Omicron

When the Omicron variant (now categorised as BA.1) swept across the world at the end of last year it was seen by optimists as the final chapter in the Covid story – it was so contagious it would infect essentially anyone, but would be far less likely to cause serious illness. Now a new wave of Omicron – the BA.2 variant – is becoming dominant in many parts of the world. In the UK, cases are again on the rise. Genomic surveys show that BA.2 made up 76 per cent of new cases in England as of 5 March. The below is from the Sanger Institute: So what's going on? Firstly, both the BA.1 and BA.2 variants do not have an intrinsically much higher growth rate than any previous variant. Instead, they have spread globally for two main reasons.

Given that lockdown was very nearly ordered on the advice of Sage last month, it’s worth keeping an eye on the ‘scenarios’ it published, and how they compare to the situation today. Another week of data offers more food for thought. This week was the period when deaths were supposed to be peaking – so given that no extra restrictions were ordered, it’s interesting to compare the peak the models predicted for this week with what actually happened. Deaths were said by Sage to peak at anything from 600 to 6,000 a day (the latter figure, predictably, hogged the headlines).

Omicron peaked in England in early January, according to figures just released by the ONS. The estimates from the weekly infection survey show that cases in the UK peaked at around four million before falling. In the week ending 15 January, 1 in 20 had Covid in England, Scotland and Northern Ireland, and 1 in 25 in Wales. We shouldn't be surprised by this We shouldn't be surprised by this — this is how Omicron seems to go world over. As in Gauteng, as in South Africa, as in Lambeth, as in London and now in the UK: it falls almost as fast as it rises. Quite simply, the variant is so infectious that it quickly reaches levels of prevalence that are unsustainable because so many people have been vaccinated, infected and become immune.

Boris Johnson latest Covid press conference was slightly confusing. The Prime Minister spent nearly an hour saying nothing particularly new. He warned that there was ‘considerable pressure’ on the NHS at the moment and unveiled daily priority lateral flow testing for 100,000 essential workers so that key services, including healthcare, don’t seize up due to staff absences. But while he accepted that hospitals were feeling the heat, he also insisted that there was no data suggesting that a lockdown was necessary or helpful. Indeed, he argued:  ‘We have a chance to ride out this Omicron wave without shutting down our country once again. We can keep our schools and our businesses open, and we can find a way to live with this virus.

The political and economic new year is all about surging Covid and a surging cost of living. The list of what families in particular will contend with in the coming weeks is enough to induce tears of exasperation. Take schools for starters. Staff absences, largely caused by coronavirus, were 8 per cent at the end of last term. On the Department for Education's own projections, the Omicron surge means these absences will rise to between 9 per cent and 13 per cent at the beginning of this term, and it is not inconceivable the upward path in absences will peak at between 20 per cent and 25 per cent. The Education Secretary, Nadhim Zahawi, is determined schools should remain open.

Public health officials in Britain and South Africa were on different planets for about a fortnight. While those in South Africa kept presenting data suggesting that Omicron caused less severe disease than earlier variants, scientists in Britain continued to claim it was too early to say. Scenarios published by the London School of Hygiene and Tropical Medicine (LSHTM) last week pictured a frightening picture of January, suggesting that hospitalisations could peak above previous waves. An assumption was made that Omicron was just as likely to land you in hospital or kill you compared with Delta. As LSHTM admitted, quite a big assumption:- Due to a lack of data, we assume Omicron has the same severity as Delta.

On Monday, Covid restrictions were rejected after the cabinet debated the issue robustly for the first time since the pandemic started. The Prime Minister said he’d revisit the decision, so the debate is very much still ongoing. But it wasn’t just ministers meeting that day. Sage assembled its experts as well, with over 70 scientists and government officials in attendance. The minutes, seen by The Spectator, give an interesting summary of the official case for more lockdown restrictions. Everyone is wrestling with two questions; if there are no more restrictions, how far will Omicron case numbers rise? And how will that translate into hospitalisations? If there is reason to believe that the NHS will be overwhelmed, this makes the case for more restrictions now.

Monday’s Cabinet meeting held over Zoom was a fraught affair by the sounds of it. Michael Gove and Sajid Javid were reportedly the leading voices calling for more restrictions on household mixing and on the hospitality sector, while the likes of Rishi Sunak and Liz Truss argued that the data did not warrant such a draconian and retrograde step. The Prime Minister seems to have been swaying somewhere in the middle. In the end it was agreed that no new restrictions would be imposed that day but the data would be constantly analysed with a view to imposing restrictions swiftly and before Christmas if alarming trends were picked up on the burden Omicron was placing on the NHS.

Man makes Covid predictions and God laughs. Yet with the stakes this high in Britain, every bit of real-world data is useful. That’s why South Africa is so important: it’s a country with a well-digitised healthcare sector that we have to thank for sequencing the Omicron variant, and has been first to experience the impact. That’s why its figures, released daily, are being watched so eagerly world over. Right now, there are two questions: is Omicron now falling? And if so, what conclusions can we draw? The epicentre is Gauteng province: home to Johannesburg, Pretoria and about a quarter of South Africans.