Pandemic “superspreader” event tonight
A well-written piece of analysis in The Times this morning describing how Boris Johnson’s Omicron gamble is facing a critical New Year’s Eve test:
“Viruses like parties. They particularly like parties that climax with drunk people loudly counting down from ten, linking arms with total strangers, and then singing lustily — before quite probably doing other things lustily too”.
And, the newspaper adds, they especially like it when the people at those parties have been unable to get any tests to see if they have the virus.
Whether you think we should have locked down two weeks ago, or whether you think we should be sneezing our way to endemicity, both sides can agree on one thing: tonight in England could well be the superspreader event of the pandemic.
The question, of course, is the same one public health chiefs have been wrestling with since the arrival of Omicron: will we, like South Africa, get away with it?
The Times reporter observes that “we are in the “twixtmas” of 2021, the oddly dead time between Christmas Day and New Year’s. We are also, still, in the twixtmas of Covid — the period between cases rising and hospitals filling. Getting through the next month depends on two numbers pulling in opposite directions: how relatively mild Omicron is, and how many cases there are. It is still not clear which number will win out”.
Omicron is the least severe wave
The South African doctors, it turned out, knew exactly what they were talking about. Just this week, yet another paper was published that yet again confirmed this last wave is also the least severe — on an individual level, at least.
Of the cases recorded in Gauteng province, where the Omicron variant was first spotted, 5 per cent ended up in hospital, compared with 15 per cent for Delta. Of those in hospital, less than a third were deemed to have severe disease, a fifth needed oxygen and the average stay was four days. For Delta, these numbers were twice as bad.
Estimates will change between populations, and as more data comes in. But in the UK, if 50,000 recorded cases a day of Delta has been leading to about 1,000 people in hospital, it seems reasonable to assume that the same number of Omicron cases will cause 500 admissions, or fewer, given the success of the booster programme. Those admissions could also be out of hospital sooner.
Cases are no longer doubling every two days. We don’t know this because of sophisticated disease surveillance. We know it instead for the simple reason that if they were, we would be pushing the limits of what is mathematically possible. Most of the nation would be being infected every day, and the NHS definitely would be in trouble.
But as to the rate at which they are doubling, it’s far less clear. It is an irony that even as our knowledge of Omicron’s severity has firmed up, our knowledge of cases has become hazier. Testing patterns over Christmas change, in part because people don’t want to isolate over Christmas Day.
The Times observes that for much of the pandemic, there was an argument deployed by Covid sceptics that seemed designed to obfuscate rather than enlighten: are people being hospitalised “with” Covid or “for” Covid? Almost always, whenever it mattered, the answer was “for”.
The newspaper admits that now that argument’s time might have come. With soaring infection levels, the probability of someone, say, with a broken leg also testing positive — and becoming a Covid admissions statistic — has never been higher. When analysing hospital admissions data, especially early data, this may prove crucial.
According to the latest NHS England data, there were 1,751 people admitted with Covid on Monday — double that of a week before, but less than half of the peak in January. There were over 10,000 people occupying Covid beds, up 3,000 since before Christmas, but still well short of the 34,000 seen last winter. The number requiring mechanical ventilation has yet to budge.
They still require additional infection control and increase the risk to staff, however. “It is striking how many chief executives are saying that, on current evidence, they think Omicron-related staff absences may be a greater challenge than the number of Omicron-related severely ill patients they have to treat,” he said.
A week before Christmas, Boris Johnson had a choice over Omicron. He could have applied the precautionary principle and, in the face of yet another surging variant, locked down. Or he could have applied the party principle and, in the face of a tired country and a struggling hospitality industry, hoped for the best.
He chose the latter — and, whether he was right or wrong, it would have been perverse to backtrack after Christmas — after allowing the biggest intergenerational mixing event of the year to coincide with the biggest surge in cases of the pandemic.
It was a gamble then, and it remains a calculated one now.
Whether the news of Nightingales being set up in hospital car parks is a sign of resolve or of panic, one thing seems near-certain: if this gamble does pay off, we are unlikely to see lockdown threatened again.
COVID-19 in Madeira: previous daily updates can be found in an earlier post
Travel latest: requirements for entering and leaving Madeira: is kept up-to-date on a previous post
New restrictions: a detailed updated explanation of the latest regulations can be found here