We need a new Covid Strategy...

[Hazelnutbean]

Suppressing Omicron, a disease that seems to be little more than a bad cold for most (having had the protection of vaccines or prior infection) seems to be so transmissible that it will be impossible to contain unless we live a permanent lockdown.

Wouldn't a better strategy be to just accept this and:
a) allow it to pass through low risk groups scrapping isolation, with people just off work if too ill;
b) bring back shielding for the CEV extending to whole households to allow proper protection, fully financially
and practically supported;

The latter would put a dent in workforce numbers, but so is all the isolation that current measures require, but the speed of Omicron transmission would mean that if it was allowed to spread exponentially in low risk groups (most of whom would only need a couple of days off if at all) it max out in a couple of weeks and burn out in a month or so, meaning these measures would only be needed for six weeks or so.

Yes, it's a bit shit for those shielding with their families, but if we carry on as we are, they'll likely have to shield anyway but for longer.

It doesn't burn out.
It mutates into something worse.

The evidence from Omicron suggests it kind of is starting to burn out, I'd say.

I don't necessarily agree with what you propose but I do think that we really haven't even started to adjust to this: we are still trying to keep things 'normal' as they were BC (before Covid). All the restrictions are an attempt to keep us living, working, socialising, travelling etc as we did BC. The 'new normal' we were all talking about last year really isn't it's an ongoing attempt to maintain the "old normal" ways of living.

It might be that this is simply not going to be possible any more. That death rates in vulnerable and older people are going to be higher, overall, from here on in. That the capacity of the health systems has to be increased in the long term. And that we start to accept a 'normal' where people die of Covid in the same way as we accept them dying of cancer, flu, pneumonia etc. or that people are left debilitated in the longer term by it. At the moment we are still fighting that acceptance - but that's going to have to change, and it will: humans are incredibly adaptable.

I'm really confused the replies on this thread.

Most of us are triple vaccinated. Judging by the comments here, we should be living I'm lockdown for the rest of human history or occupy a far away planet.

@Ovupain

Don’t underestimate Long Covid. 1/10 people will get it… Covid is a mass disabling event. I’ve suffered multiple physical and mental symptoms for over a year and I can’t even work currently. I wouldn’t wish this shitty existence on my worst enemy.

I accept Long Covid is real and recognise it must be awful for those who are impacted severely by it. However, 40%+ of the country has had Covid (based in Cambridge Uni researchers - the figure was always going to be higher than official cases) and we're simply not seeing 10% of that number becoming disabled! Sadly we can't reasonably eradicate Covid, and we're all going to get it eventually, so I don't see how restrictions really help with Long Covid in the end.

*in lockdown

I don’t know op but all this control and then it shows us a way around what we’re doing

Tg for vaccines and boosters

Keep going with medical treatment as non medical keeps getting thwarted

@LowPowerMode

I'm really confused the replies on this thread.

Most of us are triple vaccinated. Judging by the comments here, we should be living I'm lockdown for the rest of human history or occupy a far away planet.

Yes. its as though vaccines are pointless. I wonder if those who are arguing like we haven't really moved on from March 2020 are making a great case against vaccination! Their insidious despair fuels anti-vax sentiment.

@Tealightsandd

Some good news before bed.

Elsewhere, new research on Friday showed that a Covid booster shot would offer around 85% protection against severe illness from Omicron.

www.bbc.co.uk/news/health-59707252

Goodnight all.

Can someone who knows about these things explain this to me? Does that mean that someone who has had a booster has a 15% chance of ending up in hospital if they catch it? Because that doesn't feel like good news tbh 😕

@Fallagain

My DH is ECV. Able to fully work from home, no option at the moment any way as his work has closed all UK offices. I’m wondering exactly what fully practical support would look like for us as I would be home schooling a 5 year old, looking after a toddler and running the household. How would you ensure our physical needs (exercise) with no garden, social (no really interaction or a break for me) or medical needs (kid’s hospital appointments and routine dentists) would be meet?

I’m not saying the current plan is working at all but you can’t just lock up massive sections of society permanently.

I wouldn't want to lock anyone up... In my proposal, the CEV and those living with them can go out to parks and playgrounds etc as the risk is always going to be very low indeed with those.

