It is mid December 2021. The Covid-19 responses are as divided as ever, but in new ways:
- In Australia, almost all remaining Covid-19 restrictions are being removed on the same day as record case numbers.
- In Europe, UK and many other locations, restrictions are increasing.
Who has it wrong, and why do I have this feeling of impending doom? Australia is going to provide yet another test case, this time what happens if “you let it rip” with Omicron in highly vaccinated population.
- Setting the scene: What’s happening?
- Omicron: Still Early Days.
- In Australia: It’s over, let the virus in.
- In South Africa: Ready The Hospitals.
- USA: Still Delta, and Medical Fatigue Is Telling.
- In the UK and Europe:
- Doom? Really? In Sydney, It Is Almost Perfect, and Covid-19 Free!
- A Let It Rip Environment, But Hospitalisation Rates Under Control.
- Cases And Projections: Perhaps 12,0000 per day?
- Canary For The World: Could Australia Be the Ones Who Are Correct?
- Why From Zero Covid-19, To “Let It Rip”?
- But, could it work? It will help everyone to find out!
- Conclusions: We will all soon learn if we can live with Omicron.
- Case Numbers Can Be Misleadingly High.
- Less severe outcomes per case: But this is misleading.
- Potential For Increased Numbers of Severe Outcomes.
- Omicron could burn out quickly.
- Omicron is a Bump, But the Pandemic Is Losing Its Bite.
Setting the scene: What’s happening?
Omicron: Early Days, but alarming even if mild.
I was just speaking with someone who felt Omicron was no threat, as so far, only one 1 person in the entire world has died from Omicron. Meanwhile the most recent figures for case numbers from South Africa, December 12th, are just frightening. I do hope that the estimates of lower severity from Omicron cases is not just confirmation bias by those wanting to believe it is less threatening, but I suspect that is reality.
In Australia: Live With Covid-19, Let The Virus In.
Three of seven states/territories of Australia, and the majority of the population, is now enjoying relative freedom as Covid-19 spread prevention measures continue to ease following lockdowns from July through to September. The other 4 states have really only had to deal with border closures to prevent the virus arriving, and have been living the Covid-19 free life style, which unfortunately for them, will end as borders open. Overall, the strategy is “we can now live with Covid-19”. Even in the 4 states/territories where is will become less free once borders open, this is seen as only temporary, and the pandemic is seen as largely over, at least for the vaccinated.
From 15th December 2021, there is almost no restriction remaining for those in Sydney, and even for the unvaccinated, the only restriction is international arrival without quarantine. Despite this, there was still a mass protest just a few days ago, as it seems the outrage continues even when there are no restrictions even on the unvaccinated. The influence industry still thrives. This is the scene, but more on what is happening within the background below.
The state of New South Wales is the epicentre of both “living with Covid-19” and case numbers, cases rose from 400s per days to 1,700s per day as I wrote this.
In South Africa: Ready The Hospitals.
The spike in case numbers of Omicron is alarming, but so far, there is no corresponding spike in hospitalisations or deaths, possibly because it is just 3 weeks since the first recorded cases. Good news is it is to be expected that the neither hospitalisations or deaths will show anything like the spike as case numbers. Since “breakthrough” infections seem to be a large percentage of infections, many cases should be milder. A breakthrough infection suggests level 1 immunity is ineffective, but most often lower layers of immunity still provide protection against serious disease. However, with increased spread not every infection will be a breakthrough and not all breakthroughs are mild, so there will still will be increased demand on hospitals, so South Africa is preparing.
Some states have record hospitalisations. Vaccination rates are low despite many vaccines coming from the US, as you would expect given social media uptake is higher in the US than anywhere else.
(CNN)It has been exactly a year since the first Covid-19 vaccination shots, but rising case numbers and hospitalizations are leading cities and states to introduce new mandates and restrictions.In California, masks will be required in indoor public settings for a month starting Wednesday.New York Gov. Kathy Hochul last week announced a new, temporary indoor mask mandate that went into effect Monday. It requires everyone in the state to wear a mask in all indoor public spaces unless businesses implement a vaccine requirement. It will be in place until at least January 15.Starting January 3, you will need to have proof of being vaccinated to get into a Philadelphia restaurant, theater and other entertainment venues where food or drinks are served.A year after the first vaccinations, coronavirus restrictions are back
In the UK and Europe.
Europe and the UK(70%) are suffering in terms of virus and as a result economically. Germany (70%), the powerhouse economy of the Europe, is threatened by Covid-19, together with the move to electric vehicles. Even wealthy Germany is running out of vaccines.
Denmark(76%), is imposing increased restrictions in the face of record case numbers and is particularly relevant to the situation as Australia previously quoted Denmark as a reference for how a highly vaccinate country can open up. In a population of less than 6 million, Denmark has currently has a 7 day average of 10 deaths per day, which adjuster for population is the equivalent of 30 deaths per day in Australia, and higher than so far ever experienced in Australia as a 7 day average. Yet Denmark is imposing restrictions, and Australia, and NSW in particular, is removing restrictions.
