New heavily mutated variant B.1.1.529 in South Africa raises concern

[pacergal]

I still feel for those working in the medical field! Really a big part of our un-sung Covid heroes.
Have only had one mild URI symptoms this year, had a negative covid test. think it was my allergies.

 

[disneysteve]

Basically, he was going to blow it off. I'm not saying that's wrong, it just shows how easy it can be to spread this virus no matter the variant.

This has been a major problem from day one of COVID - people blowing it off. It's just a cold. It's my allergies. I have a sinus infection. I get bronchitis every year at this time. Trust me, I've heard every excuse, only to have the patient test positive for COVID.

 

[anethum]

"Omicron coronavirus variant three times more likely to cause reinfection than delta, S. Africa study says"

https://www.washingtonpost.com/world/2021/12/03/omicron-covid-variant-delta-reinfection/ (free article not behind a paywall)

"Scientists in South Africa say omicron is at least three times more likely to cause reinfection than previous coronavirus variants such as beta and delta, according to a preliminary study published Thursday.

Statistical analysis of some 2.8 million positive coronavirus samples in South Africa, 35,670 of which were suspected to be reinfections, led researchers to conclude that the omicron mutation has a “substantial ability to evade immunity from prior infection.” "
S. African scientists did not have access to immunization data, so the level of protection against omicron provided by vaccination remains unknown.

Yesterday, another article said that the number of new cases in S. Africa had tripled in 3 days. "New daily confirmed cases rose to 11,535 on Thursday from 8,561 on Wednesday and 4,373 the previous day, according to official statistics." The next day, new cases in S. Africa jumped to 16,055. That's an astonishing increase.

https://www.washingtonpost.com/world/2021/12/02/south-africa-coronavirus-omicron/ (this article may be behind a paywall)

South Africa data site: https://gis.nicd.ac.za/portal/apps/opsdashboard/index.html#/15eb33988f104b73867606c1248578ff

 

[Montecfo]

This is exactly why we are so overwhelmed in Urgent Care, coupled with the fact that PCPs no longer see any sick patients. They send them all to Urgent Care.



Pre-COVID, if someone had "a cold" they would take some OTC remedy and go about their business. Not today. Now, they need to be seen and get a COVID test.


You can do a home test but jobs and schools don't typically accept those for clearance. You need a PCR. You can go to a drive up site, but that doesn't help if you also want to be checked for flu or strep or want to have someone actually examine you. So everyone is flooding into the urgent cares. We're actually so swamped that we routinely turn people away.


Even if Omicron only causes mild symptoms, that won't change any of the above.

I think primary care physicians would be surprised to learn that they "no longer treat sick patients".

Also with case rates in New Jersey less than half what they were a year ago and even more dramatically below peak rates, certainly fewer folks should be flooding urgent care in the state, though your particular location may be the outlier.

 

[disneysteve]

I think primary care physicians would be surprised to learn that they "no longer treat sick patients".

Also with case rates in New Jersey less than half what they were a year ago and even more dramatically below peak rates, certainly fewer folks should be flooding urgent care in the state, though your particular location may be the outlier.

PCPs here do not see sick patients in the office. If you have a fever or any sort of potential COVID symptoms, they will not see you. They might possibly do a telehealth visit but most likely you're going to get referred to urgent care.


I can't give you state data but I can tell you that locally, we are seeing all-time record volumes in urgent care. Not just at my location but throughout the region. And I can tell you from posts in the national urgent care groups that it's happening across the country. It doesn't matter if COVID cases are down or not (and we still see a few every day). What matters is what I've already said. You can no longer assume that a cold is just a cold. You need to rule out COVID before you can return to work or your kid can return to school. People who never would have gone to the doctor before for these symptoms now have to get evaluated and cleared.

 

[Chuckanut]

I found this short video of a man from South Africa describing his Omicron infection quite interesting. Only anecdotal of course and may not necessarily be representative for others infected with Omicron.

Thanks for the link to the video.

The other interesting news from South Africa and several other African countries was mentioned by Gottlieb last Sunday. The government of SA has asked Phizer to delay shipping more vaccine as they have an excess at the moment that they aren't able to get to those who still need it. This tells me that the more advanced countries of the world need to help the others with the logistics of getting the vaccine out to the population more quickly.

As long as we have less advanced countries churning out variants and jet planes to transport the variants around the world in a matter of days or a few weeks, we are going to have an ongoing headache trying to control Covid.

 

[ExFlyBoy5]

I think primary care physicians would be surprised to learn that they "no longer treat sick patients".

Also with case rates in New Jersey less than half what they were a year ago and even more dramatically below peak rates, certainly fewer folks should be flooding urgent care in the state, though your particular location may be the outlier.