We have a choice. We can either protect the CEV by making the whole of society withdraw from much of life for an extended period, playing whack-a-mole with isolation which, unless we have full lockdown, is still pretty risky for those who are CEV as those who live with them will still be interacting at school, work or socially, or we target it.

Yes, your DS would miss school and interactions, but that would probably happen anyway if things spiral out on control... But if Omicron were allowed to infect those at low risk unimpeded, it would be done and dusted in a month, and you and your family could emerge into a world that would be far less risky for your DH than having to run the gauntlet of school/work that you have at present.

I recognise what I'm proposing is a bit shit for those who are CEV but there is no "non-shit" option... the alternative is also shit and more risky... and is also shit for everyone, causing long term damage to the economy and wider health.

I suspect it’s an 85% better outcome for the fraction of people that would be expected to get serious illness.

I don’t know the stat for that category, but by guess is it’s around 1-2% of symptomatic cases, and I expect that cohort is generally older and vulnerable.

Having said all that, a quick scan of your linked article explains none of that, and you’d think it quite an important point to bring out. That isn’t a good reflection on the BBC’s reporting.

I think we need to build higher capacity into the NHS for a start. I know it's something that isn't easy to do immediately, but we've known about this pandemic for nearly 2 years now, what is being done?

We had nightingale hospitals, but issues staffing them...so is staff the main issue (I appreciate not the only issue, we will need beds, equipment etc too)?

When the big push to get everyone boosted was rolled out I looked into vaccinator positions, there are schemes out there that are training up allied health professionals to become vaccinators. I work in dentistry and have done the online training in a few days and I'm now waiting to hear back. I don't think the scheme is being advertised in any effective sort of way though.
Could we get allied health professionals to vaccinate and keep nurses and GPs treating patients?

What's being done to encourage people to train as nurses, doctors, care assistants etc? Can we raise their rates of pay (particularly those on the lower bands), what can we do to increase staffing levels?

Just some ideas. I'm sure there are lots of issues and I know it isn't as simple as just increasing NHS capacity, but i do think it's a big part of the problem, especially in the long term.

But it’s interesting…

Does anyone know how they worked out the 85% improvement in outcome?

To find out for real, we’d need boosted individuals to have caught Omnicron, and passed through the illness. That means at least two weeks after jab before infection, and then at least another two weeks for the illness or develop (or hopefully not).

It seems unlikely this has happened. (There’s not been enough time.)

So anyone got an idea how the number has been arrived at?

@pupeteer that's a good question. I might ask it in the stats and data thread. See if someone can link to some info on what exactly the 85% means and how they got there.

Another vote for increasing NHS capacity as part of our COVID strategy, or a separate COVID service. Granted we couldn’t hit the ground running, but it’s already been two years and they seem to be planning for a couple more. This is time to train nurses, care workers, vaccinators etc and to progress current nurses with specialist skills and prescribing etc. Maybe they could pay a premium for working in this service.

@Largethighsbadeyes

Can someone who knows about these things explain this to me? Does that mean that someone who has had a booster has a 15% chance of ending up in hospital if they catch it? Because that doesn't feel like good news tbh 😕

No, it means that they have a 85% better chance of staying out of hospital than if they hadn't had the booster.

So if you had a 100 in 100,000 chance before boosting, you have a 15 in 100,000 after.

Omicron is growing at a staggering pace. Current stats suggest that cases would be eight times higher by Christmas Day and, crudely and in theory, sixty four times higher by New Year (NB that you shouldn't apply those multipliers to the current case numbers of eighty-something thousand a day because most of them are still delta numbers which are stable).
That should mean that it could burn itself out extremely quickly and that a very short term "protect the vulnerable, let healthy vaccinated people just get it over with" strategy might be more reasonable than it was in 2020. But a) what about infected hospital staff and care workers who by definition deal with the vulnerable b) Christmas is the one time that we make a point of getting together with elderly relatives. The latter is the driver m behind the "Christmas at Epiphany" proposal to have a bank holiday on 6th January and celebrate it then.

