The latest data on the Omicron variant is highlighted in a post on his personal Facebook account by Professor of Health Policy Elias Mosialos of Imperial College and the London School of Economics and Political Science (LSE).
Mosialos recommends calm, proper organisation by reorganising the health system, and not panic.
What is certain is that we have avoided the worst-case scenario of omicron being more infectious and more dangerous. But we have not yet avoided the risk," the professor stresses, explaining the three reasons:
1. Because Omicron will infect many more people than Delta and in a much shorter time (the wave will probably peak in a shorter time, and overall the Omicron wave may last less than Delta)
2. In countries like Greece with unfavourable demographics and many unvaccinated people over 50, even a milder disease than delta, infecting more people, will put pressure on the health system, and probably in a shorter time frame than delta
3. And even more importantly. Probably because many will be infected at the same time, they will need to be isolated for a period of 7-10 days. And this may create glitches in services like education, health, etc.
Mosialos says that with the emergence of omicron, observing the emerging data, I was positioning myself analytically and calmly, as I had done with alpha and delta and delta plus. I had also pointed out (in previous posts) that 4 dimensions will be important, and based on the evolution of these we can work out various scenarios.
What are these 4 dimensions?
1. Is the virus more easily transmitted compared to delta and if so by how much?
2. Does it cause more severe disease or not?
3. Are vaccines still effective?
4. What about the drugs? Will they be effective?
Let's start with infectivity (1). We know that variant is much more contagious and at least 3 times more contagious than delta. But the infectivity is likely to be much higher in the unvaccinated since the data we have is from the whole population.
We also know that antivirals (4) will still be effective, and we wish we had larger amounts already available, but we don't. But it seems that the majority of therapeutic antibodies (6/8) will not be effective. That leaves GSK and a Chinese one in phase III clinical trials.
As for the vaccines (3), which I put more emphasis on and refer to often, it seems that omicron causes more mild infections in vaccinees compared to delta. Nevertheless if vaccinations have been given recently they will be effective in preventing severe infection. This seems to be the case with the AstraZeneca vaccine.
Quite simply, if this were not the case we would not be seeing the favourable results we see in England, where half the population has had the AZ vaccine.
I point this out again because many Greek media have reported that the AZ and J&J vaccines no longer protect us. This may be true for preventing mild infection but not for preventing severe infection.
The only certainty is that the third dose, regardless of what the vaccines of the first 2 doses were, builds on the protection offered by the previous doses, whether AZ, Pfizer, or Moderna, and multiplies it.
But what ultimately happens with the disease? Does omicron cause more severe disease?
From recent studies in England, Scotland, and South Africa, and from the initial analysis of data from the US, Norway, Denmark, and Australia, it appears that those who get omicron are less likely to be hospitalized, compared to those who were sick with the delta variant.
But how do we justify these findings I mentioned? That those who get sick with omicron are less likely to be hospitalized, compared to those who were sick with the delta variant.
1. It is possible that the omicron variant due to mutations has structural changes that eventually infections may cause more mild symptoms.
2. We may be seeing milder symptoms because there is protection in those who contracted previous variants or because they have had the vaccine.
3. The demographics of a population may play a role such as in South Africa where the majority were young and had had coronavirus in the past (and also in young people we don't usually expect severe disease).
4. All these can be true at the same time.
To be absolutely sure, we have to wait and see the analysis, where the evidence of pathology caused in unvaccinated people by omicron, in people with the same characteristics who had contracted delta, has been thoroughly compared.
1. Because omicron will infect many more people than delta and in a much shorter time (the wave will probably peak in a shorter time, and overall the omicron wave may last less than delta)
2. In countries like Greece with unfavourable demographics and many unvaccinated people over 50, even a milder disease than delta infecting more people will put pressure on the health system, and probably in a shorter time than delta.
3. And even more importantly. Probably because many will be infected at the same time, they will need to be isolated for a period of 7-10 days. And this may create dysfunctions in services such as education, health, etc.
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