I’m so tired of this but I’ll say it once more:
If #omicron turns out to be as dangerous as it well might and we once again do little to prepare for it with the time we have, then we are compounding the biggest collective political failure I have witnessed in my lifetime.
In Germany right now we have low vaccine uptake and high case numbers, we have full ICUs, overwhelmed labs and overworked health departments.
This is not where we want to be if #Omicron boosts this pandemic…
And for those asking (and for politicians), yesterday’s @ECDC_EU brief includes more than three pages titled “Options for response”:
@ECDC_EU VACCINATIONS
"Until these initial studies for the Omicron VOC are available, the focus should be on reinforcing the vaccination efforts to close immunity gaps in order to protect the population and to ensure equitable coverage across countries and regions in Europe."
@ECDC_EU "Booster doses will increase immunity in the population and sustain transmission control beyond the immediate impact of implementing NPIs, which will be particularly important in light of the emergence of more transmissible variants with potentially reduced vaccine effectiveness"
@ECDC_EU NPIs and HOSPITALS:
"efforts should continue focusing on strengthening healthcare capacity to manage potentially high numbers of COVID-19 patients."
@ECDC_EU CONTACT TRACING:
"Contact tracing can help slow the establishment of the Omicron VOC in the country”
Contact tracing of s#omicron cases "should be prioritised and efforts made to trace and follow up both high-risk and low-risk exposure contacts in a timely manner"
@ECDC_EU "For probable or confirmed cases of SARS-CoV-2 Omicron VOC infection, the enhanced contact tracing measures as set out in the ECDC contact tracing guidance should be considered.”
That includes backward contact tracing and stricter management of contacts
@ECDC_EU TRAVEL
Require a negative test and quarantine passengers from affected areas (probably most of the world soon)
"Proof of vaccination does not exempt from testing and quarantine due to the uncertainty about the effectiveness of the currently available vaccines against this VOC."
NPIs and HOSPITALS:
"efforts should continue focusing on strengthening healthcare capacity to manage potentially high numbers of COVID-19 patients."
CONTACT TRACING:
"Contact tracing can help slow the establishment of the Omicron VOC in the country”
Contact tracing of s#omicron cases "should be prioritised and efforts made to trace and follow up both high-risk and low-risk exposure contacts in a timely manner"
"For probable or confirmed cases of SARS-CoV-2 Omicron VOC infection, the enhanced contact tracing measures as set out in the ECDC contact tracing guidance should be considered.”
That includes backward contact tracing and stricter management of contacts
TRAVEL
Require a negative test and quarantine passengers from affected areas (probably most of the world soon)
"Proof of vaccination does not exempt from testing and quarantine due to the uncertainty about the effectiveness of the currently available vaccines against this VOC."
Bans will probably just buy 2 weeks of time, but:
"Restrictions at this point in time may buy countries valuable time to better understand the characteristics of the Omicron VOC"
Remember though:
given omicron’s speed "it is likely that within the coming weeks the effectiveness of travel-related measures will decrease and countries should prepare for a rapid and measured de-escalation of such measures."
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When @WHO said on Sunday that there was “preliminary evidence” for higher risk of reinfection many people asked what that was based on.
I assume this preprint is the answer:
@WHO Remember that:
This is a preprint, not peer-reviewed yet.
It's based on small numbers and early data that can be biased in many ways.
There are always limitations, like: "Reinfections were not confirmed by sequencing or by requiring a negative test between putative infections."
@WHO The authors basically conclude that re-infections are much more common now than they were before Omicron emerged, which suggests Omicron evades immunity to some extent.
This data only tells us about people who have recovered from an infection not vaccinated individuals.
.@ECDC_EU has updated its risk assessment of #omicron.
It has some interesting bits, even though, as you all know:
“Current evidence on transmissibility, severity, and immune escape is highly uncertain for the Omicron VOC."
@ECDC_EU They did model what it might mean if omicron’s advantage is as big as current data in SA suggests:
"If this is the case, mathematical modelling indicates that the Omicron VOC is expected to cause over half of all SARS-CoV-2 infections in the EU/EEA within the next few months."
@ECDC_EU Of course, all that says is:
That data from South Africa which is hard to parse at the moment looks like #omicron is spreading fast. If that’s the case it will probably spread fast here too…
As always: We will know more when we know more...
If you’re curious how likely #omicron is to have spread from South Africa or Botswana to different places, @DirkBrockmann and colleagues have done some interesting calculations based on the world aviation network from 08/2021
You can see that US seems a very likely destination
@DirkBrockmann That percentage number tells you "how likely an infected passenger from South Africa or Botswana travels to each country and exits the airport there".
So: "0.9% in Germany means that out of 1000 such individuals, 9 are expected to have Germany as their final destination."
@DirkBrockmann There are a ton of caveats, of course.
Most importantly: We don’t know where #omicron actually emerged (it may not have been SA or Botswana at all).
And the variant is in many places now, so of course it can spread from there too.
The next week or so is a really good time to explain to people how virus neutralization assays work, why vaccine-induced immunity is different from natural immunity and why both are more than just antibodies.
We don‘t have answers yet, but we can explain how scientists are trying to get those answers and how to think about those answers when they come.
We keep saying we need to write more about the process of science and less about results. At the moment we have an audience for that.
I have not had nearly as much time as I‘d like to read colleagues‘ work these last two years, but if you’re looking for somewhere to start, @KatherineJWu stands out to me as someone who has written beautifully and clearly about the immune system.
"South Africa and Botswana’s efficient surveillance, early detection, and warning, and sharing of information have granted the world precious time. Time to implement containment measures and time to prepare”, @DrRHatchett just told the special session of the World Health Assembly
@DrRHatchett "Our industry partners are now intensively investigating whether our current vaccines have been compromised and consulting with regulators and @WHO as they develop new ones just in case."
@DrRHatchett@WHO Hatchett also talked about the origins of #omicron:
"the emergence of the Omicron variant has fulfilled, in a precise way, the predictions of the scientists who warned that the elevated transmission of the virus in areas with limited access to vaccine would speed its evolution."
"Aus unterschiedlichen, unabhängigen Modellen zeigt sich, dass bei Impf- und Boosterraten von 1-2 % der Bevölkerung pro Tag die Spitzenwerte der 7-Tages-Inzidenz der aktuellen Welle im Dezember erreicht werden”, schreiben @ViolaPriesemann und andere in einer neuen Stellungnahme.
@ViolaPriesemann "Aus der Prognose der Spitzenwerte folgt, dass die Spitzenbelastung in der Intensivmedizin für Ende Dezember-Mitte Januar erwartet wird. Für diese vulnerable Phase müssen die Krankenhäuser maximale Unterstützung erfahren."
@ViolaPriesemann Die Autoren legen dar, welche Maßnahmen aus ihrer Sicht jetzt in allen Bundesländern nötig sind:
- Impfen
- Homeoffice und 3G am Arbeitsplatz konsequent umsetzen
- Große Veranstaltungen aussetzen oder reduzieren
- 2G+ in Bars, Restaurants etc
- Testen und Lüften in Schulen...