I don't think it's an outlier. I have had a lot of my retired AF buddies (Tricare which has essentially the same coverage as Medicare) that have reported that their PCMs have referred them to urgent care for anything outside of routine care (happened to my DW a couple of weeks ago). I think much of it revolves around not enough appointments/providers to maintain the established standard of care that they are contractually required to meet. Also have a good friend in Georgia that works in a UC clinic and has reported similar things as DisneySteve.

As far as "not treating sick patients", that's not what is happening. It's the inability to meet requirements because of scheduling/staffing issues. If the contract says, "care must be provided within 48 hours for X, Y, Z" and the primary physicians aren't able to meet that standard then yes, you are shuffled off to UC.

 

[disneysteve]

As far as "not treating sick patients", that's not what is happening. It's the inability to meet requirements because of scheduling/staffing issues. If the contract says, "care must be provided within 48 hours for X, Y, Z" and the primary physicians aren't able to meet that standard then yes, you are shuffled off to UC.

That might be part of it in some places. Around here, it's that the PCPs aren't doing any testing in their offices. What's the point of having a sick patient come in if you can't test them for COVID/flu/strep? Just send them to the urgent care where they can have a proper evaluation.

 

[gattara]

PCPs here do not see sick patients in the office. If you have a fever or any sort of potential COVID symptoms, they will not see you. They might possibly do a telehealth visit but most likely you're going to get referred to urgent care.

Yep. Friends and family in NJ (my home state) have been shunted off to urgent care.

My husband deals with recurring sinus infections due to allergy issues (been going on for years). He easily gets appointments with his ENT (here in Atlanta metro), fortunately.

 

[Alan]

This is exactly why we are so overwhelmed in Urgent Care, coupled with the fact that PCPs no longer see any sick patients. They send them all to Urgent Care.

Pre-COVID, if someone had "a cold" they would take some OTC remedy and go about their business. Not today. Now, they need to be seen and get a COVID test.


You can do a home test but jobs and schools don't typically accept those for clearance. You need a PCR. You can go to a drive up site, but that doesn't help if you also want to be checked for flu or strep or want to have someone actually examine you. So everyone is flooding into the urgent cares. We're actually so swamped that we routinely turn people away.


Even if Omicron only causes mild symptoms, that won't change any of the above.

Fortunately schools in England do accept home tests (NHS approved, free tests). Also, the rules were changed some months back that if you come into contact with someone who has tested positive for Covid and are yourself fully vaccinated then you do not have to self isolate provided you take regular LFTs and have no Covid symptoms.

A few weeks back a friend here got sick, took OTC medications for a few days plus did 2 LFTs then went to see her GP, who was delighted that she had tested herself before turning up, as she had seen 2 patients that day with Covid symptoms and sent them next door to get Covid tests (there is a PCR Covid test center about 50 yards away from the GP offices). Our friend had pleurisy which was fixed after a week or so of antibiotics but would have seen the GP earlier and started treatment earlier in normal times.

 

[ExFlyBoy5]

That might be part of it in some places. Around here, it's that the PCPs aren't doing any testing in their offices. What's the point of having a sick patient come in if you can't test them for COVID/flu/strep? Just send them to the urgent care where they can have a proper evaluation.

Good point. My last PCP appointment I asked to get a flu shot. I was told that I needed to go to a pharmacy to get it. They said that the reimbursement rate had gotten so abysmal from insurance companies, they decided to stop giving most immunizations. And this isn't a small office, either....it's part of a very large Catholic healthcare system that has 20+ hospitals, 11,000 providers and 39,000 employees over 5 states.

So, I dutifully went to Wal Mart to get my flu shot and the pharmacist said they were VERY busy with immunizations and they had recently changed the policy to vaccinate everyone from the age of 3 and up since so many PCPs weren't doing them anymore.

I do have a point here...it's tough to convince people to get tested/visit the PCP for "cold like symptoms" if it's such a pain. Also, I have ZERO desire to go to an UC clinic unless I have seriously cut myself or broken a bone. As far as COVID testing, we have used (and will continue to use) the at home tests if we have any symptoms or find out we have been in close proximity to someone who has an active case.

 

[Chuckanut]

I got my booster about 6 weeks ago. The wait for the appointment was 48 hours max.

Today, a neighbor tells me that - at the same drug store - the first booster shot appointment open is after Christmas.

 

[Freedom56]

Switzerland is supposed to implement more strict measures to control new infections however, they should start by imposing existing restrictions. We went to the Christmas market in Geneva last night. They asked everyone to be masked and you had to show your COVID Certificate (passport) and ID to get inside. They asked that everyone keep their mask on inside the market but we saw very little evidence of that. Attached are some photos I took.

