key: cord-0907879-t3hdi13g
authors: Lee, Jong-Koo
title: As the incidence of Omicron increases, so will the number of deaths
date: 2022-02-28
journal: Osong Public Health Res Perspect
DOI: 10.24171/j.phrp.2022.13.1.01
sha: eea8d9473656600fc6dffa163a16857ac66ee243
doc_id: 907879
cord_uid: t3hdi13g

nan

relaxing stringent anti-COVID-19 measures because that relaxation will take place quickly. However, the government announced that if Omicron's virulence is estimated as the fatality rate for each week of the epidemic, rather than the cumulative fatality rate, the fatality rate of Omicron is lower than the original estimate; therefore, it would be better to relax social distancing and release the restrictions on freedom and economic activity. These claims were made at the same time. Let us take a closer look at the rationale for these arguments.

The rationale for prudent implementation is as follows: First, although the fatality rate of Omicron is low, considering the active immunity caused by vaccination and the natural immunity caused by infections with the delta variant (as the scale of delta infections has been very large), it has been estimated that if the Omicron epidemic continues in our country, the overall scale of deaths will be similar and the burden of disease will increase [4, 5] . To exemplify this reasoning using concrete data, according to a press release on February 21, when comparing the delta-and Omicroninfected patients from the third week of January to the third week of February, the severity rate decreased from 1.4% to 0.38%, and the fatality rate decreased from 0.7% to 0.18%. These rates both decreased to a quarter of the initial level, but the total number of patients increased by 15.6 times, so it is possible that the number of critically ill patients or the number of deaths might quadruple.

Second, Omicron countermeasures were prepared with a focus on respiratory specialist clinics, which were in charge of the transition to at-home treatment. However, the expansion of primary care clinics in accordance with the increase in the number of patients was insufficient, and there were reports of deaths during at-home care due to inadequacies in the transport system, medication system, and patient management system, we need more time to preparedness and need to reduce volume of positive cases by public health measures, such as trace-test-isolationquarantine supported by Information and Communications Technology.

Lastly, although there have been clear changes in perceptions of this disease over the past 2 years, as exemplified by a marked decrease in the severity of infection and fear scores compared to 2020, it is nonetheless noteworthy that 40.2% of residents responded that they would not be able to receive treatment for COVID-19 due to a lack of treatment facilities such as hospital beds. As the number of confirmed cases increases, the number of respondents who were concerned about the increase in severity and death took second place, accounting for 33.2% of the total, and 19.1% of the respondents also said that it would be difficult to receive timely treatment for other diseases due to the spread of COVID-19. It is necessary to consider this gap in perceptions between healthcare providers and the public [6] .

Turning to the opposing point of view, if the virulence of delta and Omicron is estimated as the fatality rate for each variant's cohort, rather than the cumulative fatality rate, it is predicted that the fatality rate of Omicron will be lower based on recent epidemiological trends. The number of patients hospitalized due to the Omicron variant is also small, so there is no shortage of beds, and the death rate is almost the same as that of influenza, so the public does not need to be anxious. Thus, there is no possibility of a major problem, even if measures against COVID-19 transmission are actually lifted.

The general public finds it difficult to accept the government's explanation. In other words, the excessively conservative prediction of the number of patients is causing distrust. Furthermore, the number of patients with BA.2 (stealth Omicron), a sub-lineage of Omicron, is increasing in some countries. This variant has a faster rate of transmission than the original Omicron variant, a higher immune evasion rate, resistance to existing treatments, and already accounts for 4.9% of infections in the Republic of Korea [4] . Therefore, while monitoring this situation, it is necessary to take a cautious approach, while avoiding anxiety, until the end of the pandemic. Prevention policies to reduce the number of patients-such as prompt screening and voluntary isolation at home, wearing a mask, preventing mass outbreaks, and promptly vaccinating those who are not vaccinated-should not be hastily chosen as policies to favor or disadvantage the upcoming election. In any case, the basic policy direction to protect the lives of the people must be faithfully observed. In addition, as long as cases continue to be imported from the epicenters of variants, international cooperation will inevitably become more important to prevent the spread of this disease.

Therefore, in order to make policy decisions accurately, there is a need for a system that can provide accurate knowledge of the facts. Instead of simple theoretical modeling or simulation, it should be possible to know the situation in the field as it unfolds. The government is responsible for the real-time identification of inpatients, critically ill patients, and fatalities. It is also necessary to establish a system that can quickly synthesize the results of various epidemiological data and interventions in real time to make decisions. Considering that the end game of Omicron is a period of preparation for a larger epidemic, rather than the end of COVID-19, improvements should be made to supplement the shortcomings of the countermeasures that have been taken to date. https://doi.org/10.24171/j.phrp.2022.13.1.01

As the incidence of Omicron increases, so will the number of deaths

Not applicable.

The author has no conflicts of interest to declare.

None.

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