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John Burn-Murdoch Profile picture
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11 Jan, 5 tweets, 2 min read
The Netherlands is one of the most interesting places for tracking the divergence of cases from more acute outcomes as Omicron takes over

Timing of its winter Delta wave meant numbers rose *and fell* before Omicron took off, so any rise now can reasonably be attributed to Omi
This is in contrast to places like the US where Omicron is piggy-backing on top of a fierce winter Delta wave, making it tricky to know whether it’s Omicron or Delta that’s sending hospitalisations ever higher
(Updated chart for all US states here)
New South Wales (Australia) similar to Netherlands:
• All metrics rose then fell in earlier Delta wave
• All have since risen with Omicron (i.e yes Omi can still cause severe disease among those with little or no immunity)
• But acute outcomes completely diverged from cases
To be clear, I wouldn’t be surprised if hospitalisations and deaths do rise again in the Netherlands in the next month, but it’s clear their rise won’t track the trajectory of cases like it did with Delta.

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More from @jburnmurdoch

John Burn-Murdoch Profile picture
6 Jan
NEW chart for US Covid-watchers:

Key question with Omicron wave is whether severe disease — hospitalisations & ICU — decouples from cases.

In the UK it has, but there are signs the US decoupling is weaker, perhaps due in part to lower vax rates.

Track it here for every state:
Here’s a quick recap of how to read these charts:

Black dotted line is peak level for each metric before Omicron arrived.

Crossing that line means a new record has been set in recent days.

I’ve put a little coloured circle below the name of each state to indicate new records.
For example, almost all states in the north-east have set new records for cases in recent days.

New Jersey, Maryland and DC have also seen hospitalisations hit an all-time high, and the latter two are now also at record Covid ICU occupancy.
Read 8 tweets
John Burn-Murdoch Profile picture
4 Jan
NEW: first thread of 2022 is an Omicron situation update, starting with a detailed look at UK hospitals, before going international.

Let’s start with severity, and the most important chart:

Despite steep rises in cases and patients, the number on ventilators has barely risen.
I’ve adjusted for lag between positive test and severe disease, so the divergence between patients and ventilated is a marked difference between this and previous waves when they were in lockstep.

The link between cases and severe disease has significantly weakened with Omicron.
We also continue to track "excess ICU pressure" — total number of people in ICU, for any reason, Covid or otherwise, compared to past winters:

Latest data show that the number of people in London ICUs has fallen in recent weeks, and is not following the same path as last winter.
Read 41 tweets
John Burn-Murdoch Profile picture
23 Dec 21
NEW: situation update from Gauteng, where cases, test-positivity and admissions are all now falling (no, this is not driven by testing capacity/behaviour or by migration).

Deaths and excess deaths still rising, but based on timing of peak will not come close to Delta levels.
Another way of looking at same data:

Cases climbed to 90% of their Delta peak, but admissions peaked at 50% and deaths will peak below 50%, demonstrating how immunity — both acquired since Delta, and differentially present among Omicron cases — reduces rates of severe disease.
As ever, a big thanks to the brilliant people at @nicd_sa who make this data available, and to the likes of @lrossouw and @tomtom_m who have consistently been providing invaluable data and commentary from South Africa.
Read 4 tweets
John Burn-Murdoch Profile picture
23 Dec 21
NEW: weekly breakdown of hospital patients being treated *for* Covid vs those *with* Covid as an incidental finding is out.

Here’s London:

Though incidentals are still rising at unprecedented rates, there is also a clear and steep rise in patients being treated for severe Covid
Comparing the current rise to the Delta wave side-by-side, we can see that although there are far more "with, not for Covid" incidentals this time around, the number of patients being treated for Covid is rising faster than it did in the summer
But the summer Delta wave never came close to overwhelming the NHS, so key question is how this stacks up vs last winter

Numbers still well below last Christmas, and recent uptick is clearest on a log scale. Long way to go to approach Alpha wave, but direction of travel is clear
Read 9 tweets
John Burn-Murdoch Profile picture
22 Dec 21
Thread summarising all of today’s Omicron severity data:

Story from me, @mroliverbarnes and @rmilneNordic, running through new data from South Africa, Denmark, England & Scotland ft.com/content/19065f…

Top-line: share of Omicron cases requiring hospital is lower than for Delta
Critical first caveat: this is *not* comparing Omicron now to Delta waves months ago.

This is comparing Omi vs Delta in the same populations, at the same time.

So we’re not just saying "Omicron appears less severe because loads of people got vaxxed/infected in recent months".
So, what do the studies show?

In all four countries, the share of Omicron cases that require hospitalisation is lower than the share of Delta cases, after adjusting for age, sex, underlying health conditions etc (but not adjusting for vax/infection: more on this in a sec)
Read 20 tweets
John Burn-Murdoch Profile picture
21 Dec 21
Some quick thoughts about the important new paper out of South Africa looking at Omicron severity medrxiv.org/content/10.110…
1) Study finds that controlling for time period, Omicron cases markedly less likely to be hospitalised
To me this is two things:
• "The @nataliexdean point": Omi’s immune evasion means lots of mild cases in people w/ good protection against severe disease
• And there may also be some innate reduction in severity at work here (but we don’t know yet)
Read 9 tweets

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