Harmless omicron?

How critical the infection is

Created: 2022-01-23 04:17

An intensive care nurse looks after a Covid 19 patient in an intensive care unit.

(Archive image) © Christoph Soeder/dpa

Omikron lights up many warning messages on the cell phone and posts tests.

Data shows severe cases are less common than Delta.

How dangerous is the infection for the individual?

Berlin – An immense wave of omicrons is rolling through Germany, and the virus variant has long been predominant.

What seems certain: omicron spreads particularly quickly, but severe courses are rarer.

In the NDR podcast "Coronavirus Update", virologist Sandra Ciesek summarizes: The risk of becoming infected has never been greater - at the same time the risk of a serious illness if you are vaccinated or boosted is lower than ever.

How Omikron changes the individual risk of infection - and why experts continue to urge caution:

The Hamburg intensive care doctor Stefan Kluge refers to data from several countries that show that the risk of having to go to the hospital with Omikron is reduced by more than half compared to Delta in all age groups.

"That's good news," said the lung specialist.

Shorter hospitalization

In the podcast, virologist Ciesek refers to a study from Southern California that was published in the preprint - i.e. without review by colleagues - that compares clinical courses in omicron patients with those of patients with delta. A broad database shows that patients with omicron need to be ventilated less often and are in the intensive care unit. On average, they would be in the hospital three or four days shorter if they were hospitalized.

According to general assessment, corona infections that require hospitalization are considered severe.

Christian Karagiannidis, scientific director of the Divi intensive care register, says: "We don't yet know that much about how severe lung failure is with omicron when the sick have to go to the intensive care unit." But "according to the first cautious reports" he is going from abroad does not assume that the use of heart-lung machines (ECMO) is as necessary at Omikron as at Delta.

Big influencing factor: the vaccination status

According to the experts, an enormous influencing factor for the individual severity of an infection is the vaccination status.

According to scientific consensus, the basic immunization with booster vaccination does not necessarily protect against infection in Omikron, but reliably against severe courses.

Looking at US data, Karagiannidis says that around 90 percent of the people hospitalized there with Corona are currently unvaccinated.

"This is certainly the risk group in which Omikron can also take a serious course," says the intensive care physician.

He also warns of the long-Covid risk after illness, especially in the unvaccinated, which is not necessarily related to its severity.

Mild doesn't necessarily mean harmless

According to Kluge, typical symptoms of an omicron infection are a runny nose, cough, sore throat and headache - they are often mild, especially in vaccinated people. Disorders of smell and taste, which are more common in delta infections, are rarely seen. However, according to the experts, the courses described as easy or mild are not to be taken lightly. Karagiannidis makes it clear that they too can “take you pretty badly” and that you can also lie in bed with clear symptoms of illness and very limited, sometimes for a long time.

Ciesek also points out that infected people, even if they are not seriously ill according to the definition, can be much more affected by an omicron infection than by a "banal cold".

She warns that nobody knows what the individual course is like when you get sick.

Taking Omicron lightly or even intentionally infecting yourself is the wrong way to go.

The focus is also on the elderly and the chronically ill

In addition to the unvaccinated, it is the group of older people that causes the experts particular concern in the omicron wave. According to Karagiannidis, the incidence among people over 60 is still comparatively low. "We'll have to take an incredibly close look at that over the next few weeks." There are always vaccination breakthroughs in fully vaccinated elderly people - the severity of the disease with which they develop remains to be seen. “It will shift even more to the unvaccinated and older being affected by infections.”

In healthy, young adults, the risk of a severe course is very low, especially with vaccination protection, with Omikron it is even lower, says Kluge.

But he emphasizes that this changes with age: It is known "that the strongest risk factor for becoming seriously ill is age".

The risk of death increases with every decade.

For people with serious previous illnesses such as cancer, cardiovascular or lung diseases, an infection can also be extremely dangerous, especially if they are not vaccinated.

"Age and previous illnesses seem to play exactly the same role as risk factors with Omikron as with Delta and previous variants," Kluge clarifies.

All-clear for children?

Experts assume that corona infections are generally less critical for children and adolescents than for adults.

This is because their immune system is more adaptable and the virus is more easily intercepted in the respiratory tract, explains Jörg Dötsch, President of the German Society for Pediatric and Adolescent Medicine (DGKJ).

With regard to Omicron, he refers to US study data, according to which the risk of having to go to the hospital for children under five is a third as high as at Delta.

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Jakob Maske, spokesman for the professional association of paediatricians, describes his everyday work in a Berlin pediatrician's practice that most of the children who have tested positive are "completely healthy and symptom-free".

They would come to the practice because of positive rapid tests in schools for the PCR test and not because of complaints.

Some children have a cold, some cough and fever or gastrointestinal problems.

Dötsch explains that the infection can also cause febrile seizures, especially in younger people.

In the case of Omicron, however, the symptoms were generally milder than those of, for example, Delta.

In the case of the rare severe courses in children, however, severe breathing problems up to and including ventilation could occur.

Complications in the blood vessels such as blood clots are also conceivable, says Dötsch.

Because these things are so much less likely in children than in adults, one could say: "In children as a whole, the course is milder." dpa