 

[disneysteve]

it's tough to convince people to get tested/visit the PCP for "cold like symptoms" if it's such a pain. Also, I have ZERO desire to go to an UC clinic unless I have seriously cut myself or broken a bone.

Fortunately, except for the "COVID is a hoax" crowd, people around here don't hesitate to get tested. That's part of why we're so busy, along with schools and jobs requiring a negative test to return. People love the convenience of UC, even though due to the volumes it isn't as convenient as it used to be as you may now be waiting a couple of hours in your car or being told to go home and return later in the day.

 

[Gumby]

Thanks for the link to the video.

The other interesting news from South Africa and several other African countries was mentioned by Gottlieb last Sunday. The government of SA has asked Phizer to delay shipping more vaccine as they have an excess at the moment that they aren't able to get to those who still need it. This tells me that the more advanced countries of the world need to help the others with the logistics of getting the vaccine out to the population more quickly.

As long as we have less advanced countries churning out variants and jet planes to transport the variants around the world in a matter of days or a few weeks, we are going to have an ongoing headache trying to control Covid.

We don't need a third world country and a jet plane to churn out variants. We've got an entire nation of almost 100 million completely unvaccinated people within our own borders. That's far larger than all of South Africa and would be approximately the 15th largest nation in the world by itself. And, as I'm sure you know, neither supply nor distribution logistics is the problem. We're going to have a headache trying to control Covid no matter what happens with less advanced countries.

 

[anethum]

The other interesting news from South Africa and several other African countries was mentioned by Gottlieb last Sunday. The government of SA has asked Phizer to delay shipping more vaccine as they have an excess at the moment that they aren't able to get to those who still need it. This tells me that the more advanced countries of the world need to help the others with the logistics of getting the vaccine out to the population more quickly.

As long as we have less advanced countries churning out variants and jet planes to transport the variants around the world in a matter of days or a few weeks, we are going to have an ongoing headache trying to control Covid.

There appears to be a lot of vaccine hesitancy in South Africa, which may possibly be a bigger factor than logistics.

https://www.bbc.com/news/59462647

"Is there an issue with vaccine hesitancy?
Uneven supply has clearly been a problem, but the fact South Africa has had to delay the delivery of doses suggests there is also something else going on.

South Africa's Health Minister Joe Phaahla suggests "fake news" is playing a role in making people - especially younger age groups - unsure about the vaccine.

There is a lot of fear - sometimes driven by misinformation or a lack of good information - about the safety of the vaccine."

"Reaching rural communities
Fear of side effects and safety were identified as two of the biggest reasons people weren't getting vaccinated. But the third was access, including the time it takes to travel to vaccination centres.

In the north-west of South Africa, many people in rural communities don't have easy access to vaccination sites, according to the report produced for the health department.

There have also been issues with supply in certain areas, with sites running out of doses before they've vaccinated everyone who's turned up to be jabbed while others can't afford the transport or time off work."

 

[Montecfo]

I'm just not able to find any data to suggest that urgent care facilities are overwhelmed nationally. The data shows Covid cases down most places, testing down.

If you Google "Urgent care overwhelmed" there are stories...but not recent ones. They are from early fall when Covid was at much higher levels.

Anecdotally, I have gotten booster and flu shots recently at my pharmacy. No line then. Went to same pharmacy yesterday. No one getting a shot, no line.

I got a PCR test a couple of months ago. Schedule was wide open. We walked in, got tests, saw no one but lab tech.

Just went to their site to look for appointment. They are wide open. I can schedule anytime or just walk in. This is in a heavily populated urban area outside of DC.

Covid testing rates per 100k folks are highest in Rhode Island, Massachusetts, Alaska, NY and Vermont and DC right now. New Jersey is middle of the pack nationally.

So by all evidence I can find, overwhelmed urgent care facilities due to covid testing does not appear to be widespread. But I am open to data (not anecdotes) to the contrary if anyone can find any.

This of course does not mean urgent care facilities are not crowded or even overwhelmed in some localities for a variety of reasons. Whenever I have been to one, I usually had to wait and this was my expectation.

 

[harllee]

Cannot speak to urgent care places but to get a booster in my town the appointments are at least a week out.

 

[street]

^ interesting! In the very rural area, I live in you can just go to the county health and get one any day. I called to see when I could get one and they said anytime, no appointments. Only thing it has to be past 6 months from your initial covid shot.

 

[anethum]

I'm just not able to find any data to suggest that urgent care facilities are overwhelmed nationally. The data shows Covid cases down most places, testing down.

If you Google "Urgent care overwhelmed" there are stories...but not recent ones. They are from early fall when Covid was at much higher levels.

Anecdotally, I have gotten booster and flu shots recently at my pharmacy. No line then. Went to same pharmacy yesterday. No one getting a shot, no line.