Doom? Really? In Sydney, Life Is Covid-free!
A Let It Rip Environment, Hospitalisation Rates Under Control.
Life in Sydney right now is basically life that can ignore Covid-19. Unlimited crowds without a need of masks, even if unvaccinated. Working from home is even discouraged officially, and of course no masks are required at the workplace.
Even on the day that broke the record for cases for both the state and the nation, there were zero deaths. Does it matter if there are thousands of cases if there are no deaths?
Cases And Projections.
Tracking the cases so far since i started writing this page:
|Day from Dec 2021||Sa11||Su12||Mo13||Tu14||We15|
|Cases Tested and Positive||485||536||804||1,360||1,742|
|Cases Tested and %||91k 0.53%||75k 0.71%||87k 0.96%||105k 1.3%||144k 1.2%|
This is doubling every two days. If the lower, doubling every 3 days is assumed going forward:
|Day from Dec 2021||18||21||24||27||30|
|Predicted Positive Cases if Tests Keep Up||3,000||6,000||12,000||24,000||48,000|
For Actual Data Please See this page. (link to be added)
This would be close to 50,000 cases per day by year end. Of course, in a country where the previous maximum was less that 3,000 it is unlike the testing system can adjust to test and verify this number of positive tests with 2 weeks, so it is unlikely the official figure will reach 50,000. The higher the numbers, the greater the under reporting. Prior to a rethink of testing, around 25,000 cases would be maximum to be reported, as that would represent around 20% or all people tested being positive. If that level is reached, cases are being radically underreported, and that would represent at least 40,000 real cases.
Exponential growth can only ever continue for a limited time period in any finite environment, so while if the growth continued for another 15 days, or 5 more doublings in early 2022 at the 3 day doubling rate, there would in theory be 96,000 192,000, 384,000, 768,000 and finally 1.3 million cases a day, but that is clearly not possible from a population of 8 million, and the question becomes, “when does the doubling end?”.
Even the government is projecting 25,000 cases per day (although well after than number would be reached in practice), as this is around the maximum number possible from current testing. Note, this projection is not for the whole of Australia, but just the state of NSW, with a population of only 8 million.
Consider, even 25,000 cases in 8 million, is 1 case per 320 people. Per day, so 1 in 10 after 32 days. So realistically, this is beyond anything recorded previously as a daily infection rate. The peak recorded in the USA is 1 case per 1100 people, and even the highest recorded cases per million population, Montenegro, has a peak of high case rate country 720 per day.
The UK has just reached a peak of 80,000 per day as a record, and that is less then 1 in every 720 people. Realistically, the maximum NSW could reach as a reported figure would be around around 12,000 per day, and this ceiling could be reached very quickly.
When there are cases numbers reported at that kind of level, it is generally considered cases are being under reported, but this happens everywhere so numbers can still be compared between countries.
It is possible that daily cases in various locations have reached even 1 in 320, or even the 1 in 160 level represented by 50,000 cases in a day in NSW, but if so, with case rates that high, testing systems always become overloaded. Further, the virus would quickly run out of new people to infect.
Even at 12,000 cases per day, and if only 1 in 500 require admission to hospital, this would soon overload the hospital system in NSW, just as a similar rate is projected to overload the UK hospital system. , and the UK with a more ready medical system does not feel it can hand the current case load in the UK.
Can NSW Handle The Cases?
To put it simply, this is into the unknown. The cases will only be handled if something about the situation in NSW results in far less hospitalisations per case than ever seen before, or, even the government health minister’s own numbers way higher than what will happen.
The UK has slightly lower vaccination rates, but then also has a substantially high rate of people with immunity through infection. Yet the UK, despite a history of being less cautious than other countries is increasing restrictions in the face of what is on balance, a similar situation. Yes, Australia in summer , and the UK in winter, but that just makes the festive season in Australia a bigger event, although perhaps with a more outdoors focus.
So the UK is judging that Australia, or more specifically NSW, is, in political terms, being courageous.
Canary For The World: Can Australia Be Right?
Why From Zero Covid-19, To “Let It Rip” in NSW.
As you can see, the figures for NSW from the government data, show almost no cases until Delta breached the tight quarantine on travellers in June 2021. Some combination of the wave passing, lockdowns plus restrictions, and vaccinations tamed cases, hospitalisations and deaths from the Delta outbreak. But during the outbreak, leadership also changed from a “moderate” to a “conservative”, a little more aligned with Donald Trump that the typical politician in Australia.
In a widely read social media post, Mr Perrottet said the rise of Donald Trump was a natural reaction to the political left trying to control political discourse.
“If you stand for free speech, you are not a bigot. If you question man-made climate change, you are not a sceptic,” he said in the post which can be read in full below.
If you support stronger borders, you are not a racist. If you want a plebiscite on same sex marriage, you are not a homophobe. If you love your country, you are not an extremist.
“These are mainstream values that people should be free to articulate without fear of ridicule or persecution by the left.”Dominic Perrottet, NSW State Leader.
