By DR AMIR KHAN | AL JAZEERA

■  Even if Omi­cron is milder than Delta, high trans­mis­si­bil­i­ty means three times more cas­es, hence more hos­pi­tal­i­sa­tions and deaths

■  If the pub­lic hold on­to this ‘milder’ nar­ra­tive, there is a risk that some peo­ple may be­come com­pla­cent … This will then re­sult in fur­ther cas­es and even­tu­al­ly an in­crease in hos­pi­tal­i­sa­tions and deaths

(AL JAZEERA) — Glob­al­ly, Omi­cron is be­com­ing the most frus­trat­ing good news/bad news sto­ry of the mo­ment. As we learn more about the coro­n­avirus vari­ant, the in­for­ma­tion and the risk it pos­es keeps chang­ing. That is to be ex­pect­ed with any nov­el dis­ease of course, but it is enough to put any­one’s head in a spin.

First, the good news… An Im­pe­r­i­al Col­lege Lon­don study has backed up what South African clin­i­cians have been say­ing since they broke the news in No­vem­ber, that there is much less like­li­hood of be­ing hos­pi­talised with an Omi­cron in­fec­tion than from Delta.

The study looked at 325,000 peo­ple who test­ed pos­i­tive for COVID-19 via a PCR test in Eng­land be­tween De­cem­ber 1 and 14—56,000 cas­es of Omi­cron and 269,000 cas­es of Delta. It found that the risk of need­ing any hos­pi­tal treat­ment was down by 20-25 per­cent with Omi­cron com­pared with Delta, but the need for an overnight hos­pi­tal stay was down by 40-45 per­cent. For those in­clud­ed in the study who had not had the vac­cine or pre­vi­ous in­fec­tion, the risk of hos­pi­tal­i­sa­tion was about 11 per­cent low­er for Omi­cron ver­sus Delta.

The study showed that two dos­es of the vac­cine were not enough to pro­vide any se­ri­ous lev­el of pro­tec­tion and that boost­ers are the safest and best way to pro­tect against se­ri­ous ill­ness from Omi­cron and Delta. It al­so found that hav­ing had a pre­vi­ous COVID-19 in­fec­tion re­duced the risk of hos­pi­tal­i­sa­tion from Omi­cron by about half. Still, I would ex­er­cise cau­tion when re­ly­ing on nat­ur­al im­mu­ni­ty to pro­tect against COVID-19 as this in­volves get­ting in­fect­ed with a high­ly un­pre­dictable virus that risks not on­ly se­ri­ous ill­ness and death but al­so Long COVID; it is much safer to opt for the vac­cines.

Pro­fes­sor Neil Fer­gu­son, who led the study, said it was good news but still warned about the sheer num­ber of in­fec­tions from Omi­cron lead­ing to more hos­pi­tal ad­mis­sions in the long run.

An­oth­er study from South Africa al­so sug­gest­ed Omi­cron re­sults in few­er hos­pi­tal­i­sa­tions. The study led by the Na­tion­al In­sti­tute for Com­mu­ni­ca­ble Dis­eases (NICD), fol­lowed more than 160,000 peo­ple who test­ed pos­i­tive for COVID-19 be­tween Oc­to­ber 1 and De­cem­ber 6, and found that those in­fect­ed with Omi­cron were 80 per­cent less like­ly to end up in hos­pi­tal when com­pared with oth­er vari­ants. The au­thors of this study, which is yet to be peer-re­viewed, have said it is dif­fi­cult to know how much this is due to Omi­cron be­ing more “mild” or how much is due to im­mu­ni­ty lev­els in the South African pop­u­la­tion from pre­vi­ous in­fec­tions and vac­ci­na­tions.

Mean­while, an Ed­in­burgh study used na­tion­al sur­veil­lance da­ta to com­pare Omi­cron and Delta in­fec­tions from No­vem­ber 23—when Omi­cron was first de­tect­ed—to De­cem­ber 19. The study on­ly in­volved a small num­ber of cas­es, and has yet to be peer-re­viewed, but found a 65 per­cent low­er risk of hos­pi­tal ad­mis­sion when com­pared with Delta. Jim Mc­Me­namin, the na­tion­al COVID-19 in­ci­dent di­rec­tor at Pub­lic Health Scot­land, de­scribed the find­ings as a “qual­i­fied good news sto­ry”.

Good news this may all be, but it is prob­a­bly not yet time to rest on our lau­rels.

Which brings us to the bad news… Omi­cron cas­es have been ris­ing across the world, far faster than ini­tial­ly thought. The Unit­ed States and the Unit­ed King­dom are re­port­ing record dai­ly cas­es, with cities like Lon­don and New York worst af­fect­ed.

Even ac­count­ing for 40-50 per­cent less sever­i­ty and hos­pi­tal ad­mis­sions, if there are three times more cas­es, that will re­sult in more hos­pi­tal­i­sa­tions and deaths than what we saw with Delta.

But it is not just about hos­pi­tal­i­sa­tions and deaths. When peo­ple test pos­i­tive for COVID-19 they must then iso­late. With Omi­cron be­ing so trans­mis­si­ble, num­bers of pos­i­tive cas­es are ris­ing steeply, re­sult­ing in more and more peo­ple be­ing off work. This will in­evitably start to af­fect front line ser­vices: trans­port, the po­lice force, fire ser­vices and health­care.

When this starts to hap­pen, these vi­tal ser­vices be­come un­vi­able, and can­cel­la­tions start to hap­pen. Per­haps we can tol­er­ate trains be­ing can­celled—it is an in­con­ve­nience but not life-threat­en­ing—but when hos­pi­tal pro­ce­dures have to be can­celled due to a lack of staff, then lives be­gin to be put at risk. Many health­care sys­tems around the world are just be­gin­ning to ease the back­log of pro­ce­dures caused by the ini­tial phas­es of the pan­dem­ic when medics were most­ly fo­cused on COVID-19 pa­tients. Now we hear about peo­ple hav­ing to wait hours for an am­bu­lance due to crew short­ages, can­cer treat­ments risk­ing fur­ther de­lays, and sur­gi­cal op­er­a­tions risk­ing can­cel­la­tion yet again. Omi­cron may be milder, but it pos­es an equal­ly lethal threat to health­care sys­tems as any pre­vi­ous vari­ants be­fore it.

The oth­er dan­ger is if the pub­lic holds on­to this “milder” nar­ra­tive, there is a risk that some peo­ple may be­come com­pla­cent about reg­u­lar lat­er­al flow test­ing, mask-wear­ing and ven­ti­lat­ing in­door spaces. It may even lead to few­er peo­ple tak­ing up the boost­er vac­cines. This will then re­sult in fur­ther cas­es and even­tu­al­ly an in­crease in hos­pi­tal­i­sa­tions and deaths.

Gov­ern­ments across the world have re­act­ed dif­fer­ent­ly to the emer­gence and spread of Omi­cron. Coun­tries like the Nether­lands have adopt­ed a firm lock­down ap­proach where­as the US and UK have very lax mea­sures in place. His­to­ry has shown us the quick­er we act the bet­ter the out­come when it comes to putting re­stric­tions in place. Re­ly­ing on the “milder” nar­ra­tive may well come back to haunt some of our world lead­ers who most like­ly have their eyes closed and their fin­gers crossed, hop­ing that the surge in cas­es will not trans­late in­to hos­pi­tal ad­mis­sions.