COVID19 update 28/11/21

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I’ve shared a couple of posts over the past couple of days regarding the Omicron variant. Today I’m returning to my usual update on Data. First, as always here’s the case numbers for the UK.

Cases

As you can see, there was a very small decrease in reported cases on Saturday 27th November after a couple of weeks of rising cases.

This may turn out to be one good day before a return to growth. However, it does fit in the the expected pattern of a cycle of growth before a cycle of case reduction. However, we are now entering a period of uncertainty where all bets are off due to Omicron. It is possible that the new variant will lead to a spike in cases and if it’s already in the country this could happen rapidly depending on vaccine efficacy against it. It’s also equally possible that we will see cases fall as people begin to adapt their behaviour out of caution and concern.

I’m not sure that the return of facemasks in and of itself will affect case numbers. We’ve been seeing cases spiking in other countries where face mask mandates remain in place recently. Indeed one of my concerns at the moment is that people are using Omicron as an argument for introducing the so called “plan B” for the winter. But from what I can tell, such a plan was likely to include facemasks along with vaccine passports. Yet the one thing that matters regarding the new variant is its ability to evade vaccines. If it does, then that will render vaccine passports pretty much useless. So it’s not that plan B measures in and of themselves will reduce cases. Instead it is possible that the tone of public health announcements and policy will lead to people modifying their behaviour and reducing social interaction.

So, watch and see over the next week or two but (and this will become a theme) I would not make projections about what may or may not be happening later into December based on this.

Admissions and mortality

The figures continue to look positive here with both admissions and deaths continuing to fall.

Mechanical Ventilation (ICU)

I expected us to see some increases around about now in admissions based on what has been happening with cases. That we haven’t is positive and reflects further improvements in the ratio of admissions and deaths to cases.

What this suggests is that we are continuing to see the effectiveness of the vaccine at work assisted by the booster jabs. Although cases are relatively high at the moment, this has not led to a surge in hospital admissions because cases are primarily among the young. The vaccine is working at reducing transmission amongst the more at risk population and even when people do get infected they are much more less likely to get seriously ill and have to go to hospital.

This is another reminder that the crucial question that needs to be answered for our context is whether or not the vaccine continues to be effective against the new variant.

What happens next?

Usually at this stage I’d talk about projections for this stage and beyond. However it is very difficult to say too much. I suspect that admissions for the next 10 days and mortality up to Christmas is hard baked in. However, we do not know what case numbers will be like in the next few weeks.

All now depends on what comes back from investigations into what is happening with omicron. There are two key questions here. The first is whether we can get more of a feel for exactly how long it has been in circulation and the extent to which it has already spread. This will give us a feel for how infectious it is. Watching South African case and mortality rates over the next few weeks may give us a helpful feel for what to expect elsewhere. Here’s the current case situation. As you can see, there’s been a small spike in cases recently.

It does look like the spike may have slowed already but that may turn out to be a blip as Omicron takes hold. That’s why we need to keep a close eye on this. However, South Africa has quite low vaccine uptake.

So the crucial question remains as to whether or not vaccine efficacy holds. As I mentioned previously if we see evidence that vaccines are not proving effective against Omicron then the plan B approach to Delta won’t be much use now.

We need a plan A for what happens when a particularly worrying vaccine of concern shows up. Indeed I suspect there has been one in place for some time. That plan will include things like surge testing in areas where the variant shows up, further border restrictions and other measures as needed to buy time. The next part of the plan will depend on whether or not we need to either adapt the vaccines or simply to include substantially more people in the booster campaign. Indeed, it is possible that there will be no need to make changes at all. Just because a variant is concerning does not mean that the threat will be realised as we’ve seen before. However caution is the best course right now.

Risk Assessment and management

I’ve updated my sample risk assessment as follows.

This is taking into account Boris Johnson’s announcement on Saturday 27th November. Whilst churches were not immediately affected by measures, I think the overall tone and the decision to introduce some restrictions suggests we may well expect more to follow and soon. This makes lockdown measures more likely.

I would not make too many changes at the moment. However, have your plan Bs ready. Additionally I would tighten up a little on face masking and requirements for when moving around and in crowded areas.

I would also encourage you to think ahead. We were caught on the hop and had to adapt quickly to the first lockdown. However we have a bit more time now to consider how we might approach a new one. I think the crucial question would be “how do we ensure as much in person contact as possible within any restrictions.” This may include church small group bubbles, outdoor events etc.

Let’s continue to pray that there is positive news to come on Omicron and let’s continue to trust God’s sovereignty whatever happens.

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