Omicron New Variant Thread 2 *title edited by MNHQ at OP's request*

[Thewiseoneincognito]

Continuation of the last thread

@herecomesthsun

SA only had about 24% of its population vaccinated, didn't they?

So, a large pool to start with?

And if primarily younger people were infected then

• they have a younger population to start with, so that is to be expected

• the vaccines presumably would have gone to older people first (it would be relevant how this was organised), so they may have had more protection

I wonder what is the local community prevalence of antibodies, if that has been assessed? As that would give some idea of pre-existing immunity from infection and vaccination combined.

They think the Delta wave over the summer in SA pretty much went through the whole population. So although the number vaccinated is comparitively low compared to Europe, levels of immunity and antibodies aren't necessarily as low as you might think.

@BanditoShipman, herecomesthesun explains the higher transmissibility but less virilent paradox and how even if less severe Omicron could still be a massive problem for the NHS.

@Arcadia

Thanks *@RedToothBrush* really helpful and thoughtful post, I've bookmarked it to refer back to.

Seconded. Excellent post.

I agree with you @RedToothBrush about how this is going to become a political hot potato. It feels like there’s too many pages for the majority to ever be on the same one, if that makes any sense.

I Also have a feeling we will soon have a globalised definition of what the term ‘Fully vaccinated’ means if travel is to return as it was before.

I really do not understand how hospital cases can increase if it is a very mild variant.

@Guacamole001

I really do not understand how hospital cases can increase if it is a very mild variant.

Because very mild always means very mild in most people. It's normal with al illnesses for outliers to get it much worse, eg my friends some was hospitalised and briefly in ICU with chicken pox, that's rare, but happens in a percentage of cases. If half the kids got chicken pox at the same time, all those rare cases would be hospitalised at the same time, effecting demand.

It'd the rare serious cases were spread out, less issue. If they, as with contagious Nobel virus happens, they get simultaneously, all the rare serious cases hospitalised around same time.

To add, spreading out the serious cases is pretty much government policy, in a nutshell.

I see. Yes that would explain it.

Looks like the government may approve rollout out of vaccinations to 5 - 11 year olds before Christmas. Apparently its currently being considered.

Finland has just approved it for clinically vulnerable 5 - 11 year olds but have stopped short of going further.

I think I recall seeing that the early data for SA was that children with asthma were more likely to get hospitalised with omicron so I think thats an interesting development.

Not only that but it could be very disruptive. Imagine nhs staff, teachers other workers all going off sick at the same time or in quick succession. Even if it’s mild, it does seem like people need some time off work to recover.

@RedToothBrush I’m interested to know where you estimate our vaccination strategy will be heading over the next 6 months, are we likely to follow Germany and Austria’s path?

Going back to the hot potato, people are going to get restless if after their boosters they’re still under restrictions and yet cases continue to rise.

@chesirecat99

He took three PCR tests on November 20, 21 and 24 - all negative. After returning to Israel he displayed symptoms and took a fourth PCR test (on 27th November) which was positive.

Maybe he caught it London but it isn't an absolute certainty. The average time between infection and onset of symptoms is 5 days but it can range from 1-14 days (with a few cases of longer incubation periods but I think it is something like 97% of cases are within 14 days of exposure). Incubation periods of 3 days or less (ie after he left the UK) are very common.

One of my DC caught delta in a super spreader event (so we can be very sure when he was infected). Everyone who was infected had symptoms within 24-48 hours after exposure.

My husband had symptoms 2.5 days after attending an event where five out of 40 were infected. He hadn’t been anywhere else the days before (because he didn’t want to risk getting COVID and miss the event).

@TheScenicWay

Not only that but it could be very disruptive. Imagine nhs staff, teachers other workers all going off sick at the same time or in quick succession. Even if it’s mild, it does seem like people need some time off work to recover.

The entire A&E department, those running the electricity plant, the entire staff at your local Tesco...

...and the problem is less about you being positive with omicron. Its also that close contacts have to isolate again for 10 days.

For this reason alone I think companies are wise to be cancelling large parties. They don't want a situation where the entire workforce ends up being pinged.

Given the possible R rate on this, it could get very difficult with shortages left, right and centre.

Thats one of the reasons rule of 6 is something I can well see being a thing. Perhaps not to stop the spread which I fear may be near impossible, but more to limit the social groups who get it at the same time. We know that people tend to socialise within certain socio-economic groups or with work colleagues, so this would tend stagger within those groups slightly rather than everyone being out at the same time. But I also fear, its not going to be able to stagger things a great deal because you also have to consider the effects of an outbreak in a school. You tend to find certain schools have higher than average numbers of key worker families...

Thank you to everyone who has taken time to post on these threads. I have nothing new to add, except it's starting to feel very like the late middle ages when they had recurrent waves of "the sweat" covering Europe.

Stay at home and pray you don't get it, basically.

It's the isolation rules that could be a huge stumbling block if everyone gets this
10 days is a long time. Plus if it goes back to the whole household having to isolate , that might also cause problems too
The rules for the vaccinated are currently a bit different regarding staying at home etc. That might alter , who knows?
It's still the unknown, apart from getting boosters, nobody has set out any other ' plans'
as they are waiting on the data it seems.

[quote Thewiseoneincognito]@RedToothBrush I’m interested to know where you estimate our vaccination strategy will be heading over the next 6 months, are we likely to follow Germany and Austria’s path?

