South Africa: Most Patients in Covid-19 Wards in Tshwane - Unvaccinated, Young

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The majority of the patients who were treated for COVID-19 at Tshwane public hospitals were unvaccinated.

The information is contained in a report on the early experience of the patient profile at the Steve Biko Academic Hospital and Tshwane District Hospital (SBAH-TDH) complex, in the heart of the Tshwane District.

The SBAH combined its workforce with TDH to create the SBAH-TDH complex to manage SARS-CoV-2 patients.

According to data, of the 38 adults in the COVID wards on 2 December 2021, 24 were unvaccinated, while eight had unknown vaccination status and only six were jabbed.

The statistics are based on the "sharp rise" in admissions at the two hospitals with 166 new admissions between 14 and 29 November 2021, the first two weeks of the Omicron wave in Tshwane.

Meanwhile, of the nine patients who were hospitalised for COVID-19 pneumonia, eight were unvaccinated including a child.

"Only a single patient on oxygen was fully vaccinated but the oxygen was for chronic obstructive pulmonary disease," said the author of the report, Dr Fareed Abdullah.

Abdullah is the Director of the Office of AIDS and TB Research at the South African Medical Research Council (SAMRC) and a part-time HIV Clinician at the SBAH.

The SAMRC has described Tshwane as a global epicentre, where the first cases of the newly discovered Omicron outbreak were discovered.

Age profile

Abdullah said the age profile of the 166 patients between 14 and 29 November differed "markedly" from the previous waves.

In the last two weeks, the doctor said the data indicates that no fewer than 80% of admissions were below the age of 50 years.

"It may be that this is a vaccination effect as 57% of people over the age of 50 have been vaccinated in the province compared to 34% in the 18 to 49 age group," Abdullah said.

In addition, the research found that 19% were children aged between zero and nine, while the highest number of admissions was in the age group between 30 and 39 years, making up 28%.

Community transmission

According to the data, 66% of patients were "incidental COVID admissions", meaning they were for other conditions and found they were positive upon the hospital arrival.

"The high proportion of COVID-19 incidental adult patients and the increased number of SARS-CoV-2 positive admissions among children aged zero to nine may reflect higher rates of community transmission compared to previous waves that are not translating into higher admission rates for a primary COVID-19 diagnosis."

Severity

Is Omicron more severe than the other variants? "The best indicator of disease severity is measured by the in-hospital death rate. There were 10 deaths in the SBAH-TDH cohort in the past two weeks, making up 6.6% of the 166 admissions," Abdullah explained.

Four deaths were in adults aged between 26 and 36 and five were in adults over 60.

"One death was in a child in whom the cause of death was unrelated to COVID," he said, adding that there were no COVID-related deaths among 34 admissions in the paediatric COVID-19 wards over the last two weeks.

"For now, the death rates over the last two weeks as well as over the past 18 months at the SBAH-TDH complex are lower than the overall in-hospital death rate of 23% for the country overall previous waves, as reported by the NICD," he added.

In addition, the report found a shorter average length of hospital stay of 2.8 days compared to 8.5 days for the past 18 months.

However, according to the doctor, more time is required to fully answer the questions about the severity of COVID-19 caused by the new variant.

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