This for the first time gives a state leader in Australia closely aligned with National leadership, with a strong belief that there is a trade-off between economic and health outcomes. This belief logically suggests Australia, with one of the best health outcomes of the pandemic, must have so far heavily compromised economic outcomes to a greater extent than most countries, despite Australia performing relatively strongly during the pandemic, as did other other nations with better health outcomes.
The easing of restrictions in NSW was already seeing cases rise before the arrival of Omicron, and despite warnings that the pandemic cannot be handled by vaccines alone, the leadership in NSW believes the previous wave was defeated by vaccines alone, and so can Omicron. The alternatives to opening result in reduction of economic activity, which is unacceptable.
But, could it work? It will help everyone to find out!
In a work, yes. It is possible it could work. Taking the risk to try to find out will provide extremely valuable answers to the rest of the world. On one had, a huge positive is that a very high percentage of those eligible for vaccination are vaccinated, and above the national average for Australia, which is between levels of Denmark and the UK. Against this, the level of 3rd does vaccination is very low, while eligibility for a 3rd does was recently lowered from 6 to 5 months, this is longer than recommended, particularly for a country where most of the earlier vaccinations were Astra Zeneca. Further, while vaccinations levels are high, the lack of addiction numbers of people with immunity from prior infection, together with the lack of 3rd doses during the critical period, means that if opening like this even with Omicron works in NSW, it would work anywhere in Western Europe.
The only way it will work, is if the rapid spread of Omicron works against the virus, by creating a ring of immunity from active and very recently active cases with level 1 immunity.
There will be in any event turmoil within Australia as other states grapple with keeping border to NSW open as case numbers skyrocket.
But, could it work? It will provide an example for the world if the experiment succeeds.
Conclusions: We will all soon learn if we can live with Omicron.
NSW government has stated they will not lockdown no matter what. Mask wearing is already optional with the exception of on public transport, but the plan is for all mask wearing to be optional. Given it takes at least 3 weeks from a spike for hospitalisations to rise, and longer for deaths, NSW will most likely hit the maximum possible official case count per day soon after New Year, so by mid January, if hospitalisations do not start to rise steeply, the NSW will be vindicated and the rest of the world can breathe a sigh of relief.
Of course if they are wrong, and it becomes clear the medical system will not be able to cope, there is a problem. Just as rising hospitalisations lag rising infection number, fall hospitalisations would also only start to result around one month after successful implementing measures to reduce cases. There could be a period where health care becomes very dysfunctional.
The predications are:
1. Case Numbers Can Be Misleadingly High.
With previous strains, many people with a very mild infection would never record a positive test result. With Omicron these same individual may test positive, simply because infecting is that little bit worse. This means infections that previously were undetected, are now detected, and this alone can inflate cases numbers.
Consider 10,000 people all exposed to the virus. With Omicron, a far larger number of people become ‘cases’, perhaps 5x more. This could mean for example, 2,000 cases from the 10,000 exposed, up from 400 cases with the same exposure to previous strain of the virus. This would suggest there would always have been 2,000 people with some degree of infection, as Omicron is no better are spreading through the air, just better as turning a very mild infection into a detectable infection.
2. Less Severe Outcomes Per ‘Case’: But This is Misleading.
This means even if there are more severe cases and deaths per 10,000 people exposed to the virus, with Omicron. If 5x more people become cases, and 3x more people die, then there would be less deaths per case, despite there being 3x more deaths. Lies, dam lies and statistics. The reality is there is no evidence for the virus variant really being less virulent, and the “reduction” is the statistical anomaly from detecting more cases.
So even if Omicron is far more virulent and causes more deaths, which it probably is not, then severe outcomes per ‘case’ will look lower, but sever outcomes in the population will probably not be lower.
Because more people become cases, even if an increased number have severe Covid-19 or die, so the virus is more severe, there will still be data reporting typical cases are less severe.
3. Potential For Increased Numbers With Severe Outcomes.
Omicron results in increased spread. Increased spread means in higher viral loads for initial infection, and higher viral loads are linked to worse outcomes. However, while this will likely mean worse outcomes than will previous strains, as immunity levels in the population rise, the background picture should be a continuation of a reduction in severe outcomes. Omicron will likely slow the decline in severe outcomes, but is very unlikely to reverse the trend.
4. Omicron Could Burn Out Very Quickly.
But it is possible, that Omicron could just burn quickly. Exponential growth is never sustainable within a finite environment. Fast spread, means reaching that same limit faster. The faster the limit is reached, the more people are still fully immune leaving fewer opportunities for more spread. Very good for the NSW government to conduct and experiment for the benefit of humanity.
5. Omicron is a Bump, But the Pandemic Is Losing Its Bite.
Every new wave, the death toll is reduced. Delta created waves as large as any previous wave, but the death toll was generally significantly lower. It is not that Delta was less virulent, and in fact the opposite is understood to be true, but despite this, the death toll was significantly reduced.
Despite all the reasons Omicron should be even more dangerous, I expect the death toll will be even lower again. Instead of the virus evolving to be less virulent, through previous infections, vaccines and treatments, humans are adjusting to be less susceptible.