Going back to the hot potato, people are going to get restless if after their boosters they’re still under restrictions and yet cases continue to rise.[/quote]
Go read threads on MN about mandatory vaccines.

There is surprising little support for it even amongst highly pro-vaccine supporters in the UK. Which is perhaps surprising given we have high support for vaccines. Freedom of choice is a subject which still ranks higher it seems though.

I don't think we will see a wider rule out on mandatory vaccines beyond social care tbh because of where the political fault lines in the UK line.

That might change depending on what happens, but I actually don't think it'll be regarded as a vote winner.

Young people are less likely to want to be vaccinated so its actually not a good policy for Labour to start throwing its weight around on plus I suspect a few of the powerful unions will be opposed to it.

On the flip side there are a few distinct groups within the Tories who won't like it. The more libertarian wing of the party will HATE it and the more pro-business ones will worry about implications for hiring staff they already can't get or reducing custom. I think the numbers are as such that Johnson might struggle to get it through a vote without support from opposition parties. And if he tries that, he might face a vote of no confidence. The party rebellions have been getting more and more vocal lately and I think it will be taken seriously with mandates one of those subjects most likely to spark a real mutiny.

Which brings us back to Labour likely being lukewarm to the idea.

Then there is the problem with NHS doctors and nurses not wanting to be vaccinated even now. There's been on going rumblings about mandating it for the NHS which have dead ended - largely because the anti-vaxx NHS pretty much have the government over a barrel in terms of how desparately short we already are on healthcare professionals.

The idea of vaccine passports also died a bit of a death in England too for these same reasons.

Once you add into the mix that existing vaccines don't necessarily work for omicron it also almost weakens your hand for mandating vaccines in the UK rather than strengthening it because it sort of undermines public support. Why support a vaccine mandate or passport system that doesn't necessarily protect you anyway? At the expense of your personal freedom?

I also think that we have a fair number of scientific advisors who think that mandates can be counter productive and work against public trust rather than encouraging take up too, so there isn't necessarily pressure from those quarters either.

So no, I would be really surprised to see vaccine passports and mandates in England actually happen. I've been saying that all the way through, though I did have a wobble and wonder if they really would do it despite everything at one point.

The Scottish and Welsh on the other hand...

It's still the unknown, apart from getting boosters, nobody has set out any other ' plans' as they are waiting on the data it seems.

'Other plans' v Omicron might be a rather short list too. Simply because of limitations on effectiveness.

I am confused about the link between this whole thing and the mandate for more vaccines. Seeing as the new variant has spread across the world and most countries are insisting that the people who can travel are fully vaccinated and have covid passports, how then can this be used to encourage mandates as it seemed to have not prevented the spread?
(Sorry if this was covered already. I’ve joined rather late)

Thank you to all on the thread, especially @RedToothBrush @herecomesthsun @idiotfacelicker for explaining the point re mild still equals hospitalisations 🙂

I think the behavioural science advisers must be working round the clock. It is very difficult to balance what should be done with what people will accept, and nudging the public in the best direction must be a real headache atm. As RedToothbrush observes, the last thing we need is civil disorder.

@TheScenicWay

I am confused about the link between this whole thing and the mandate for more vaccines. Seeing as the new variant has spread across the world and most countries are insisting that the people who can travel are fully vaccinated and have covid passports, how then can this be used to encourage mandates as it seemed to have not prevented the spread? (Sorry if this was covered already. I’ve joined rather late)

Indeed. Thats the problem in the uk about making the case for a mandate.

But we have a good uptake on vaccines.

Germany and Austria don't. So Delta poses a big threat to them because of how many older unvaccinated they have and if that doesn't cause enough problems you have Omicron in the background lurking. They have a huge anti-vax movement in both so these proposals are going to cause a huge stink and probably protests and unrest.

I think both are at a really difficult cross roads however you look at this tbh.

The “maybe it’s mild” thing is stopping us (the world) taking the right action at the right time.

We need to stop looking for false comfort in fake news, and act now.

How many times will we let this virus kick out arse before we learn that fast action is vital?

If in two weeks it's not as bad as the mutations make it look as if it could be then - oh no, we'll have brought our cases down and saved some lives.

The longer the government wait to implement NPIs the longer the lockdown that follows generally.

Doesn't anyone else have original covid/alpha/delta deja vu?

I had a trawl on Twitter today. The same accounts who gave us optimism that those variants of covid were nothing much to worry about are still doing it for this one.

I'm opening wine tonight.

Decisions won’t be made based on the mild claim.

@RedToothBrush

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.

1. 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).
2. 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)
3. 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....

Ah, I'm back on the Covid threads, I've been ignoring them for a bit. I remember @RedToothBrush posting sensibly and being accurate with predictions. I also won't be booking a holiday for Feb half term and I am expecting some restrictions from the NY (some kind of lockdown light I think, for economic reasons, as they can't afford to throw only at furlough, grants again).

Will be back to read more when I have time.

Data from SA on reinfections: not encouraging

twitter.com/miamalan/status/1466460836143239179?s=21

@MarshaBradyo

Decisions won’t be made based on the mild claim.

We have a populist government overly concerned with the concept of "behavioural fatigue" they seem to have made up.

So of course it factors in to their decision-making if they think the population isn't worried enough about omicron to comply with restrictions.

But don't worry

We're probably ok until YouGov start asking us if we've finished our Christmas shopping yet and which restrictions we would support being brought back.