[quote Hazelnutbean]@Largethighsbadeyes

Can someone who knows about these things explain this to me? Does that mean that someone who has had a booster has a 15% chance of ending up in hospital if they catch it? Because that doesn't feel like good news tbh 😕

No, it means that they have a 85% better chance of staying out of hospital than if they hadn't had the booster.

So if you had a 100 in 100,000 chance before boosting, you have a 15 in 100,000 after.[/quote]
Yes, this is how the majority of manufacturers have been reporting their data.

In other words (using the above numbers for example):

You are 6.7 times less likely to be hospitalised.

OR

Your risk of hospitalisation is decreased from 0.1% to 0.015%.

(Just to be clear again, these numbers are using the 100 in 100,000 that the pp gave as an example! They are not the real risk numbers!)

We're in a different place now with vaccines to where we were when this was said back in March 2020. Seriously I'm very pro-vaccine and have been boosted but what's the point if it changes nothing!

@Hazelnutbean

The vaccines have changed everything.

They do the majority of the work.

We would be completely screwed with this variant without them.

But they can't do it on their own.

We also have to control covid with NPIs

Or don't - and have lockdowns instead.

Ok how about nhs staff still isolate if positive. The rest of us only stay home if actually unwell enough to go to work. CEV shield for a few weeks until omicron has infected enough people for the curve to be right back down to where it was a week or two ago.

@Montecristocount your idea in theory is good, but if there are thousands of healthcare staff off at once, then safe care can't be provided. If things get really bad then staff may still have to go in even if positive as it will either be that or hospitals turning away patients. If omicron is truly so transmissible then a) most vulnerable will get it anyway whether that be in the community/hospital or they will already be in hospital because of it. I just don't see any other way around the situation. As pp have said it's hardly ideal, but we simply cannot have so many nhs staff off at one time, particularly when for many of them it will be a mild illness. We cannot justify staff isolating for 10 days when the services are so stretched as it is. Of course if there are enough staff to adequately run services then yes they absolutely should isolate, but if they are all off at once there will be no other option than them go in. It's a very frightening situation

CEV shield for a few weeks until omicron has infected enough people for the curve to be right back down to where it was a week or two ago.

And you know that for sure because? SARS-COV-2 is a new disease (with still much to understand). It's even more unpredictable due to potentially being of lab (rather than natural) origin.

Not that your plan is in any way practical. Or (especially given Long Covid) ethical.

The UK government designated CEV group excludes many of the CV - who include some of the very highest risk of hospitalisation and death conditions. The CV comprise over 50% of the UK population. Diabetes alone is millions of people. Add in their household members - and that's the majority of the population off work or school.

Shielding only the UK government's CEV group won't stop hospitals being overwhelmed. Nor will it stop mass staff sickness.

And, as pp have pointed out, but you keep ignoring. Long Covid disables a significant minority.

'It mutates into something worse. Or it has so far, anyway.''

It hasn't. In fact it is just doing the opposite: mutating into something more transmissible but milder, like most viruses do...

When I read the comments, I wonder why after two years people are still grasping at straws and believe that somehow we can control the virus or that lockdowns make any difference. Just bizarre.

Sadly we can't reasonably eradicate Covid, and we're all going to get it eventually, so I don't see how restrictions really help with Long Covid in the end.

Well that's not true. Obviously we can. We just chose not to. Had we followed Asia Pacific, we would have. We still could. If we really wanted to. I doubt we'll opt for that but of course it's possible.

We can't eliminate a lot of risks - but we generally take mitigations against risk. Hence seat belts, drink drive laws, annual flu jabs, etc. And, in more civic minded countries, routine wearing of masks when sick out of courtesy to others.

Other countries are good examples to look to for basic infection control mitigations. Of course now we probably need a lockdown - because we failed to take the advice of the experts (the people most qualified to suggest best policy). But this time, once it's helped, we should really finally listen to those that know their stuff, at least whilst the risk is still present.

Vaccine Plus. Masks, good ventilation (eg. HEPA filters), vaccine passes. Basically what many other more sensible countries are already doing.

What do the Netherlands have in place?

Even Germany had a delta wave

Omicron is going to be tough no matter what. Light touch stuff won’t do much