The above Tweet is by Professor Devi Lalita SridharÂ FRSE who is both professor and chair of globalÂ public healthÂ at theÂ University of Edinburgh. Not some random hoaxer or conspiracy theorist on the social media. She is a member of theÂ Scottish Government’s COVID-19 advisory group. From 2008, Sridhar was aÂ postdoctoralÂ fellowÂ atÂ All Souls College, Oxford. In 2011, she was appointed toÂ Wolfson College, OxfordÂ as an Associate Professor inÂ global health politics. She is one of the world’s top public health academics. Let’s unpack what she says.
The different strains of the Covid virus are Darwinian. Survival of the fittest. By its very nature large numbers of new strains are created every day and they all fail. To succeed a new strain must outcompete. For a human pathogen this competition takes two forms. It can be more contagious than the existing dominant strain, reaching more victims. Or it can be better at beating its victims immune system. Either of these happen very, very rarely.Â Omicron is both. By some margin.
We are lucky that we can detect Omicron without genomic sequencing. The existing PCR test throws up an anomaly called a “S-gene dropout” which clearly differentiates between Omicron and the Delta version it is supplanting. Scottish public health officials revisited recent Covid tests and found a cluster of nine people who had caught Omicron at a private gathering. A super spreader event. And none of the nine had any connections with South Africa. So Omicron is already endemic within the community. Tom Wenseleers, an evolutionary biologist at KU-Leuven in Belgium has used the available data to estimate that Omicron can infect 3 to 6 times as many people as Delta, over the same time period. In South Africa Covid cases have just about quadrupled in four days. On Friday, South Africa reported 16,055 new cases, up from 4,373 new cases on Tuesday. Expect similar exponential spread to happen everywhere.
No wonder it is becoming the dominant strain. All public events are now risky. We are all going to be exposed to this virus, no matter how repressive and authoritarian our governments become. Expect measures such as banning crowds from sporting events and lockdown measures that take away our basic rights and freedoms. All of which are proven not to stop the virus, just to slow it down.
Now let’s look at Omicron and our immune systems. We have two main mechanisms against virus infections. Antibodies prevent us catching the disease, T cells make any infection less bad, so we become less ill, keeping us out of hospital and alive. Both forms of protection come from previous exposure, either by having had the disease or being vaccinated. The very bad news from South Africa is that our antibodies aren’t working against Omicron. That it is so mutated that they don’t recognise it. So when we are exposed to it we will get it. And we are all going to be exposed to it.
The good news is that our T cell immunity appears to be holding up. The existing vaccines were engineered to beat the original Wuhan strain. They have provided decreasing antibody protection against successive subsequent strains. That Darwin thing again. But T cell immunity against these strains has persisted.Â So there is no reason to suppose that they don’t work against Omicron, as Devi’s Tweet says.
So it is a no brainer to ensure maximum vaccination. Devi says that this is a priority. Everyone is going to get Omicron. It is so vastly more successful than Delta at spreading and at infecting people that this is inevitable. So it is the vaccine that will stop people becoming seriously ill, keep them out of intensive care, prevent them from dying. Anti vaxxers will be very dangerously exposed. And boosters are essential, the science has proven that they cut the risk of infection by up to 93%. Currently UK Covid vaccine coverage for all ages is 67.6% for dose 1, 61.7% for dose 2, reaching more than 90% in the 65 and over years and more than 80% in the over 50 years. 33.8% of the over 12s have had a third dose.
Which brings us to the NHS. If it reaches capacity and people cannot be properly treated then there will be unnecessary deaths. We have seen this happen with previous surges of Covid in Italy and Spain. Professor Gordon Dougan of the Institute for Therapeutic Immunology and Infectious Disease at the University of Cambridge says that the UKâ€™s high level of immunity provides a â€œcushionâ€ of protection against Omicron. Lockdowns can only slow the disease down (to “save” the NHS), not stop it. If we get a lockdown it will be because of the unvaccinated taking up the NHS capacity. Two doses of the Pfizer/BioNTech or Oxford/AstraZeneca vaccine are 96% and 92% effective against hospitalisation with the Delta variant.
There is now a lot of anecdotal evidence coming from South Africa. Richard Friedland the CEO of Netcare, operating the largest private health business in South Africa says: â€œIf in the second and third wave weâ€™d seen these levels of positivity to tests conducted, we would have seen very significant increases in hospital admissions and weâ€™re not seeing that. In our primary care clinics it is mainly people under 30-years-old.â€ and â€œWe are seeing breakthrough infections of people who have been vaccinated, but the infections weâ€™re seeing are very mild to moderate. So for health care workers who have had boosters, itâ€™s mostly mildâ€.
So what can you do in the face of Omicron? Firstly maximise your vaccine status. It is dangerous for the individual and incredibly inconsiderate of others (especially your friends and family) not to be immunised. Minimise your contacts with large groups. Use the free instant tests to asses Covid status before meeting others, especially the vulnerable. Take vitamin D and zinc picolinate supplements to keep your immune system working properly. And wear a mask. They definitely work. FFP2 masks are the most effective.
Or maybe just get on with life and take it on the chin when you get it.