A really good analogy for an epidemic is a forest fire. It rages out of control until it runs out of fuel. Each tree catching fire spreading it on to other trees. Sometimes one tree will ignite many other trees. And sometimes a tree doesn’t catch fire whilst all around are in flames. Whilst mankind can act to stop the fire by constructing a firebreak.
Omicron is a forest fire with a very stiff breeze behind it. Everything is happening very much faster than with previous variants. It will all be over in a few weeks. And the strength of the breeze means that the fire is jumping previously erected firebreaks, so we are busy trying to construct new ones.
A lot of people are placing reliance on anecdotal evidence from South Africa (which is not science). But South Africa has a completely different kind of forest.
- Much fewer old people than in Europe.
- A vastly higher proportion of young people.
- Less advanced medical and scientific systems.
- Patients typically presenting later with symptoms.
- Far far lower level of immunisation.
- Much lower average BMI. No epidemic of porkers.
- Much lower levels of Vitamin D deficiency.
- Much higher level of socialisation.
- Plenty of HIV around.
Some very ignorant people are saying that Ted Kennedy’s car at Chappaquiddick killed more people than Omicron has. Or that Michael Barrymore’s pool has. Or that Alec Baldwin has. What they don’t understand is that for Covid-19 it takes about three weeks from symptoms to death. And there was very little Omicron around three weeks ago.
For those that are actually interested in the science and who understand it there are three good sources of Omicron facts so far. United Kingdom. Denmark (in English). South Africa. Obviously the facts are continually changing, our forest fire is only just getting into its stride.
So what can we take away from all this (with obvious caveats)?
- AZ vaccine gives very little protection from catching Omicron. Pfizer vaccine about 30% effective. Both still very effective at preventing hospitalisation, serious illness and death (due to T cell action). Immunity restored to 70-80% with booster.
- Omicron kills, but seems to be less dangerous. Perhaps a sixth the percentage so far dying compared to Delta. We will find out.
- On Monday this week 200,000 British people were infected with Omicron. But because of an average one week incubation period the vast majority of these have not yet developed symptoms.
- Omicron is more than four times more contagious than Delta, which was already extremely contagious. This is exponential in a population.
- The number of people with Omicron doubles every two to three days. And will do until the fire starts running out of fuel. And the only ways to achieve this are boosters and social measures. (Masks definitely work).
- By Christmas day in the UK the fire will (mathematically) have infected very approximately 6.5 million people. But this number will be reduced by boosters and social measures working.
- Omicron here will peak in mid January and will be fizzling out by the end of the month. No more trees left to burn. Whereupon Delta will return as the dominant variant. Unless something new turns up.
- Previous infection (with another variant) is not much protection against Omicron.
We can slow this thing down, but we can’t stop it. We are all going to be exposed to it. But it looks very likely (we really don’t yet know) that there will be a smaller percentage seriously ill and hospitalised than with earlier versions. But far, far more people are going to have it at the same time. Tens of millions at the peak. Hospitals are going to be overwhelmed. There are only about 160,000 hospital beds in the UK for all illnesses.
So we can expect organisations; pubs, hospitals, schools, restaurants, shops etc to quite simply run out of staff. There will not be enough able bodied people around to make society function properly.
There is more than a glimmer of light however. The British government have obviously rejected lockdown unless things get really, really bad. Instead they have gone for a strategy of a massive booster jab campaign (coming up to nearly 50% of adults jabbed already) combined with personal responsibility for public health measures. The compulsory measures they have brought in look modest, proportionate and thought out. They will make little or no difference to most people’s lives. The boosters put up a firebreak against the forest fire. The problem is that they take about two weeks to become fully effective. And for Omicron two weeks is a very long time indeed.
Some think that having Omicron will give immunity against other Covid strains. There is no evidence yet of this (obviously) but it will be very nice indeed if it does.
Big Pharma have done an incredible job, risking billions and using the sharpest cutting edge science, to dig humanity out of a hole with its vaccines, which have saved tens of millions of lives. In parallel with this they have also risked more billions developing actual treatments for Covid-19. Antivirals (usually pills) and antibodies (usually injections). These are going through testing, certification, licensing and manufacturing right now. Soon we will be able to properly treat those who are hospitalised and to take most of the pressure off ICUs. Then our health systems can return to normal.
It really looks like short term, with Omicron, we can only slow down the inevitable and also protect ourselves with boosters. Vulnerable people must be shielded. The daily life of the nation will be fraught for a few weeks. But longer term we have Covid-19 under control. We have the knowledge and the technology now to live with this disease, as an endemic pathogen like ‘Flu.
In this ex vivo study (press release), Michael Chan, Malik Peiris & John Nicholls et al.
show that at 24h after infection Omicron replicated ~70x faster than Delta in bronchus.
Another analysis also supports these findings. In this lab study w/ pseudoviruses, Omicron showed greater ability to infect cells than other variants, which was ~ 4 times more infectious than the original strain, also more than Delta.