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Out of Africa

By Karen Kier, Pharmacist on behalf of the ONU HealthWise team

In 1985, the successful film Out of Africa was released even though it was not well received by critics. The film was loosely based on the 1937 autobiography of Isak Dinesen, which was the pseudonym of Danish writer Karen Blixen. The film starred Meryl Streep and Robert Redford and was directed by Sydney Pollack. The movie won seven Academy Awards including Best Picture and Best Director. The Golden Globe for Best Motion Picture for a Drama was awarded to Out of Africa in 1986. Meryl Streep was nominated for both the Golden Globe and the Academy Award for Best Actress but did not win either award in 1986. Robert Redford was not nominated for either award for Out of Africa. 

Both actors have won numerous accolades for their acting and activism. Meryl Streep has been nominated 32 times for a Golden Globe and has won eight. She has been nominated 21 times for an Academy Award with three wins.  Robert Redford has won two Golden Globes and one Academy Award.  Both actors were awarded the Presidential Medal of Freedom by President Obama. John Barry won an Oscar for the Best Original Score for the music. The American Film Institute has named the film score for Out of Africa has number 15 of all time. The movie was filmed at the Ngong Hills in Nairobi, Kenyon within the African continent. 

Why the discussion about Africa? The omicron variant of SARS-CoV-2 originated out of Africa so some of our best data are being published in professional medical journals from the African experience with omicron. The first study of patient outcomes was published in the Journal of the American Medical Association on (JAMA) December 30, 2021. The South African study compared the four waves of COVID-19 in 49 acute care hospitals. The first wave was the original virus from June to August 2020. The second wave was the beta variant from November 2020 to January 2021. The third wave was the delta variant from May to September 2021. The data was taken from the fourth wave of the omicron variant from November 15 to December 7, 2021. The study reported significantly different results between wave three (delta) and wave four (omicron). The median age of patients had been 59 years for delta and dropped to a median of 36 years with omicron. More females were admitted to the hospital with omicron compared to delta. In addition, healthier patients were more likely to be hospitalized with omicron where less than ¼ of the patients had a comorbidity such as being overweight or having diabetes. So, omicron cases represented younger and healthier patients. The other outcomes indicated that 31.6% of omicron patients were admitted with an acute respiratory cause versus 91.2% with delta. Only 17.6% of omicron patients required oxygen therapy compared to 74% with delta. Admission to the ICU was 18.5% with omicron compared to 29.9% with delta. The length of stay in the hospital was three days shorter for omicron patients than delta. The rate of death was 19.7% in the first wave, 29.1% in the third wave versus 2.7% in the fourth wave.  

At the time that omicron dominated South African cases, approximately 44.3% of the country was vaccinated while more than 50% of the population had a previous variant infection exposure. The study evaluated vaccination status of the patients exposed to omicron and seeking care. The researchers were able to document that 24.2% of those admitted to the hospital had been vaccinated (two doses) against COVID-19 versus 66.4% admitted who were unvaccinated. The New England of Medicine (NEJM) published two studies on December 29, 2021 on the effectiveness of the Pfizer mRNA COVID-19 vaccine in South Africa. The first study researched the effectiveness of the mRNA vaccine in actual patients with only two doses of Pfizer. The outcome evaluated was hospitalization due to COVID-19. The results indicated a 70% protection (range 62-76%) against hospitalization with the omicron variant if vaccinated.  The second study published in NEJM evaluated two doses of Pfizer with a third Pfizer booster dose. The study took serum from patients that had all three doses to determine the ability of the serum to neutralize the omicron variant. The study reported a significant advantage to the booster dose in fighting omicron. The authors did not speculate as to how long this protection would last and when another booster dose may be helpful in the fight against COVID-19. These studies are consistent with some early data on omicron indicating vaccines help and the illness is not quite as severe for most patients compared to the delta variant.  

Feel free to call the ONU HealthWise Pharmacy to get more information on getting vaccinated. ONU HealthWise is offering COVID-19 and flu vaccines Monday through Friday from 4 pm to 6 pm. Call the pharmacy at 419-772-3784 for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna, Pfizer, and Janssen (Johnson & Johnson), as well as flu shots and high-dose flu vaccines for those over the age of 65. Pediatric Pfizer vaccines (5 to 11-years) are available by appointment through the state Vaccine Management Solution (VMS) system.