Post #1354: South Africa and Great Britain

Posted on December 18, 2021


They are getting a lot of new cases.  That was expected, with Omicron.  In both countries, daily new cases now exceed the peaks of last year’s winter waves.

But that’s happening to their hospitalizations?  What’s happening to their COVID deaths?  That’s what inquiring minds want to know.


South Africa

In South Africa, for the past week, the case hospitalization rate for Omicron was 91% lower than for Delta.  A broad measure of deaths (excess deaths) was also remarkably lower than under Delta.  (This, per Bloomberg). (You can see another take on the same data here.)

In addition, several sources report that Omicron has already peaked in Gautenberg Province, South Africa.  That’s where this outbreak was centered.  That’s also significant, because it means that this wave might be as self-limiting as all the prior waves.  I think there is a general expectation that because this spreads so fast, it must also result in vastly more total cases.  But that does not seem to be the case in South Africa, assuming the reported peak in Gautenberg province is real.

Public health officials seem to be doing their best to downplay the lower average severity of Omicron, and explain it as the result of anything but Omicron resulting in less severe cases. 

But as far as I can tell, the two most-frequently-cited potential explanations (vaccination, prior infections) just don’t hold water.  That’s because these estimates (91% lower) are comparisons between the Omicron wave, and South African’s summer/fall 2021 Delta wave.  And the fact is, South Africa today just isn’t all that different from South Africa five months ago.

Between the Delta and Omicron waves, perhaps another 15 to 20 percent of the population is vaccinated.  Presumably more now have a prior infection due to the Delta wave itself.  (But all immunity from prior infection will have faded by a further half-year or so).

In other words, the modestly higher vaccination and prior immunity rates in the Omicron wave might plausibly generate slightly lower hospitalization rates and death rates.  To me, they are nowhere large enough to create the order-of-magnitude differences being seen currently.


Great Britain

I am finding it difficult to get current statistics for hospitalizations in the U.K.  Accordingly, I’m going to rely on some piecemeal reporting.

Per this report from Reuters, in terms of confirmed Omicron cases, as of 12/17/2021, Great Britain had the following cumulative totals:

  • 24968 confirmed cases
  • 85 hospitalizations
  • 7 deaths

To be clear, that’s an apples-to-apples comparison.  That’s all the cases that have been genetically sequenced and found to be Omicron.  (It’s not total cases, because only a sample of cases is sequenced.).

It’s probably too early to see many deaths yet. So I don’t think you can make much of the deaths data.  But as far as I have ever seen, hospitalizations are concurrent with the new case counts.

That gives a case hospitalization rate for Omicron, so far, of 0.3%, or about one-fifth the British rate for Delta.  I note that this is unchanged from my 12/13/2021 posting, despite a vastly higher total number of cases.  So that appears to be a relatively stable number.

My bottom line remains that Great Britain should now see total COVID-19 hospitalizations fall, as Omicron takes over from Delta.  We can’t see that yet, unfortunately, as the official UK data on total COVID-19 hospitalizations is almost a week out of date.

Source:  Government of U.K.

Right now, as best I can tell, it’s simply failing to rise, per the most recent data.  Give it another week or two.  If the case hospitalization rate for Omicron is as I’ve calculated, total COVID hospitalizations should fall as Omicron displaces Delta in the U.K.


Near as I can tell, everything out of South Africa and Great Britain so far points to Omicron having vastly lower average severity of cases compared to Delta.  And, while you can find that if you look, you won’t find any official sources saying that.  Certainly not with any clarity.

And I bet you never will.

Why not?

My best guess is that public health officials the world over are downplaying the reduced severity of Omicron.

That’s not due to some grand international conspiracy.  It’s because, within the context of their profession, that would be the ethical thing for them to do.  They really don’t want people to let down their guard over the holidays.  Downplaying the reduced severity of Omicron is the public health “messaging” that would result in the fewest additional hospitalizations and deaths.  And that’s their goal.

I’m reminded of the CDC’s initial advice on masks.  The initial advice was that masks were unnecessary.  Then the advice was to wear a cloth mask.  That “cloth” part was pure social engineering, as cloth masks are nowhere near as good as a proper N95 respirator.  But the CDC didn’t want public demand to strain existing supplies of N95 masks.

As a result, CDC advice was part science, part social engineering.  Public health messaging was not based on strictly medical advice (wear the best mask you can get), but was tailored to achieve what the CDC then saw as a better result (wear a mask that is unsuited for medical use.)

The CDC never changed its mind about that, by the way.  The CDC didn’t ever rescind it, and certainly never apologized for it.  Even now, the most recent update (August 2021) of CDC advice points you to a page that tells you to wear a cloth mask, and leave the N95s for health professionals. 

Instead, the CDC did what it though it had to do.  And that bad information has eventually faded into irrelevance.

Don’t hold your breath waiting for CDC to come out and tell you to wear an N95.   Likewise, regarding any official announcements that the latest strain of COVID-19 is vastly milder than the prior strain, on average.

It’s just not in the DNA of a public health agency to say anything of the sort.