Thread by @Marks1Guy

Compared to the other variants, Omicron is less trophic for the lower respiratory tract and therefore less prone to cause pneumonitis. This probably explains the lower case-fatality and case-ventilation rates. However, the expectation that somehow Omicron variant will

bring an end to the pandemic by harmlessly inducing so-called herd immunity is, IMHO, dangerous magical and wishful thinking, for three reasons. 1. Omicron is causing severe consequences in some people, particularly, those who are vulnerable. With very high case numbers,

even relatively uncommon bad outcomes (death or permanent disability) will occur in large numbers. 2. There is no evidence that natural infection with SARS-CoV-2 leads to sustain protection against re-infection. Hence, protective herd immunity cannot be achieved by

"letting it rip". 3. Variants arise due to massive (uncontrolled) transmission events. This is how each of the previous variants of concern have arisen. The rate of transmission in many countries right now (including Australia) makes it very likely that new variants will arise.

Future variants may be even more transmissible and may be more pathogenic (as was the case with Delta). For all these reasons, we are NOT on a good track towards elimination of COVID-19. It will not be eliminated without concerted and coordinated action. That action needs to

achieve a low rate of transmission (Reff < 1) simultaneously across the entire planet. The good news is that this probably only needs to be sustained for a few weeks to be effective in leading to elimination but it does need to be effective and simultaneous. How can this be done?

Clearly the backbone of the response needs to be effective, equitable and acceptable vaccination: sufficient to achieve high levels of neutralising antibodies in most (> 90%) of the population. Some slippage in either effectiveness (level of neutralising antibodies) or coverage

(eg due to refusal) can probably be accommodated by implementation of additional measures to reduce airborne transmission: universal use of well-fitted N95 masks indoors, effective ventilation and filtration of indoor environments, and TTIQ. This "vaccine plus" strategy is

feasible and can achieve Reff < 1.0. We need international cooperation at the highest level to achieve this, simultaneously, across the planet. This is our only way out. We've tried magical thinking - its not working. We now need to do the hard work. @theunion_tblh @RealOzSAGE

@lenoretaylor @lauratingle @trishgreenhalgh @linseymarr @Don_Milton @mvankerkhove @CrabbBrendan

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