COVID-19: SURELY OMICRON'S DISEASE SHOULD BE CALLED COVID-21?

The disease COVID-19 is caused by the virus officially named SARS-COV-2.  The Omicron variant of the virus has a whole host of differences to other variants, but apparently not yet fundamental enough for the virus to be called SARS-COV-3

But we know Omicron behaves very differently from Delta and other variants.  The latest report from the Imperial College London COVID-19 response team, albeit not yet peer-reviewed, is consistent with other studies.  It suggests:

• The proportion of Omicron among all COVID cases was doubling every 2 days up to 11 December
• That implies that the reproduction number (R) of Omicron was above 3 over that period , despite a high level of vaccination.  That is high
  
• Vaccine effectiveness estimate against symptomatic Omicron infection is between 0% and 20% after two doses, and between 55% and 80% after a booster dose.  That’s:
• Vaccines basically ineffective for people only double-vaccinated 
• For those people with a booster, 20% or more exposed to Omicron will become infected.  Boosters well worthwhile at a population level. But as an individual, more than 1 in 5 chance the booster will not be effective in preventing basic infection
  
• The risk of reinfection with the Omicron variant, for someone who has already had COVID-19, is 5.4 times greater than that for the Delta variant.  In the pre-Omicron era, the UK “SIREN” study of COVID infection in healthcare workers estimated that prior infection afforded 85% protection against a second COVID infection over 6 months. The reinfection risk estimated in the current study suggests this protection has fallen to 19% (95%CI: 0-27%) against an Omicron infection.
• This level of immunity evasion means that Omicron poses a major, imminent threat to public health
• The hope has been that Omicron would have lower severity than Delta.  But the study finds no evidence of lower severity, judged by either the proportion of people testing positive who report symptoms, or by the proportion of cases seeking hospital care after infection.
  

IMPLICATIONS FOR GOVERNMENT POLICY

However, hospitalisation data remains very limited at this time, and there is still the hope that vaccine boosters will reduce the level of severe disease requiring hospitalisation.  But it's too early to say. 

On the basis that "Hope for the best, prepare for the worst", the Government should assume the worst, and ignore those MPs saying policy should reflect it could be better.  Because should it be worse. Omicron is spreading so rapidly, it will be too late to prevent catastrophe.

Indeed the ineffectiveness of double-vaccination means evidence of vaccination shouldn't be used to control entry to higher risk venues.  Tests are still being carried out to see if the current Lateral Flow Tests work as well with Omicron as with previous variants.  Some doubts that Omicron can bypass detection, given how Omicron bypasses immunity.

The only credible option is actually an immediate full lockdown.  A 'circuit break' for 3 weeks, not just 10 days, given the lifecycle of the virus.  Plus re-introduction of controls over anyone arriving in the UK from anywhere.

Politically, that is difficult with Christmas and family gatherings a few days away.  But delay could be catastrophic.  A very difficult decision for the four nations of the UK today.

WHAT ABOUT COVID-21?

Omicron is certainly very different from earlier variants, including a much higher risk of reinfection.  Now 2021 is nearly over, shouldn’t we be calling the disease COVID-21 ?

Currently neither PCR (Polymerase Chain Reaction) nor LFT (Lateral Flow Test) testing routinely identifies Omicron infection separately from other variants.  It would be some weeks or months before we get upgraded LFT kits.  But PCR testing should be extended to variant identification asap. Not least so people know if they have been infected by an earlier variant that doesn't provide much protection against Omicron. Then we could, and should, call disease from Omicron as COVID-21.