These are strange times. Over the last few days, we have seen a massive rise in Covid case numbers in New South Wales, going from 482 last Sunday to 2,213 on Friday. For the same period, the effective reproduction number has gone from 1.37 to 2.12, which tells us that case numbers will now double every four days. This increase in case numbers is partially due to increased social gatherings as we approach Christmas, and potentially the impact of the Omicron variant now spreading in NSW.
The Omicron was only declared a variant of concern by WHO on 26 November, yet it is rapidly infecting people around the world, and now accounts for 20% of all cases in the UK. Initial laboratory data shows that this highly mutated variant is about twice as transmissible as the Delta variant, and more easily evades immunity. Current vaccines appear to give lower protection against being infected with Omicron. However, being fully vaccinated does give you some protection against serious illness and death from Omicron. Importantly, we now know that the mRNA boosters, including Pfizer and half-dose Moderna, give well over 70% protection against symptomatic infection by Omicron.
Because of this, countries like the US and the UK are swiftly rolling out booster shots, allowing people to have one 12 weeks after their second dose. A week ago, we were told that we would have to wait six months from our second dose before we could get a booster. Then Atagi changed that to five months. I can pretty much guarantee that, before long, Atagi will change it to three months – but in the meantime, thousands of people will get infected. Why don’t we ever learn from other countries and follow their lead earlier?
Better news is that Omicron appears to be milder than Delta and even the original Wuhan strain, with lower rates of hospitalisation and death. However, much of the current information about Omicron is in unpublished literature and yet to be confirmed. Even more reason not to take risks with public health measures.
So, you would think that a sensible approach would be putting on the brakes and increasing public health measures. But in this Alice in Wonderland world we live in, the NSW government has just removed most of the public health measures aimed at reducing transmission. It is all fine, according to Brad Hazzard, the NSW health minister: “The real focus should be, and will remain, that we have a health system that can cope.” This has been echoed by the prime minister, Scott Morrison, who wants the focus to shift from case numbers to the number of people becoming seriously ill and requiring hospitalisation.
However, there are a couple of major flaws in this argument. Firstly, as case numbers run into their thousands, we will inevitably see a rise in hospitalisations and deaths. Secondly, everyone seems to have forgotten about long Covid. About a third of Covid survivors are likely to suffer from symptoms three to six months after being infected, including people who have no symptoms from the initial infection. So case numbers are still very important.
Throughout the epidemic, there has always been a fine balance between protecting the public and minimising damage to the economy. Most governments have rightly given public health priority over business. After all, the first priority of any government is to protect its citizens. However, the NSW government has always been reluctant to introduce lockdowns because of their impact on business. But there are many public health measures that we can take that have little or no impact on business – things like wearing face masks in shops, hand sanitisers, and improved ventilation.
A sensible approach from the government would be to at the very least retain these measures, especially now in the face of rapidly rising case numbers, and in the lead-up to Christmas shopping and festivities. These are strange times.