Thread by @marcdaalder

Overseas, Omicron has upended conventional wisdom about how to respond to the pandemic. It will do the same when it arrives in New Zealand. We must have a new playbook ready before it takes off - and we're running out of time.
newsroom.co.nz/long-read-how-… #nzpol #Covid19 #Covid19nz

Three key things when Omicron gets here:
1. We won't be able to control it like previous variants, only slow it.

2. Even if we slow it down, far more people will be infected than in any previous phase of the pandemic, leading to labour shortages.

3. The health system will still be threatened. Even though Omicron has a lower hospitalisation rate, it will likely infect enough people to send more patients to hospital than in previous outbreaks. Plus, shortages of health workers will reduce capacity.

So, what's the game plan? We're back to mitigation - you might remember it from March 2020 as flattening the curve. The more we can delay and diminish the peak of the outbreak, the less likely the number of people needing hospital care exceeds capacity on any given day.

One of the key strengths of our pandemic response has been the recognition that the Government has a central role to play. With Omicron, it will be easier to individualise the response like other countries have. We should avoid that temptation.

Okay, so how do we actually do all of this? There are four measures that should be at the root of our new strategy:
1. Boosters
2. Better masks
3. Rapid tests
4. New isolation rules

1. Boosters are a no-brainer. Two shots protect against serious illness and death but aren't much use at slowing spread at a population level. The third shot improves protection against negative health outcomes and restores protection against symptomatic infection to 80%+.

Unfortunately, we aren't boosting fast enough. There are 800,000 eligible-but-unboosted NZers. Per my calculations, our national immunity wall is crumbling: The number of people with waning immunity is far higher than those getting boosted. We're losing a war of attrition.

2. Masks are just as important in fighting Omicron as with all the previous variants. We should update guidances and mask mandates to reflect the increasing evidence on the superiority N95s over cloth or surgical masks. They're also variant-proof, unlike vaccines.

3. Omicron will transform the way we test for the virus. PCR capacity won't be sufficient for the testing demand we'll see. Rapid tests are less sensitive but they'll do the job for detecting if someone is infectious. The Govt needs to make them freely available in large numbers.

They'll be used for symptomatic testing, testing of people before they attend large gatherings or high-risk events and testing of contacts and cases. The Government will need to make sure results can be uploaded into national reporting systems and case management databases.

4. Enough people will be infected that the current isolation rules (10 days for vaxxed, 14 for unvaxxed, plus extra isolation time for household contacts *after* the case's isolation period finishes) won't be feasible.

We need to review these rules and likely shorten them. We could also link the end of isolation for cases to a negative rapid test result (which usually indicate someone is no longer infectious).

FINALLY: Maybe, in concert, these four additional measures will slow Omicron and protect the health system. But we have to keep all options on the table in the event the virus still threatens our hospitals. Here's Michael Baker: