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Did the UK record the first Omicron death?

AP Photo/Matt Dunham

This question has hung in the air for the last month: Is the Omicron variant or COVID-19 fatal, or a mild mutation that could spell an end to the pandemic? As late as yesterday, the World Health Organization had not yet confirmed a death from an infection of the Omicron variant, despite rapid transmission for weeks in South Africa, Europe, and potentially the US.

That might have changed overnight. Speaking to reporters outside a vaccination clinic to promote boosters, Boris Johnson reported that the first death had occurred in the United Kingdom — “with Omicron”. But was it “from” Omicron, as the Washington Post reported the remarks?

At least one person has died from the omicron variant, the British Prime Minister Boris Johnson said on Monday as he urged Britons to increase their protection with a booster shot. It is the first reported fatality in the country from the variant.

Johnson, who was speaking to reporters during a visit to a vaccination clinic in West London on Monday, said that the omicron variant “was producing hospitalizations and sadly at least one patient has been confirmed to have died with omicron.”

“I think the idea that this is somehow a milder version of the virus, I think that’s something we need to set on one side and just recognize the sheer pace at which it accelerates through the population,” he said, adding, “the best thing we can do is all get our boosters.”

Emphases mine. There is a very significant difference between “with” and “from” when talking about causes of death, or even causes of hospitalizations. If the person died from an acute Omicron infection, that would signal that this mutation is fatal to some extent and that the rapid-transmission profile of Omicron could mean a large number of deaths in a short period of time.

However, if the patient died with Omicron, that could mean something much different. The Omicron infection might have been secondary to another cause of death, or entirely coincidental to it. With a variant this transmissible, it would be inevitable to see Omicron infections among those terminally and/or critically ill, and those patients would likely be far more susceptible to getting an acute infection from exposure. That doesn’t mean that Omicron would be the cause of the death, however, or even that it had anything to do with the fatality except be present at the time it occurred.

Furthermore, there are other reasons to question what Johnson meant. Normally deaths from COVID-19 are associated with hospitalization spikes. According to Health Secretary Sajid Javid, only ten people in the UK identified as carrying Omicron have been hospitalized — and again, note the preposition choice:

On Monday, Health Secretary Sajid Javid said 10 people were in hospital in England with the Omicron variant.

With, not necessarily from again. Having only ten people testing positive for Omicron in hospital in the entire country while the UK undergoes a transmission spike tends to point more toward coincidence or unusual co-morbidities than a high risk to the larger population.

The World Health Organization has escalated Omicron to a “very high global risk” category, which makes sense in terms of its transmissibility. But they’re worried about overloading health-care systems as the cause of death, not Omicron directly so far:

“The overall risk related to the new variant of concern Omicron remains very high for a number of reasons,” it said, reiterating its first assessment of Nov. 29.

It added there were early signs that vaccinated and previously infected people would not build enough antibodies to ward off an infection from Omicron, resulting in high transmission rates and “severe consequences”. …

The WHO cited some preliminary evidence that the number of people getting reinfected with the virus has increased in South Africa.

While early findings from South Africa suggest that Omicron may be less severe than the Delta variant – currently dominant worldwide – and all cases reported in the Europe region have been mild or asymptomatic, it remained unclear to what extent Omicron may be inherently less dangerous, it said.

“More data are needed to understand the severity profile,” it said. “Even if the severity is potentially lower than for the Delta variant, it is expected that hospitalisations will increase as a result of increasing transmission. More hospitalizations can put a burden on health systems and lead to more deaths.”

This is an issue in terms of “excess deaths” especially. If hospitals get crowded with Omicron cases, that reduces the ability of health-care systems to respond to patients in acute crisis with other health issues. Countries could easily get more deaths in a transmission wave with the potential Omicron has without any deaths at all from the virus, at least theoretically. But even while talking about a massive transmission wave in the UK, only ten people in the entire country have been hospitalized — and “with” it rather than “from” it.

The UK’s leadership seems oddly vague about this, too. Why say “with” if Omicron is the cause? The fact that these statements came in the midst of a booster campaign gives some reason to consider whether these are releases of scientific fact or simply a messaging choice. (It certainly wouldn’t be the first time in this pandemic that politicians decided to offer spin as a way to emphasize their vision of social policy, if not outright “noble lies.”) If the patient did indeed die from an acute Omicron infection, why not just say that and give the details?

For now, it’s still too early to chalk up Omicron as fatal in any case, let alone a general case. Perhaps reporters will put more pressure on Johnson and Javid to cough up the details on this death.