GUEST BLOG: Ian Powell – Responding to omicron

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Associate Professor Siouxsie Wiles knows a lot about viruses. She heads up the bioluminescent (the production and emission of light by a living organism for us mere mortals) superbugs laboratory at Auckland University.

She is a proven standout communicator on coronavirus, in particular, and science, in general, in both the mainstream and social media. Further, Dr Wiles is also often viciously attacked in Cameron Slater’s far right blog. Credentials don’t often get as impressive as this.

One of her regular media outlooks is Newsroom which, on 20 December, published an excellent article from her: .

Dr Wiles discusses the worrying rise of the latest globally threatening Covid-19 variant, omicron. It has also arrived in Aotearoa New Zealand although to date all cases have been caught at the border.

The Gauteng experience

Dr Wiles focusses on omicron’s very high transmissibility noting that cases are rising really fast. She draws upon data analysis by Dr Ridhwaan Suliman (mathematician) in South Africa. Suliman analyses data from Gauteng.

Situated on the Highveld, Gauteng is one of the nine provinces of South Africa. Although the smallest province in that it only comprises 1.5% of the country’s land area Gauteng is a good choice for data analysis.  But, within this relatively small area resides over 25% (nearly 16 million) of the nation’s population, including Johannesburg and Pretoria.

Dr Suliman compares the four main Covid-19 waves (southern seasons) – the first (winter 2020) followed by beta (summer 2020-21), delta (winter 2021), and omicron (summer 2021). Omicron’s transmissibility compared with the earlier waves is astonishing.

Comparing daily infection cases (based on seven day rolling averages) Omicron is presently nearly 10,000 per day. For the same number of days delta was around 8,000 (the first two waves were about half delta’s).

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This rings obvious alarm bells as delta subsequently reached its peak daily case rate of over 10,000. But it is early days for omicron. To the extent that waves are connected for convenience with seasons omicron, has experienced less than half a season in Gauteng.

Suliman’s data records a slight dip (previously it had been just above 10,000) although there was an earlier small dip quickly followed by a bigger rise. Delta’s current daily rate has now fallen to below that of the first two waves for the same length of time.

Further, the effects of vaccination rates have to be factored in when considering the implications for New Zealand. Our vaccination rate for the whole population is 75% (76% in Australia). Compare this with South Africa’s 26%. This does put us in a much better position all other things being equal. But this is different from being in a good position.

Dr Suliman also looks at weekly hospitalisation rates in Gauteng comparing them with the earlier Covid-19 waves. Hospitalisations are seriously on the rise. Currently it is around 3,000 (per capita roughly 1,000 in New Zealand). Delta at its peak was around 6,500 but is now declining.

Allowing for big differences in vaccination rates, Gauteng is consistent with what is happening internationally including across Europe. Even though delta continues to surge in the United Kingdom, it has been swamped by omicron as the dominant strain. Across the Tasman New South Wales has rocked up to over 2,500 cases a day compared with around 500 a week ago.

Omicron a milder variant?

It has been suggested that the effects of omicron are milder than delta although this is now being challenged. One has to be very cautious in drawing firm conclusions. Dr Wiles notes research revealing that omicron was 70 times better than the delta variant at infecting and replicating in bronchial tissues and 10 times worse at infecting and replicating in lung tissue.

Hospitalisations and deaths normally lag cases by several weeks as it takes time for people to get very sick, and sometimes they can be in intensive care for weeks to months before they die. Not enough is known about the effectiveness of vaccines against serious illness and death and what happens to people who aren’t vaccinated who get omicron.

As Dr Wiles points out:  “…even if does turn out that omicron causes a milder illness for most people, that won’t be the case for everyone. And because of the sheer volume of people catching omicron, hospitals are still likely to be overwhelmed. We also don’t yet know whether those who have a mild illness from omicron will go on to develop long covid and be impacted for life.”

Timely advice for New Zealand’s response

Public health specialists at Otago University have published in their online publication Public Health Expert very timely quality advice on how to respond not just to the delta threat but now also omicron: .

The article is written in the context of encouraging progress now being made in reducing the delta threat with significantly decreasing infection rates in Auckland and well contained to small numbers in a small number of other provinces. Increasing vaccination rates have clearly made a big difference. Their focus is on strengthening international border security and a range of public health measures. It is recommended reading.

It is unfortunate that we have just got back to September when Auckland was trending downwards. The decision to lower alert levels from 4 to 3 was too early and contrary to the advice of the Government’s modellers (the Government was let down by wrong Health Ministry advice).

This unwise decision meant more than just a delay of around two months. It also meant a subsequent exponential increase in infections and hospitalisations leading to an avoidable longer overall lockdown.

Aotearoa would be in a much better place now if external experts had not been kept out of the loop and been able to directly and proactively access government. The reality is, like most other areas of health, most of the expertise rests within the health system but outside the Health Ministry. If omicron is to be successfully combatted this expertise should not be allowed to be so disengaged again.

Where we are at

But we are at where we are at. There is a big question mark over whether the combination of loosing restrictions and the festive season will lead to a further delta surge. This is now made worse with the arrival of omicron at our border.

The most critical response is better securing the overseas border from omicron. The Government’s announcement yesterday of delaying the returnees from Australia until the end of February, reducing the time between the second vaccine dose and first booster to four months, and the 5-11 year olds vaccine rollout are good strong steps in the right direction.

This announcement suggests a veering back to the zero tolerance approach which has served New Zealanders so well, at least until October this year.

But it appears that on average we have a case of community transmission after every 200 or so overseas arrivals in managed isolation and quarantine. As hard as it will be the tap of arrivals needs to be significantly slowed down, particularly from high risk countries (there are many), to ensure numbers are safely manageable.

This slowdown would be at least until good progress has been made with vaccinating 5-11 year olds, providing boosters to the already vaccinated, and further improving vaccination rates for those over 12 years (or much more is learned about the effects of omicron).

When asked whether the French Revolution of 1789 was a good idea Chinese revolutionary Mao Zedong is reported as saying that it is too early to tell (actually I think it was his fellow revolutionary  Zhou Enlai).

Regardless of who said it, what is certain is that while it is too early to say what the effects of omicron will be, it will not be very long before we do.

Continuing the zero tolerance approach evidenced yesterday by government, including its scope, will make the difference between success and failure.

Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the professional union representing senior doctors and dentists in New Zealand, for over 30 years, until December 2019. He is now a health systems, labour market, and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published at Otaihanga Second Opinion

26 COMMENTS

  1. The other alternative is to let Covid in. Get infection rates way up and start to build natural immunity. Let Darwin’s theory rule.

    And the reason why is simple. Judging by observations since October, contract tracing is not being done if what I noticed yesterday at a busy mall. I would say about 10% of people scanned the QR codes. Even in the food courts and hospitality areas the need to show the vaccine passport was non existent. I have never had the request to show the passport anywhere as yet. Hospitality included. Sure you had around 95% mask wearing compliance.

    The other reason is that even a hard lockdown will not be physically able to be enforced. Each lockdown the holes in the compliance colander get bigger and more numerous. There is simply not enough enforcement police available neither is the financial or political capital to strictly force compliance to another lockdown.

    So eradication is no longer an option. No matter what the “experts” say.

    Friends in Sydney are celebrating “No Mask Day” and getting on with life. Time we did the same. Let covid run its course.

    https://www.smh.com.au/politics/nsw/nsw-prepares-to-end-mask-wearing-qr-codes-and-jab-certificates-in-certain-settings-20211125-p59c7y.html

    • we can have fewer restrictions with a real enforced mask mandate..but guess which bunch of muppets takes that off the table—-yup you got it, the selfish minority.

      • Idiocy come from lack of comprehension and selective reading to a woke standard.

        read the whole line;

        “So eradication is no longer an option. No matter what the “experts” say.”

        Even our leaders acknowledge eradication (or elimination) in no longer an option

        https://www.stuff.co.nz/national/explained/300422753/why-new-zealands-covid19-elimination-strategy-is-over

        Be interesting to discuss my whole comment in detail instead of a cherry picked single line to suit your narrative.

        I made my comment on observations here in South Auckland.

        Maybe discuss these instead?

        “And the reason why is simple. Judging by observations since October, contract tracing is not being done if what I noticed yesterday at a busy mall. I would say about 10% of people scanned the QR codes. Even in the food courts and hospitality areas the need to show the vaccine passport was non existent. I have never had the request to show the passport anywhere as yet. Hospitality included. Sure you had around 95% mask wearing compliance.

        The other reason is that even a hard lockdown will not be physically able to be enforced. Each lockdown the holes in the compliance colander get bigger and more numerous. There is simply not enough enforcement police available neither is the financial or political capital to strictly force compliance to another lockdown.”

        Have a happy and safe 2022.

  2. Wiles lost any admiration I had when she piled in with the lynch mob going after the seven Auckland University academics who said Maori traditional knowledge did not equate to science.

    • I agree John Roy.

      While I don’t condone the vitriol directed at Dr Wiles, I think her behaviour towards the seven members of the Royal Society was conduct unbecoming.

      Of course that doesn’t mean her analysis and take on omicron is correct

    • I suggest you don’t let yourself get involved in finality and absolutes when deciding on things in this complex age John Roy. It is a junior response in an era requiring constant checking of relevance of our ideas.

      • didn’t realise she’d got into that little bit of fantasy…suppose it just means you can be an expert in one field and a total dickhead in another….doesn’t effect the soundness of her science but does harm her chances of an invite to and party at my place.

    • Yes John, it was a strange position to take for someone that has been adamant that we “follow the science”.
      Myths have their place but they’re metaphorical truths not scientific knowledge of material reality; perhaps little different to the various theories she has been quick to dismiss.
      One of the great, metaphorically true, stories is the Biblical flood, the story of how, when a society (or individual?) becomes corrupted by lies, it ends up drowning in chaos. Wiles and Hendy and all of us would do well to remember that.