I got a PCR test a couple of months ago. Schedule was wide open. We walked in, got tests, saw no one but lab tech.

Just went to their site to look for appointment. They are wide open. I can schedule anytime or just walk in. This is in a heavily populated urban area outside of DC.

Covid testing rates per 100k folks are highest in Rhode Island, Massachusetts, Alaska, NY and Vermont and DC right now. New Jersey is middle of the pack nationally.

So by all evidence I can find, overwhelmed urgent care facilities due to covid testing does not appear to be widespread. But I am open to data (not anecdotes) to the contrary if anyone can find any.

This if course does not mean urgent care facilities are not crowded or even overwhelmed in some localities for a variety of reasons. Whenever I have been to one, I usually had to wait and this was my expectation.

<emphasis mine>

I don't know where you are getting your data from, but every data source I've seen is indicating that cases are up significantly in nearly every state in the US right now. Cases numbers were up significantly last year right after Thanksgiving, too. We don't know yet how widespread omicron is in the US and to what extent that may be a factor this year.

Here's one data source:

https://www.washingtonpost.com/grap...us-us-cases-deaths/?itid=hp_pandemic&state=US

I do not understand why you have been routinely disputing the first-hand experiences of a physician who is seeing patients at an Urgent Care center in New Jersey. You're not a physician and you don't live in New Jersey. So please, just stop.

 

[Calico]

I'm just not able to find any data to suggest that urgent care facilities are overwhelmed nationally. The data shows Covid cases down most places, testing down.

If you Google "Urgent care overwhelmed" there are stories...but not recent ones. They are from early fall when Covid was at much higher levels.

Anecdotally, I have gotten booster and flu shots recently at my pharmacy. No line then. Went to same pharmacy yesterday. No one getting a shot, no line. (Anecdote #1)

I got a PCR test a couple of months ago. Schedule was wide open. We walked in, got tests, saw no one but lab tech. (Anecdote #2)

Just went to their site to look for appointment. They are wide open. I can schedule anytime or just walk in. This is in a heavily populated urban area outside of DC. (Anecdote #3)

Covid testing rates per 100k folks are highest in Rhode Island, Massachusetts, Alaska, NY and Vermont and DC right now. New Jersey is middle of the pack nationally.

So by all evidence I can find, overwhelmed urgent care facilities due to covid testing does not appear to be widespread. But I am open to data (not anecdotes) to the contrary if anyone can find any.

This of course does not mean urgent care facilities are not crowded or even overwhelmed in some localities for a variety of reasons. Whenever I have been to one, I usually had to wait and this was my expectation.

 

[Chuckanut]

In the last month appointment time have skyrocketed from a few days to weeks. Some places seem to adding some extra slots.

It appears that many of those who have been on the fence regarding Covid vaccine shots are joining those who want the booster. IMO, people are figuring out that this virus is going to be with us for many years and we might as well find an easier way to manage it in our personal lives.

 

[USGrant1962]

In the last month appointment time have skyrocketed from a few days to weeks. Some places seem to adding some extra slots.

It appears that many of those who have been on the fence regarding Covid vaccine shots are joining those who want the booster. IMO, people are figuring out that this virus is going to be with us for many years and we might as well find an easier way to manage it in our personal lives.

Boosters were just approved for all adults two weeks ago. A surge in vax appointments is to be expected, nothing to do with on/off the fence.

 

[Sunset]

<emphasis mine>

I don't know where you are getting your data from, but every data source I've seen is indicating that cases are up significantly in nearly every state in the US right now. Cases numbers were up significantly last year right after Thanksgiving, too. We don't know yet how widespread omicron is in the US and to what extent that may be a factor this year.

Here's one data source:

https://www.washingtonpost.com/grap...us-us-cases-deaths/?itid=hp_pandemic&state=US

I do not understand why you have been routinely disputing the first-hand experiences of a physician who is seeing patients at an Urgent Care center in New Jersey. You're not a physician and you don't live in New Jersey. So please, just stop.

I also heard on the news about rising cases here in IL, and this site shows the USA is increasing in cases since Nov 1.

https://www.worldometers.info/coronavirus/country/us/

 

[disneysteve]

I also heard on the news about rising cases here in IL, and this site shows the USA is increasing in cases since Nov 1.

https://www.worldometers.info/coronavirus/country/us/

Cases are rising all over. The daily average number of new cases in the US is the highest it's been in 2 months.


In our hospital system, there were 52 patients hospitalized with COVID on 11/9. By 12/3, that number was up to 105, so it doubled in under a month.



As for testing, I saw 24 patients today. 17 of them were for COVID testing. Not all get rapid tests but of the ones who did, 2 were positive. Most likely a couple others will also turn up positive when their PCRs come back in a couple of days.