Some thoughts
That I think shows the messages arent that mixed. It looks to be a very transmissible variant causing high cases because the case graph shows very high growth.
Agree that there isn't that much mixed messages. Its consistent - just different points being picked up which have implications for it being a concern or not.
- High transmission (this bad because large numbers of cases inevitably means large numbers in hospital purely from how many have the disease at the same time).
- Vaccine breakthrough in transmission even in double or triple vaxxed - the positivity rate is not a good sign for a population beleived to largely have some level of immunity. (this was one of the big fears. Atm high levels of immunity are driving down infections in the uk by almost 'containing' outbreaks to a degree. This means the pool of people likely to catch covid is comparatively low and mainly restricted to unvaxxed populations - mainly school outbreaks. This would mark a change as the pool of people getting covid would grow and be much more widespread and uncontained. We are likely to see large outbreaks in settings which have been relatively 'safe' because most people in them have been protected from getting covid by the vaccine. So more outbreaks connected with the workplace, parties, adult social gatherings etc seems likely. And i think the comments from various quarters about thinking about your socialising aren't extreme for this reason at this stage)
- Hospitalisations are going up, but arent going up as steeply as you would expect for the number of cases (this is good, and does suggest a protective effect of vaccinations / a weaker version of the disease but this one needs to be caveted heavily as its still early days on this data point and we need to see if there is a longer lag or that its problematic for older populations).
So that is now where concerns and positives seem to lie.
For the UK I do think we are going to have to look at reintroducing something like the rule of 6 as a realistic possibility early in the new year as well as home working. There will be too much pressure on hospitals and therefore politically to avoid it. Then theres schools and a worse case scenario - if you get Omicron hitting a school its going to go through like wildfire and thats going to spread into the wider community much much more than Delta has. This is going to be a huge challenge. So i think school bubbles are likely to make a return. I don't know how thats going to work for after school clubs of various kinds which have recently restarted though...
It looks likely this is going to hit, fast and hard even if its mild and its likely to start becoming an issue at the end of Jan I suspect.
I still don't think we are going to get a full lockdown but I do think this is going to get really rather nervy and this is going to be a rapidly changing situation.
I still stand by the point that i dont think the government will do a formal change on socialising before the new year for economic reasons. However i think the 3 week review may give advice on older and more vulnerable groups to be more cautious over Christmas with regards to mixing, leaving it up to individual choice (which still fucks a lot of businesses). I think the advice will be to lateral flow test but i also think there will be a growing under current about not fully trusting and completely relying on them because we are already seeing a number of cases where people have being in a tested environment and therefore regarded 'safe' only for an outbreak to occur.
This renders vaccine passports and environments where test requirements are needed less effective. (Implications for strategies in Europe that are currently heavily relying on them being effective). Thats also clearly not good news for hospital or care home settings either if its the case.
To me that really raises questions about how we aren't going to easily stop this one and we are going to struggle to even slow this wave down. I think thats going to be a big political hot potato.
That leaves us only with a reliance on vaccines giving us enough immunity to mitigate these concerns as a viable strategy if restrictions are going to have such limitations this time around.
Now consider where the government is throwing pretty much all its time, resources and planning in terms of strategy for this next wave: Boosters. Strikes me we may be seeing a classic case of look at what government are doing ahead of what they are saying to give the best indicators of what they might happen.
It might well be an early indication of these fears that restrictions used previously might prove to be useless (remember how alpha almost overwhelmed the tier system and they had to go to full on banning of Christmas at the last minute because of how it changed how effective they were). And very real concern over growing public non-compliance which Whitty has voiced.
Some restrictions being brought in, may well be more to appease parts of the population to make the government look like they are taking action rather than because they are ultimately that useful.
Where this falls down is in the economic and indirect health costs so if the penny drops with sections of the Tory party over this, Johnson is going to get a hell of a lot of opposition to reintroducing restrictions. So populism versus effectiveness of restrictions very much a minefield to navigate here. Johnson may be aided only by a public fed up of restrictions though. So I do think theres a very big political tension here which is going to be difficult to navigate: a growing gap between pro-restrictions groups and the NHS itself and an increasing anti-restrictions lobby with several factions: economic groups concerned over jobs and businesses , mental health concerns and the new scientific followers increasingly questioning effectiveness of restrictions against omicron (and how this wave differs from previous). This worries me enormously. The potential for civil unrest is growing.
There is one other wide card I'm going to throw in here and thats over which vaccines have been used in South Africa. I've had a bit of a look at this. Its interesting reading.
Source Wikipedia:
South Africa has accepted delivery of 3 different vaccines, Janssen (Johnson & Johnson), Pfizer-BioNTech and Oxford-AstraZeneca, administering both Janssen and Pfizer-BioNTech, with the Oxford-AstraZeneca vaccine suspended, due to its ineffectiveness against the Beta variant.
On 7 February 2021, the government suspended the planned deployment of around 1 million doses of the vaccine whilst they examined the data and awaited advice on how to proceed. The South African government subsequently cancelled the use of the vaccine, selling its supply to other African countries, and switched its vaccination program to use the Janssen COVID-19 vaccine.
On 27 August 2021, the government announced that they were in the process of procuring the Oxford–AstraZeneca COVID-19 vaccine due to data showing good protection against the Delta variant but were only expecting stock to become available late September/early October.
Remember J&J is one dose only and we know that its not perhaps done as well in the US in the real world in terms of effectiveness compared with Moderna and Pfizer. And we know that 3 doses in the UK of Pfizer/Moderna/AZ is pushing up immunity to highest ever levels. So SA's programme of vaccinations is intrinsically different and might make a significant difference in helping to disrupt transmission.
The other unknown is also therefore over AZ. Studies seem to suggest that AZ followed by Pfizer gave the best TCell response but we know that antibodies do not last as long with AZ. This begs the question of what happens with Omicron and a large percentage of the population AZ / Pfizer mixed boosters. Will it perform better than Pfizer alone? Its an interesting consideration and potential curve ball because its tcell response to omicron which is being talked about a lot and SA doesn't have a high uptake of AZ. So thats another population difference to keep your eyes on (which is somewhat entirely unique to the UK). Not just which vaccine, but also combinations of vaccines and how many doses of vaccine. The term 'fully vaccinated' is one thats rapidly already becoming an international bone of contention over how different countries define it.
We are still in the land of wait and see but I do think there are a few points that are already becoming considerably more concerning than a few days ago as information starts to filter in.
I wont be booking a holiday for February half term though thats for sure. That seems in the realms of being a bit too optimistic right now!
But I think things will look better one way or another come April / May.
But yeah, those positivity rates and the curve of hospitalisations in that context - worrying, but also not into the land of total disaster quite yet. It won't stop the political noise in the meantime....