  3. Twenty eight cases of Omicron from overseas arrivals as of yesterday. All fully vaxxed, what’s up with that.

    On the bright side the wave of infections in South African looks to have rapidly peaked with few serious consequences.

      • Well yes Brenty but what does it say about the value of being “fully vaxxed” or why we are vilifying the unvaxxed. We’re persecuting people for no good reason, it’s wrong.

        • the unvaxxed have a greater tendency to die and more importantly take up hospital space with their selfish BS, whereas the vaxxed tend toward milder illness….please tell me what makes that so difficult to understand.

  4. You’ve forgotten the golden rule @Ian. Politicians and the bureaucracy equipped with the cult of neoliberal/3rd way ideology and managerialism ALWAYS know best. (It’s in the book, or maybe on Meta somewhere).
    Thankfully growing numbers are beginning to see through the bullshit and PR spin that’s essential to keep it all going.
    Meanwhile those dedicated bureaucrat disciples and neoliberal/3rd way pollies remain oblivious as to why people are losing faith in our various democratic systems and institutions.

  5. I think we have to be very cautious about labelling the new omicron variant as “less dangerous” when all the facts are not known, and information is still being analysed.
    I remember that the first COVID outbreak was hailed by some people as “no worse than the flu…” and that was proven by events to be wrong, and misleading.
    Those that immediately label the omicron variant as such are wishful thinkers, or are calculating just what an impact it will have on the size of their bank balances.
    The government has done the right thing suspending the planned opening of the borders.
    Tourist operators and the National Party will scream that the government has betrayed them and cares nothing for their livelihoods but any responsible government would not do so when a plague is threatening.
    I’m glad we have a responsible government in power now rather than the alternative that would open the borders to anything and everything and to hell with the consequences.

    • “I’m glad we have a responsible government in power now rather than the alternative that would open the borders to anything and everything and to hell with the consequences.”
      As am I.
      Unfortunately I wasn’t aware that the ability to multitask had died and that the plebian class should only ever expect progress on a single issue. (very inspirational and aspirational in this space going forward)

  6. Interesting points in a piece from USA NZ resident visiting family there.
    https://www.rnz.co.nz/news/on-the-inside/458467/going-home-in-the-age-of-omicron
    …I didn’t want to make a return visit to my native California until things returned to “normal,” even though I hadn’t seen my parents for going on two years.
    But in June, I learned that my mother had Stage IV lung cancer. And normal suddenly didn’t seem like anything but a jumble of vowels and consonants..
    My return trip date has already changed twice in the past fortnight due to changing border conditions and I’m hoping it and my MIQ date remain stable for the rest of my time here.
    I can’t blame anybody. It’s all part of the vanished world we took for granted.

    The numbers are stark. My small California mountain county of just under 100,000 people has had 121 deaths, compared to only about 50 for New Zealand’s 5 million people.

    About 63 percent of the eligible population in this area are fully vaccinated, as opposed to about 93 to 95 percent in west Auckland where I live. (American figures include children under 12, who aren’t eligible yet for vaccination in New Zealand.)…
    Like Aotearoa, there are big signs everywhere about masking up when entering businesses and following social distancing.
    The main difference is that far fewer people in America seem willing to follow those rules.
    Between 20 to 50 percent of visitors at stores I have visited are proudly unmasked despite a statewide mandate and the rise of Omicron. I haven’t seen anyone enforcing that mandate at any place I’ve been…

    And the misinformation and conspiracy theory voices are far louder here, bombarding local council meetings yelling and trying to get health officials fired. Entire media organisations are geared at undermining confidence in vaccines and sowing division under the cloak of “freedom,” while their ranting celebrity outrage merchants are quietly mostly vaccinated…

    It’s hard to imagine any immigrant will ever view global travel quite so casually as we did at the end of 2019.

  7. Agree 100% Mike the Lefty.
    The immunosuppressed community who are fully vaccinated at best can expect 75% protection at peak antibody response with a rapid decline by the 4th month to a 40-50% level.
    Omicron has only just started and yet its spread is groundbreaking, especially in countries that have not heeded the advice of medical experts but rather leaders who have taken a political/economic path to “normality”.
    Obviously the death rate has been the ultimate measure during this pandemic but make no mistake the numerous life changing health disorders that can result from long covid can, and will, plague any individual and their loved ones for decades if not for their life.
    Subsequently, global health systems, rich and poor will need to increase their budgets accordingly to maintain any semblance of public health order.
    Our government must stay strong on the border control, follow strictly the advice from the medical science advisors and resist making any “poll driven” decisions.
    NHS England reports a doubling of hospitalisations in London in 2 weeks.
    Thank you for your post IP.

  8. Overall, the only thing we know about omicron etc is that we don’t know about omicron etc.
    So. What can be done with that knowledge?
    I say we keep away from it.
    If you see a thing and you don’t know what it is other than it infects, then is some cases kills and you don’t know what that thing is and you’ve never seen it before, there’s no real cure for it and it’s changing and mutating in unfamiliar ways then you keep the fuck away from it until you do, if you can.
    In AO/NZ’s case, we can.

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