As of Friday, the seven-day running average for new cases of COVID-19 in the United States had fallen by over 600,000 cases a day compared to the peak hit during the second week of January. That’s a genuinely amazing decline. It’s definitely cause to celebrate, and in some areas, time to breathe a sigh of relief as beds finally open up in what have been badly overstrained hospitals and ICUs. States in the Northeast in particular have seen the rate of hospitalizations drop dramatically.
That rapid drop is causing more than just signs of hope. It’s causing state and local governments across the nation to shed social distancing constraints and mask mandates like Punxsutawney Phil got back a negative test and now it’s time for virus-free spring.
Except that’s objectively not the case. Not yet. The 203,000 cases a day average now present in the U.S. is a huge drop from where the nation was a month ago, but it’s also 40,000 cases a day more than the worst of the delta wave. The Centers for Disease Control and Prevention (CDC) data tracker, using the same values that were fixed back in spring of 2021, puts 98.7% of the counties in the nation at high levels of community transmission. The answer to the question “is it safe?” is a resounding “no” (and please, don’t get out your drills).
However, it is getting safer. In just a matter of weeks, maybe even days, we’re going to know where this thing is headed next. By next Friday, it’s highly likely that officials can make rules that will be responsive to where we’re going, and do so in a way that won’t require another round of finger-pointing and sudden reversals should omicron not go out with a whimper.
In the meantime, there’s a January study from South Africa that deserves a look, because one thing about omicron threatens to flip the script on something we thought we knew about COVID-19.
That January study is actually a compilation of data from South Africa’s Government Employees Medical Scheme, a health care plan that represents over 2 million state employees and their families. As of the time the data was put together, about a tenth of all those beneficiaries (260,000) had tested positive for COVID-19, 56,000 had been hospitalized, and 11,000 had died.
With the omicron variant becoming dominant in South Africa during the first two weeks of November, the data contains just over a month’s worth of records where almost every case can be expected to result from omicron, along with some weeks containing a mixture of omicron and other variants.
The data suggests a serious concern that increased along with omicron: Young people became more likely to develop serious disease. Young people in this case doesn’t mean people under 40, or under 30. It means teenagers and children.
Even before omicron became the most common variant, South Africa already saw a rise in the percentage of cases that were attributed to younger people. Before the delta wave, the average age of someone testing positive in South Africa was 45. Under delta, it went to 40. With omicron, it dropped to 38.
Those numbers may make it seem like the fault lies with younger adults disregarding social distancing guidelines, but the change in average age really came from a sharp rise in the proportion of cases among those 18 and younger.
Most concerning was that as omicron became dominant, something very odd happened with rates of those admitted to hospital. Omicron is less likely to cause serious disease—if you’re not a kid.
It was early data from South Africa that helped reassure the world that omicron was the kinder, gentler form of COVID-19. And that’s true. Omicron is less likely to case serious illness than delta. However, too many people interpreted “milder” as “mild.” That’s far from the case. Overall, the rate of hospitalization from omicron in South Africa was lower, but it only declined 27%. That’s not the kind of drop that should make anyone feel safe.
And among young people, that trend was actually reversed. In the South African data, adults in their 40s and 50s saw their chance for hospitalizations cut in half. On the other hand, teenagers were actually more likely to be hospitalized by omicron than by delta. For younger kids, this effect was even worse. With children under the age of 5, the chance of being hospitalized with omicron as actually up by 48% compared to delta.
Does this mean that omicron is actually harder on kids than adults? No. Is it harder on kids than delta? Probably.
There are several factors to consider. That drop in the overall age of those testing positive in South Africa can be tied to the wider availability of vaccines to people over 18 and the complete lack of vaccine for children under five. In fact, it wasn’t until November that the CDC approved the first vaccine for kids 5 to 11 in the United States, and pediatric vaccines have very limited availability in many countries.
That difference is a little harder to map to the hospitalization rates. Yes, a relative lack of vaccine should see kids getting sick at a higher level when expressed as an overall percentage of the population, but that shouldn’t make a difference when comparing children under 5 during omicron to children under 5 during delta. In both cases, vaccines simply weren’t available for the youngest kids.
The biggest factor during this period may simply have been the number of cases of COVID-19. Like the United States, South Africa saw an enormous jump in cases as omicron came on. In fact, South Africa—with the help of a national network of testing and case management—did a terrific job of ending the delta wave and bringing down daily cases to a very low level. Then omicron overwhelmed the system and increased the daily count by 50 times over the span of a month. The level of viral particles going around may have been so high that they overwhelmed children’s normally robust immune systems, similar to the way omicron’s increased transmission bulldozed the steps taken to protect the nation.
But … we don’t know. These are just statistics. They’re also incomplete statistics, ones that could be in for adjustment when a more complete look at the omicron wave across more time and more countries is available.
Also, note that these percentages are relative. A 48% increase in the rate of children going to the hospital is awful, but the rate of kids being hospitalized was low, and it remains lower than the rate among older groups.
The only thing clear at the moment is that making good decisions about how to manage the pandemic is something that should be resistant to both political pressure and snap judgments. High levels of disease are not suddenly safe because they were recently higher, and the same people who insist that they should be the ones to make decisions for their children should realize that they’re making decisions for their children, not to score political points.
To put it another way, suppose a car was traveling along the highway at 30 mph. Would you stand in front of that car? Would you shove your child in front of it? What if the car then sped up to 120 mph—would you do it now? And what about when the car leans on the brakes and brings the speed back down to 40? Is that somehow safer that the original 30? Your kid should not be in front of that speeding car. Neither should you.
That’s where we are with COVID-19. In the next week, that car could slow to a walking pace … or not. But before you decide where to position either yourself or your child, you should at least check to see if the brake lights stay on.