South African Doctors Say Patients With Omicron Variant Have ‘Very Mild' Symptoms

Dr. Unben Pillay, a general practitioner in Gauteng province where 81% of the new cases have been reported, said most patients are treated at home and the vaccinated have faired better

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South Africa's rapid increase in COVID-19 cases attributed to the new omicron variant is resulting in mostly mild symptoms, doctors say.

“We've seen a sharp increase in cases for the past 10 days. So far they have mostly been very mild cases, with patients having flu-like symptoms: dry coughs, fever, night sweats, a lot of body pains," said Dr. Unben Pillay, a general practitioner in Gauteng province where 81% of the new cases have been reported.

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“Most of these patients have been treated at home,” Pillay told an online press briefing Monday. “Vaccinated people tend to do much better. We have not seen a vast increase in hospitalizations, but this is still early days. Hospitalizations often come several days after a rise in confirmed cases.”

Dr. Angelique Coetzee, the South African doctor who first raised the alarm over the new strain, told the BBC on Sunday that patients she has seen so far with the omicron variant had also experienced what she described as "extremely mild" symptoms.

"What we are seeing clinically in South Africa — and remember I'm at the epicenter of this where I'm practicing — is extremely mild, for us [these are] mild cases," she said. "We haven't admitted anyone, I've spoken to other colleagues of mine and they give the same picture."

Coetzee said she started to see patients around Nov.18 presenting with "unusual symptoms" that differed slightly from those associated with the delta variant. One male patient, who's around 33-years-old, reported feeling extremely tired with body aches and a "scratchy throat" instead of a sore one, but no cough or loss of taste or smell — symptoms that have been associated with previous strains of the coronavirus. The man and his family tested positive, and Coetzee said she saw began to see more patients that presented with the same kinds of symptoms.

That's when Coetzee raised the alarm with South Africa's vaccine advisory committee, of which she is a member.

Most of the new cases in South Africa have been among people in their 20s and 30s, and doctors note that age group generally has milder symptoms of COVID-19 in any case. They warn that older people infected by the new variant could have more severe symptoms.

Learning more about the omicron variant is important as nations around the world sought Monday to keep the new variant at bay with travel bans and further restrictions, even as it remains unclear what the variant means for the COVID-19 pandemic.

Japan announced it would suspend entry for all foreign visitors, while new cases of the variant identified days ago by researchers in southern Africa appeared as far away as Hong Kong, Australia and Portugal. Portuguese authorities were investigating whether some infections there could be among the first reported cases of local transmission of the variant outside of southern Africa.

South Africa has seen its seven-day average of new cases over the past two weeks surge from about 200 per day to more than 2,000.

Omicron appears to be more transmissible than previous variants and the surge in South Africa could bring the daily number of new cases to 10,000 by the end of the week, infectious diseases specialist Salim Abdool Karim, told the briefing.

“Our biggest challenge will be to stop super-spreading events, particularly indoors,” he said, suggesting that it might be necessary to restrict indoor gatherings to those who are vaccinated.

A new variant, named B.1.1.529, was named a “variant of concern” by the World Health Organization and given the name “omicron” from the letter in the Greek alphabet.

The hotspot for the new surge is Gauteng's Tshwane metropolitan area, incorporating the capital, Pretoria. The “vast majority” of those hospitalized there have been unvaccinated people, said Waasila Jassat of the National Institute for Communicable Diseases.

“Of recent hospitalizations 87% have been unvaccinated, 13% have been vaccinated,” Jassat said of the 455 hospital admissions in the Tshwane area in the past two weeks.

Vaccination appears to have also helped people avoid infection, she said.

Of South Africa's 60 million people, 16.5 million are vaccinated and the number of fully vaccinated who are testing positive is very small, said Nicholas Crisp, the acting director general of the department of health. "It is a very small number of those people who tested positive. It’s minute in comparison to unvaccinated people.”

To combat the surge of COVID-19 cases attributed to the omicron variant, South Africa is urging vaccinations and is weighing making vaccines mandatory to enter indoor areas, the minister of health said Monday.

The government is not planning to impose centralized vaccine mandates, but will support businesses and organizations that seek proof of vaccination to enter indoor areas, Minister of Health Joe Phaahla told reporters.

The government is considering requiring vaccines for health workers, including those who work at state hospitals, he said.

“We are looking at concrete proposals on how to deal with vaccine mandates in workplaces and health care workplaces,” Phaahla said.

A few African countries, including Angola, Egypt, Mauritius and Rwanda, have joined the slew of nations that have placed travel restrictions on South Africa and other countries in southern Africa.

“It’s quite regrettable, very unfortunate and I’ll even say sad to be talking about travel restrictions imposed by a fellow African country,” said Clayson Monyela, spokesman for the Department of International Affairs and Cooperation. He called the decisions “unwarranted and unjustified because it’s not based on science,”

The Associated Press/NBC
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