious virus on the face of the earth after measles.
The information from two studies in the U.K. show that Omicron produces 40% to 70% fewer severe cases than Delta (based on the U.K. population which is approx. 82% vaccinated). However one of the studies noted an increase in severity for Omicron among the unvaccinated when compared to Delta.
The information from South Africa indicates that over 90% of those who were hospitalized with Omicron are unvaccinated (unchanged from Delta) They also noted an increase in the number of children hospitalized with Omicron when compared to Delta. The information from South Africa noted that only 6% of those hospitalized with Omicron were in ICU compared to over 18% with Delta. About 25% of the population of South Africa is fully vaccinated.
There are estimates in the U.K. that 80% of those hospitalized with Omicron will be unvaccinated compared to numbers close to 90% with Delta. This is reflective of increasing vaccination rates in the U.K. as well as the likelyhood that Omicron is more vaccine evasive. The concept of base rate fallacy must be kept in mind when attempting to do comparisons.
There are lab experiments involving neutralizing antibodies and vaccines which shows that Omicron appears to be more vaccine evasive. The expectation is that there will be more breakthrough cases with Omicron (which appears to be occurring). With Delta the breakthrough case rate was below 0.5% generally. With Omicron this may increase significantly. Note that most vaccines (measles, mumps, etc.) have over a 3% breakthrough infection rate in a population with high prevalence of the disease.
The ability of Omicron to breakthrough is not limited to vaccines -- there are studies showing that previous Covid infection in the unvaccinated provides nearly no protection against Omicron.
So in summary - at this point Omicron appears to be more vaccine evasive, previous infection provides little protection, more infectious, and less severe. The next few weeks will provide better insights on the realities.
So we have rolled over into the New Year, 2022. Let's see where things are at with Omicron.
Multiple recent studies indicate that vaccines are less effective with Omicron. The MRNA vaccines (with two doses) wane over time quicker against Omicron in stopping infections, however a booster greatly helps the situation. Likewise other non-mRNA vaccines have a significant drop in efficacy against Omicron -- to the point where some may not be useful. The vaccinated breakthrough rate should climb significantly with Omicron but we need to wait for large-scale December data on this to understand the percentage (both for boosted and un-boosted).
These same studies also show that having a recent non-Omicron case of Covid nearly provides no protection against Omicron. Underlining that vaccines -- even with reduced efficacy are the best alternative for prevention.
On the monoclonal antibody treatment front only one of the three available treatments; Sotrovimab is effective against Omicron. Eli Lilly and Regeneron are not effective against Omicron. Unfortunately Sotrovimab is in short supply. In the U.S. the federal government is hoping to increase the Sotrovimab supply by mid-January.
In terms of severity; data from the U.K. and South Africa is showing that Omicron is 70% less severe than Delta. Note that this figure is for the fully vaccinated. For the unvaccinated it appears that Omicron is less severe -- but not 70% less severe. "Less severe" is typically measured by hospitalization rates. From a medical front it appears that Omicron is less apt to attack the lungs and remains in the upper respiratory system leading to the a drop in severe cases.
The death rate from Omicron appears to be lower -- aligned with the drop in severity. However good figures are not available on Omicron death rate yet -- since deaths lag hospitalizations.
Omicron is much more infectious than previous variants according to multiple studies. We are seeing this reflected in the spike in cases across the U.S. and world. If the world-wide pattern follows South Africa then we expect the Omicron surge to peak rapidly then decline quickly. Models for the U.S. believe the Omicron peak in places with current high case rates will peak in the last two weeks of January -- time will tell if this model prediction is correct. And, of course, currently less impacted areas in the U.S. will experience the Omicron surge later.
Of course, the recent holiday season has probably served to accelerate the spread of Omicron to new communities and households. This is coupled with the return to school which will further spread Omicron acquired over holidays among children and back into households & communities.