Majority of the patients hospitalised with COVID-19 either belong to the old age group (above age 60) with underlying medical conditions or not fully unvaccinated. Hospital deaths above the 60 age group are being increasingly seen in recent days, even when deceased patients had completed two doses of COVID-19 vaccines.
Over the last few days, Nepal has witnessed approximately 10,000 new coronavirus cases each day.
On January 7, the Ministry of Health and Population (MoHP) had confirmed that 250 (22%) S-gene target failure samples were detected among the 1,146 random positive samples.
Of the 250 S-gene target failure samples, 24 samples were sequenced and confirmed the Omicron variant in all of them, indicating that the circulating delta variant is being rapidly replaced by the Omicron variant in Nepal. Almost all confirmed coronavirus cases presented with a history of severe headache (forehead and eye ball pain), severe bodyache (especially lower back pain), sore throat, and fever or chills that mimic an acute phase of dengue infection.
In fact, the author has noticed dengue-like illnesses among people who sought treatment or counseling for their illnesses, even before the government had announced publicly about the growing number of S-gene negative coronaviruses confirmed in Nepal. It seems that Omicron has been circulating in Nepal long before the government's announcement.
However, due to its mild nature and overlapping symptoms with the common cold and dengue infection, most of them, perhaps, did not come for coronavirus testing. Moreover, to my surprise, until the government's announcement, unusual activities, for instance, overwhelming hospitals/hospitalisation or deaths, did not significantly increase in Nepal.
After India began recording a drastic increase in Omicron cases, the number of coronavirus cases has begun skyrocketing in the country. One of the main reasons for getting tested was to make sure if they were infected with the coronavirus, so that they could isolate themselves to prevent further spread of the infection within the family members.
It is becoming increasingly apparent that Omicron shows symptoms different from other or previous coronavirus variants.
High grade fever, cough (dry), shortness of breath and loss of smell/taste are classical symptoms presented in the previous variants.
However, in the last couple of days, most of the people with PCR positive show symptoms of throat pain/irritation, severe body ache (especially lower back pain), severe headache (especially forehead), running/congested nose, low grade fever and fatigue.
Nevertheless, some of them presented with high grade fever, cough, loose motion and nausea/vomiting, especially in children.
It shows that Omicron is presenting with hybrid symptoms of the "common cold and dengue infection".
Most of these patients begin improving by the third day (up to 1week) after the onset of the symptoms.
At present, on average, nearly 10,000 coronavirus cases are reported daily, which is similar to the highest number of cases during the second wave of Nepal.
However, the number of deaths is much lower compared to the delta wave, which indicates a less severe variant compared to the delta or previous variants.
In fact, the author has cautioned/doubted against its severity when the whole world was in panic after it was announced as a "variant of concern" by the WHO. Occurrence of mutations in a virus does not automatically mean bad, and until now, hundreds of thousands of people may have already been infected with coronaviruses (with or without symptoms).
Moreover, a mass vaccination campaign against COVID-19 is progressing apace. Based on these facts, the author speculated that the Omicron wave may not be as severe as the delta wave. Probably, the coronavirus may appear even weaker or at least become endemic from a pandemic in the year 2022.
It is believed that Omicron has already spread in the communities and reached out to every household in Nepal. Currently, the positivity rate of COVID-19 is nearly 50 per cent, meaning one in two people is testing positive for the coronavirus in Nepal.
However, the risk of hospitalisation or death did not appear with increasing number of infections as seen in the delta wave.
Hence, the Omicron wave can be regarded as a wave of only infections rather than a wave of hospitalisations and or deaths.
Perhaps, it is worth counting the hospitalization and or death numbers rather than just case counts, because it creates panic in the communities, despite the fact that Omicron is more contagious but less severe in nature than the previous variants. It will be helpful in developing strategic plans against Omicron in the days ahead.
Nowadays, majority of the patients hospitalised with COVID-19 either belong to the old age group (above age 60) with underlying medical conditions or not fully unvaccinated (or not vaccinated at all). Hospital deaths above the 60 age group are being increasingly seen in recent days, even when deceased patients had completed two doses of COVID-19 vaccines. It shows that aggressive vaccination campaign needs to be instituted.
At the same time, it is high time to think or manage/administer booster shots for the older age group with underlying medical conditions. It is also essential to administer vaccines to the unvaccinated population. It is learnt that the old age group with physically weak/underlying medical conditions, daily-wage workers and those who refuse to get vaccinated (vaccine-hesitancy) are the main remaining unvaccinated group in Nepal.
Thus, such issues must be identified and addressed accordingly to achieve the vaccination coverage target as early as possible.
To sum up, Omicron has arrived Nepal, and penetrated in the communities with symptoms different but less severe than previous coronavirus variants.
Almost all people infected with coronavirus presented with symptoms of severe headache especially of the forehead and eye ball pain, severe bodyache (especially lower back pain), throat pain/irritation, and fatigue.
Are you suffering from these dengue-like symptoms? It could be an Omicron infection!
Dr Pun is Chief of the Clinical Research Unit, Sukraraj Tropical and Infectious Disease Hospital
A version of this article appears in the print on January 26, 2022, of The Himalayan Times.
