Omicron is triggering a “rather different” set of symptoms compared to previous variants, experts have warned, including lower back pain and a scratchy throat.
An analysis of roughly 78,000 omicron cases in South Africa, published on Tuesday, found that the variant is resulting in milder disease compared to previous waves, with 29 per cent fewer hospitalisations than the Wuhan strain and 23 per cent fewer compared to delta.
Speaking at a briefing Ryan Noach – chief executive of Discovery Health, the country’s largest private health insurer, which was behind the study – said doctors have noted a slightly different set of symptoms among those testing positive.
The most common early sign was a scratchy throat, he said, followed by nasal congestion, a dry cough and myalgia manifesting in lower back pain.
While most cases tend to be mild, Dr Noach stressed this does not mean that omicron is less virulent; instead that multiple layers of immunity acquired via both infection and vaccination have likely played a significant role in shifting the severity of disease.
Sir John Bell, Regius Chair of Medicine at the University of Oxford and a UK Government advisor on Covid-19, added that the emerging data suggests omicron is “behaving rather differently” to previous variants.
“I think one of the things we do know is the clinical syndrome is rather different,” he told BBC Radio 4’s Today programme on Tuesday. “That is, the symptoms people get from this particular virus are different to the previous variants.
Sir John listed a stuffy nose, sore throat, myalgia and loose stools as symptoms to look out for.
Currently the NHS lists a high temperature, continuous cough or loss of smell and/or taste as the key symptoms of Covid-19, though the Zoe Covid-19 tracking app also suggests that headaches, a runny nose and sneezing are also common.
Angelique Coetzee, a GP who was among the first to raise the alarm about omicron in South Africa, told Sky News that symptoms are worse and more long lasting among the unvaccinated.
“Unvaccinated patients seem to experience the severity of the myalgia and headache more intensely than our vaccinated patients,” she said, urging people who develop these symptoms to take a coronavirus test.
The latest South Africa study also found that, while two doses of a Pfizer-BioNTech shot provide lower protection against mild disease in the face of omicron, the vaccine is 70 per cent effective at preventing severe disease – defined as hospitalisation.
This figure is substantially lower than the 93 per cent protection reported during South Africa’s delta wave, but remains much higher than the original benchmark of 50 per cent set by the World Health Organization. It is also much better than many hoped in the face of omicron, which has a high number of mutations on the spike protein which vaccines target.
“This is relatively good news, we might have easily seen a bigger drop,” Ravi Gupta, professor of clinical microbiology at the University of Cambridge, told the Telegraph. “However [the] sheer numbers due to the speed of spread could overwhelm health systems. It reinforces the need for three doses, especially in high risk groups.”
But responding to today’s data, the head of the World Health Organization warned against underestimating omicron – which has now been detected in 77 countries across the world.
“Omicron is spreading at a rate we have not seen with any previous variant,” Dr Tedros Adhanom Ghebreyesus said at a WHO press briefing, adding he was concerned that people are dismissing the variant as “mild”.
“Surely we have learned by now that we underestimate this virus at our peril. Even if omicron does cause less severe disease, the sheer number of cases could once again overwhelm unprepared health systems,” he said, adding vaccines alone will not halt the variant’s spread.
“It’s not vaccines instead of masks. It’s not vaccines instead of distancing. It’s not vaccines instead of ventilation or hand hygiene,” he said. “Do it all, do it consistently.”
Dr Tedros added that he was concerned that the roll out of boosters around the world would increase the vaccine inequity that has been a hallmark of the pandemic.
“Let me be very clear. WHO is not against boosters - we are against inequity. Our main concern is to save lives everywhere,” he said.
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