Last week, I expressed my concern that if the Government’s aim was to prevent a high level of cases driven by the Omicron variant then I wasn’t convinced that the measures announced at the time were likely to affect case rates much. In fact, by delaying some measures I was concerned that this might drive behaviours over the weekend that would exacerbate the coming spike in case numbers. Well, we are now in a position to see what has happened and I’m afraid that things have been pretty much in line with my expectations.
Yesterday’s reported cases were the highest reported in the UK during COVID and 53% higher than the previous Wednesday. The rolling average increased by 7.2%.
Given my view that the measures implemented thus far are unlikely to have much impact on infections, I expect case numbers to continue to keep increasing at a substantial rate for a little while yet. As I’ve mentioned several times so far, the hope is that the booster programme will not only reduce risk of serious disease but will also help to dampen down transmission.
I think there are some encouraging signs regarding the booster programme. Currently 52% of those who were already vaccinated have received a booster which equates to about 36 of the total population or 45% of the adult population (over 18). That’s a promising start and it should mean that those most at risk of hospitalisation and death are about as well protected as possible given that many 50s and most over 60s were already boosted as Omicron broke.
However, although there’s promising data suggesting that the booster also provides 70-75% protection against infection, we need to remember that it takes a couple of weeks for the full benefits of vaccines to begin to work. This means that most under 40s are still not going to be truly benefiting from that protection until the New Year. It will also take longer for the most mobile age groups including students and school pupils to get up to full vaccination status, though the school holidays may help to reduce transmission among under 18s.
It remains my view therefore that the worst of the Omicron wave will already have hit and passed by the beginning of January. In the New Year, it looks like most of us will have built up a level of immunity either through natural infection or vaccine. In other words, any measures introduced in the New Year are likely to be either unnecessary or too late.
So, the question still remains as to what the impact of this variant will be on the thing that particularly matters, hospital admissions and the ability of health services to cope.
I will keep repeating this, but the crucial thing is going to be how case rates affect admission rates. Some people have expressed the hope that the new variant is milder based on early data coming out of South Africa. Chris Whitty was at pains to caution against this in Wednesday’s press conference. If the variant turns out milder then we may have a bit of wiggle room if it reduces admission rates a bit further. However, it seems the jury is still out on this. Whitty’s view is that any appearance of mildness in South Africa is not due to anything intrinsic about the variant but rather that people have built up some immunity. Whilst that will be true here, that immunity has already been present and so may not lead to any gains regarding Omicron.
London is ahead of the rest of England on the curve and it is noticeable that so far, admissions seem to be going up in line with cases there, suggesting that the recent rate of admissions (1.8% of cases) is remaining stable.
On this basis we are likely to be looking at admissions at around 1400-1500 by Christmas Day (these will feed into reports the following week). If cases go over 100,000 then we are looking at admissions climbing to 1800 daily. At around about 150000 cases we would expect to see admissions of 2700 plus. 200,000 cases daily results in the kind of peak figures we saw during the 1st and 2nd wave of 3,500 -4000. Against the context of other winter pressures and the potential for high numbers of NHS staff themselves to be off sick then that’s when things look particularly challenging.
So, in the light of that situation, what should we be doing? Well, it remains my view that the Government’s primary focus should be on
- Ensuring that as many people as possible are boosted as quickly as possible.
- Tightening up contact tracing. I still think that there is too much of a delay between people testing positive and their contacts being notified to stay put.
- Getting NHS surge capacity in place.
Note that the latter may be a little bit more possible if South African Reports that there has been less need for ventilation and mechanical ventilation even among the hospitalised.
What then about our personal responsibilities -and for churches? First of all, I think churches do need to be alert to the potential risks of infection and so I would continue to advise additional precautions. I’d strongly encourage the provision of online and zoom links during this time period. I would also recommend that you encourage people to test with an LFT prior to attending and to use the NHS app to book in to the venue for services.
You may also wish to consider the option of Zoom rather than in person small group events and perhaps to delay things like Christmas parties until the New Year. Carol Services may also be a more attractive prospect to visitors if held outside.
Finally, I want to pick up on something that Andrew Lilico has suggested which is that this time around we do need to focus purely on shielding the vulnerable. I think that with boosters in place and as Andrew suggests, the likelihood that we are going to unavoidably see that, then there is more of a case for this than what amounted to “let it rip” as an option back in 2020. Sometimes setting yourself up too defensively against incoming attack is the riskier option.
However, where I disagree with Andrew is that over the past few days he’s talked a lot on social media about this idea in terms of postponing Christmas with nan until Epiphany. Nan is then shielded from catching COVID and doesn’t end up in A&E with 5000 other people on New Year’s Day.
The problem is this. Nan isn’t the most vulnerable person. Nan and Grandad are in the late 50s/early 60s and have been triple jabbed for some time. It’s Great nan or “mum” to many people in their 40s and 50s who is into her 80s, perhaps living on her own and who has found the last 2 years costly in terms of her emotional health through loneliness and physical health through postponed routine treatment that is in the vulnerable category. For her, it’s not about when an annual festivity takes place that matters but her regular, in person contact with those she loves and who love her.
So, I would suggest a modification to Andrew’s suggestion. I would encourage extra caution remembering that that vaccine isn’t 100% effective. I know that we do not fear death as believers but this is not about fear of death. It’s about recognising that there are other costs in terms of suffering. You just don’t want to be seeing her off in the ambulance on New Year’s Day.
What about this then? If those family members who have also been triple vaccinated for a couple of weeks plan to visit Great nan on Christmas Day. Maybe take her to a church service and have lunch with her, then that enables her to have company and not to be isolated. I would assume that they would also make sure they take a lateral flow test before visiting.
I’m looking at my diary over the next week and my inclination right now based on the advice coming out is not to cancel seeing people but to look carefully at the settings in which we meet up. So for example, my inclination is to avoid the city centre and public transport given the likelihood of overcrowding.