COVID19 update 02/12/2021

Photo by Anna Shvets on

Daily reported cases returned to growth on the 1st December after a few days when numbers were tracking downward again.

This might be a temporary bounce back or may suggest that we’ve got a little further to go before we hit the Herd Immunity Threshold (HIT) for under 15s. It’s also possible that the last few days has seen an increased take up of testing as people become concerned about the Omicron Variant.

If Omicron manages – or indeed already has got a foothold then the question of adolescent HIT becomes moot because that immunity had been primarily driven by natural infection. Early data suggests that prior infection is less effective at giving immunity for Omicron.

This means that there are two crucial questions to be alert to. The first is whether or not Omicron experienced as a re-infection will be milder due to repeat exposure or whether it will be experienced as in effect a novel virus. This is distinct from the question of whether the variant is generally milder. I wouldn’t get too excited about premature reports to this effect, it is far too early to say.

The second is vaccine efficacy. This isn’t just about efficacy at reducing transmission but also against serious disease and death. If the vaccines are able to damper transmission even a little whilst retaining a high level of efficacy against hospitalisation and death then we might just get through this stage of the Global Pandemic in one piece. I appreciate that this is a parochial comment from a UK perspective where there is high uptake and availability of vaccines. We need to be alert to the potentially horrific impact that there may well be on countries which haven’t been able to vaccinate at the same levels. There is a real challenge here concerning the ethics of vaccine distribution.

The reason why the vaccine efficacy against admissions and deaths matters can be seen in the data. Whilst cases have remained high, admissions and deaths have been falling.

What this means is that we are not just seeing admissions and deaths fall as a lag measure from reduction in cases. We are seeing that if you do get ill with COVID you are much less likely to end up in hospital.

And you are much less likely to die.

In fact what we are seeing is a situation where due to the vaccination programme an illness that was looking highly fatal amongst older generations is primarily an illness affecting the young where its impact is much milder.

If the vaccine wall of protection holds firm, then we may see quite a substantial increase in cases from an Omicron driven wave without there being too much concern for our health services. At current ratios, even with cases crossing the infamous 100k per day threshold we would still be looking at admissions around the 1.8k per day level, substantially lower than at the peak of the first and second waves.

There are of course still other costs involved in such scenarios including significant disruption to social and economic life. Further, vaccine efficacy still does remain a major unknown. So, we continue to hold our breath and wait.

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