Covid-19: beyond Omicron
The writer is an Adjunct Professor of Epidemiology at the University of Nebraska and has worked for the US Centers for Disease Control and Prevention. He can be reached at jasghar@gmail.com
The US and Europe were already riding their fourth wave of coronavirus even before the identification of the Omicron variant. Nearly 50% of all new infections of SARS-COV-2 were occurring in these countries. In the last week of November, the Omicron variant was identified in South Africa and Botswana. In response to this, once again people with zero experience in epidemic controls imposed travel restrictions on mostly African countries knowing well that it’s just a political manoeuvre and will not stop a respiratory virus, which is airborne and has many asymptomatic cases. Within weeks Omicron spread like wildfire and is now being reported in increasing numbers in most countries.
South Africa, where cases surged exponentially due to Omicron, also saw a steep decline of cases after the peak. Only five weeks have passed since the identification of the first case of Omicron so it is very difficult to make a judgment on mortality rates, but all the initial data favours a milder disease. Important questions are that even if milder, will it stay milder? Second important question is that even with mild disease, an increase in the total number of cases by manifolds, how quickly can the hospitals come under pressure? Third, how much protection do we have after vaccination, and how safe are our healthcare workers?
Those who recently got Omicron could tell you that a mild disease is a misnomer. Yes, after vaccination you have better chances of avoiding hospitalisation and death, but the extreme weakness, cough and other symptoms put you on a bed for a week if not more. Let’s not discuss the issue of long Covid here in which symptoms prolong for months. But like Omicron, there could be another variant of concern getting ready to launch another attack and it may have different mutations with different infectiousness and lethality levels. The only way out is a united world using public health strategies including vaccinations to bring down the transmission across the globe in a coordinated way. Unfortunately, this is not happening at this moment.
Omicron is highly infectious, and countries have reported a record number of cases since the start of the pandemic. The US reported close to 600,000 cases in a single day and the daily cases in the UK have reached nearly 200,000. In areas with a high number of cases, healthcare workers are also getting infected. In some regions, 20% of the workforce has been infected and is quarantined, which is putting a strain on the healthcare systems. Pakistan is also witnessing an increase in the number of cases. Although still small with our lack of a representative and reliable disease surveillance system, this only shows some trends. In the next four to six weeks, we may see its peak.
Still, most of the hospitalised Covid-19 patients are unvaccinated. Though vaccination may not provide good protection from a new infection, it can still protect people from a serious illness. Therefore, it is necessary to get a booster dose as soon as possible. Children have been found to be more vulnerable to Omicron. In the US, many schools have closed and moved to virtual classes. To keep schools open, we need to ensure all children are vaccinated and wear masks, and the availability of ventilation in classes.
What will happen after Omicron? With increasing immunity levels (through vaccinations and natural infections), and availability of antiviral medicines, the WHO and the US Centers for Disease Control and Prevention acknowledge that its spread is predominately airborne. Resultantly, appropriate public health interventions will be devised, and eventually, Covid-19 will be at a manageable level in 2022. This requires a complete overhaul of building bylaws of public buildings including hospital constructions and maintenance. Every living place needs to have ventilation or high-quality filtration systems. SARS-COV-2 will be controlled but what about the next respiratory disease on the verge of the next pandemic? We need to come out of this pandemic better prepared for a next one. Our victory will be short-lived if we let this chance slip out of our hands. Public health experts with real-life experiences of epidemic control should lead the way. The battle may be over soon, but the war has just begun!
Published in The Express Tribune, January 5th, 2022.
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