The steepness of Omicron’s rise and fall in South Africa really is something to behold.

Here’s Gauteng first, where it all began.

Cases, test positivity, admissions, deaths and excess deaths too all down almost as steeply as they rose, and in much less time than past waves.
We’ve all got used to comparing the height of "new daily x" charts over the last couple of years, but at the end of the day it’s not just wave height but also wave duration that determines the ultimate toll on public health, so it’s worth looking at each wave cumulatively...
And here we are:

*Daily* cases peaked close to Delta, but shorter wave means total cases much lower

With more acute outcomes it’s striking:
• Less than 40% as many hospitalisations
• 10% as many deaths, and excess deaths lower still

These numbers will rise, but not by much
Here are the same charts for the country as a whole.

Remarkably symmetrical meteoric rise and fall in cases and test positivity, with admissions, deaths and excess deaths also now all falling.
The cumulative numbers for Omicron will all keep climbing for some time yet, especially deaths, but it’s already very clear that the Omicron wave will end up being South Africa’s least lethal, possibly by a large margin.
It’s also clear that infections have passed the peak in all English regions, not just based on case numbers but also the ONS’s gold-standard random sample infection survey
Scotland, Wales and Northern Ireland too show declines in both source datasets, though the two series don’t track one-another quite as neatly outside of England.
And that’s backed up in the data from hospitals, where admissions are now falling in every UK nation and region
But... while early UK data mirrors South Africa, it may not necessarily stay that way.

Today’s English data show the rate of decline in cases has slowed, virtually to a standstill:
• Cases rising in children
• No longer falling in 35-59s (their parents’ cohort)
That pattern is what we expected, as schools drive transmission among children, and that spreads to their parents.

Question is whether this is a temporary blip in a downward trajectory, or whether it sends us back to a bona-fide second peak.

Our story: ft.com/content/8d6bdc…
One more note from England:

I’ve seen suggestions the recent rise in Covid deaths may be due to ‘incidentals’ where someone tested positive but died for other reasons.

Nope: reported Covid deaths in London still track the ONS cause-of-death series. Good news is, rise is slowing
(that last one possibly of interest to fellow nerds @PaulMainwood @JamesWard73 and of course the actuaries @ActuaryByDay @john_actuary)

ONS series is adjusted upwards in accordance with historical upward revisions for the same week last year.

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More from @jburnmurdoch

Jan 17
Lots of people asking if UK cases are really falling, or have we just exceeded testing capacity or seeing effect of the pause in requiring confirmatory PCRs

By comparing ONS infection survey to dashboard cases, we see the trends match. The fall in cases in recent days is real ✅
There is of course some variation, e.g prevalence in Yorkshire still climbing when reported cases began falling, but even there we clearly see a slowdown in ONS series, and looking across all regions it’s clear that those minor discrepancies are the exceptions that prove the rule
On top of that, new cases in hospitals — where testing capacity is certainly not limited — are flat or falling in all UK nations & regions, with that peak coming a week or so after cases turned, exactly as expected. Absolutely zero reason not to trust that infection peak is real.
Read 5 tweets
Jan 11
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)
Read 5 tweets
Jan 6
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
Jan 4
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
Dec 23, 2021
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
Dec 23, 2021
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

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