A report on hospital admissions in South Africa's worst-affected Omicron (B.1.1.529) COVID-19 variant district—Tshwane near Pretoria—sheds light on clinical patterns, offering some optimism, but with the caveat that the information portrays only the first 2 weeks of the surge.

Meanwhile, some scientists who are assessing transmission data say case counts could dwarf the Delta (B1617.2) variant, which even in the face of milder disease would still overburden healthcare systems. The worries about the more transmissible variant come amid reports of super spreader events in Norway and Denmark.

Early snapshot at hot spot hospital

In a Dec 4 report from the South Africa Medical Research Council, scientists detailed clinical findings and data from a hospital complex in Tshwane. where the country's Omicron outbreak began. It covers Nov 14 through Nov 29. Since then, South Africa has reported an exponential increase in cases.

For 76% of patients, COVID-19 was an incidental finding, meaning many were admitted for other conditions but were tested because of hospital policy. Admitted patients were younger than in previous waves, with nearly 80% below 50 years. The report authors noted that 57% of people over age 60 have been vaccinated in Gauteng province. Children under age 10 made up 19% of the Omicron cases.

Only 2 patients were admitted to the intensive care unit (ICU), compared with 63 in "high care" and slightly more than 100 in general wards. The ICU rate is lower than in earlier waves. Only 21% were treated with oxygen, also lower than in earlier surges.

Ten patients died, five of them people ages 60 and older. One child died, but the cause of death wasn't related to COVID-19. At 6.6%, the death rate was lower than the 23% seen for hospitalized South Africans in earlier waves.

Of 38 patients in COVID-19 wards, 24 were unvaccinated, 6 were vaccinated, and 8 had an unknown status. And, of 9 patients with COVID-19–related pneumonia, 8 (including 1 child) were unvaccinated.

In urging caution about interpreting the early data, the authors wrote, "The clinical profile of admitted patients could change significantly over the next two weeks, by which time we can draw conclusions about the severity of disease with greater precision."

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