South Africa’s noticeable drop in new COVID-19 cases in recent days may signal that the country’s dramatic omicron-driven surge has passed its peak, medical experts say.
Because of the possibility that they may be affected by unreliability in testing and reporting delays, daily virus cases can become unpredictable. But they are offering one tantalizing hint—far from conclusive yet—that omicron infections may recede quickly after a ferocious spike.
South Africa is at the forefront the Omicron Wave and the rest of the world has begun to watch for signs to see how this may unfold. On Thursday there were nearly 27,000 newly diagnosed cases in South Africa. However, Tuesday saw a drop to around 15,424 cases. In Gauteng province—South Africa’s most populous with 16 million people, including the largest city, Johannesburg, and the capital, Pretoria—the decrease started earlier and has continued.
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“The drop in new cases nationally combined with the sustained drop in new cases seen here in Gauteng province, which for weeks has been the center of this wave, indicates that we are past the peak,” Marta Nunes, senior researcher at the Vaccines and Infectious Diseases Analytics department of the University of Witwatersrand, told The Associated Press. “It was a short wave … and the good news is that it was not very severe in terms of hospitalizations and deaths,” she said. It is “not unexpected in epidemiology that a very steep increase, like what we saw in November, is followed by a steep decrease.”
Gauteng’s population saw a sharp rise in the middle of November. The new variant, which was highly mutational in omicron, was identified by genetic sequencing. It was released to the public on Nov. 25, 2015. Omicron was significantly more easily transmissible and quickly seized the lead in South Africa. Tests have shown that omicron has been responsible for 90% of COVID-19 related cases in Gauteng Province since November.
The world is following suit, as omicron has already surpassed the delta variant in certain countries. In the U.S., omicron accounted for 73% of new infections last week, health officials said—and the variant is responsible for an estimated 90% or more of new infections in the New York area, the Southeast, the industrial Midwest and the Pacific Northwest. The number of confirmed coronavirus infections in the U.K. has increased by 60% over the past week, as omicron took the lead from delta. The World Health Organization reports that the variant was detected in at most 89 countries worldwide.
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In South Africa, experts worried that the sheer volume of new infections would overwhelm the country’s hospitals, even though omicron appears to cause milder disease, with significantly less hospitalizations, patients needing oxygen and deaths. Gauteng’s cases began to decline. After reaching 16,000 new infections on Dec. 12, the province’s numbers have steadily dropped, to just over 3,300 cases Tuesday.
“It’s significant. It’s very significant,” Dr. Fareed Abdullah said of the decrease. “The rapid rise of new cases has been followed by a rapid fall and it appears we’re seeing the beginning of the decline of this wave,” said Abdullah, working in the COVID-19 ward at Pretoria’s Steve Biko Academic Hospital.
In another sign that South Africa’s omicron surge may be receding, a study of health care professionals who tested positive for COVID-19 at Chris Hani Baragwanath hospital in Soweto shows a rapid increase and then a quick decline in cases. “Two weeks ago we were seeing more than 20 new cases per day and now it is about five or six cases per day,” Nunes said. She said it’s still early so there are many factors to be watched.
South Africa’s positivity rate has remained high at 29%, up from just 2% in early November, indicating the virus is still circulating among the population at relatively high levels, she said. And the country’s holiday season is now underway, when many businesses close down for a month and people travel to visit family, often in rural areas. This could accelerate omicron’s spread across South Africa and to neighboring countries, experts said.
“In terms of the massive everyday doubling that we were seeing just over a week ago with huge numbers, that seems to have settled,” said Professor Veronica Uekermann, head of the COVID-19 response team at Steve Biko Academic Hospital. “But it is way too early to suggest that we have passed the peak. There are too many external factors, including the movement during the holiday season and the general behavior during this period,” she said, noting that infections spiked last year after the holiday break.
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It’s summertime in South Africa and many gatherings are outdoors, which may make a difference between the omicron-driven wave here and the surges in Europe and North America, where people tend to gather indoors. The unknown is whether omicron has been transmitted to South Africans and not caused disease.
New York health officials have suggested that the variant could behave in the same way in South Africa and the U.S. because it appears South Africa has experienced an omicron wave. However, Nunes warns that these conclusions should not be jumped to. “Each setting, each country is different. Different populations exist. The demographics of the population, the immunity is different in different countries,” she said. South Africa’s population, with an average age of 27, is more youthful than many Western countries, for instance.
Uekermann stressed that most of those being treated in hospitals for COVID-19 are not currently vaccinated. Around 40% of South African adults have received two doses. “All my patients in ICU are unvaccinated,” Uekermann said. “So our vaccinated people are doing better in this wave, for sure. We have got some patients who are very ill with severe COVID, and these are unvaccinated patients.”
Mogomotsi Magome, an AP journalist from Johannesburg, contributed.
