welcome to another MedCram covet 19 update today we're going to talk about some of the
preliminary data about the omicron variant of sarsko v2 in this chart detailing the daily new
cases in south africa you can see here a very precipitous but small increase in the number
of daily cases are we catching everything let's take a look at some preliminary data
and for this we turn to the daily maverick which is a leading south african newspaper
which published the results of wastewater surveillance data from south africa and
specifically the hao tang province the hao tang province is one of the most populated and is the
home of one of the capital cities of pretoria and also one of the largest cities of johannesburg
so the way that this is done is they look at a specific city population and they look and test
the water of the wastewater that is coming out of the city and they sample a specific amount every
time and they treat it the same each time and why that is important is because as people in the city
become infected with sars cov2 the viral particles will be shed into the sewer water so what's
happening here is as more and more people in the city become infected with sars cov2 you'll see
these viral particles start to increase in their respective patients and of course this nucleic
acid in the middle of this viral particle is the rna which of course is very specific for sars cov2
well of course as people become infected and these viral particles are dumped into the waste
water they break down and what we can find in the waste water are those nucleic acids or the rna
the point being as there are more and more people that are infected with sars cov2
we'll see a linear increase in the amount of nucleic acids what we then do is we do something
called pcr which amplifies in a very specific and standard way these nucleic acids and so we
can actually graph that out and so what happens is when we see an increase in the nucleic acids
or the rna in the waste water that corresponds with an increase of infections in human beings
that are in that city so this is a nice way of detecting increases in infections that you may
not be able to detect because you're not able to test everybody and you're still able to get that
information even though you're not testing every single person in the city and that could be very
valuable to pick up very early on cases of sars cov2 and specifically in increases in surges in
sars kovi 2 in specific cities where you can have access to waste water so here are results
from the hau tang province in south chuane city you can see here that there are changes
in the sars kovi 2 viral load the data points and colored lines these are these things here
in in-flowing untreated waste water from plants in the city of schwannet compared with these
bar graphs which are laboratory confirmed cases of residents in the city of chwane which are the gray
bars by epidemiological week here in 2021 and you can see that these bars which are confirmed covet
cases are associated and seem to correlate well with the waste water data these brown data points
represent the waste water data in das port which is a locale in pretoria and you can see here as
we go on things were going down until just a few weeks ago about four or five weeks ago when there
was a sudden takeoff in terms of the amount of positivity in the untreated wastewater but
we're not seeing a huge increase in the number of actual confirmed cases not as yet at least
and one may ask why would the data points of the wastewater nucleic acids be going up
when the official cases are not going up several explanations for this at least two of which could
be that this is happening in a population that doesn't have good access to testing it could also
be that this could be related to very asymptomatic disease where the patients or the subjects don't
know that they're infected and could be shedding viral particles in the wastewater and therefore be
picking those up as nucleic acids whereas because they're not symptomatic they're not getting tested
i think at this point it's just mere speculation and we'll need more data to figure that out
exactly we're also seeing this here in schwanne north you can see here as well in some parts of
the precinct here the number of cases seemingly going up again this is derived from waste water
we're seeing the amplification of these rna fragments or rna remnants going up where we're
only seeing a slight increase in the number of cases so an important question at this point is
can we tell exactly what type of sars cov2 variant is in the wastewater and the answer to that is no
we can only tell if it is sarsko v2 we can't tell which variant it is so of course this increase in
the wastewater sars cova-2 nucleic acid could all be delta or could be any other variant we can't
tell that this is an increase in just omicron and so here on the world health organization's website
they do talk about the transmissibility and they do acknowledge that the number of people
testing positive has risen in areas of south africa affected by the omicron variant however
more epidemiological studies are underway to understand if it is because of omicron or
because of other variants so it's possible that those uptick in cases could be from something
else or it could be that the omicron variant has found a pocket of susceptible people that
have either not been vaccinated or have not had previously been infected the concern of course
is that omicron may be infecting people that have been infected before with sars kobe do but because
omicron is so different than previous infections the immunity post-infectious that was built up by
these subjects is not adequate enough to protect them against this new variant that we still don't
have hard evidence for as yet but they are working on that there has also been some reports that
hospitalizations are up that is true it's unclear as to whether or not those hospitalizations are
increased simply because of the omicron variant or whether or not it is affecting the young
predominantly or the very old there have been reports of that as well however the who website
says it's not clear as yet whether infection with the omicron variant causes more severe disease
compared to other infections or other variants including delta preliminary data suggests that
there are increasing rates of hospitalization in south africa but this may be due to increasing
overall numbers of people becoming infected rather than a specific infection with omicron despite
the fact that there have been some reports of physicians saying that the symptoms from
omicron are more mild and asymptomatic they say here that there is currently no information to
suggest that symptoms associated with omicron are different from those from other variants
they go on to say that initial reported infections were among university students
younger individuals who tend to have more mild disease but understanding the level of severity
of the omicron variant will take days to several weeks dr michael minna former harvard professor
in the school of public health who we've had on a number of times here on medcram to talk about
antigen testing said this on his twitter feed rapid antigen tests detect omicron the bulk of
mutations in omicron i.e on the spike are not near the sites that most rapid antigen tests
pick up and we will put a link in the description below to the same paper that dr michael minna also
links to in his tweet that describes the process at abbott pharmaceuticals which is just one of
many manufacturers that are making these rapid antigen tests this one being the binax now covet
19 antigen self test with results available within 15 minutes over the counter without a prescription
and as more information comes out medcram will be following
that data and will presenting further videos as that information becomes available don't forget
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