Dr Zoë Hyde Profile picture
Mar 3 9 tweets 3 min read
Today, Western Australia ended the border controls that have kept its people safe for two years. During that time, only 10 people died from COVID-19, making the state’s response one of the world’s best.
Unfortunately, the emergence of the omicron variant finally made Western Australia’s elimination strategy unviable.

Nonetheless, the Government continues to follow a suppression strategy for now. Better vaccines may make this easier in future.
I’m not concerned by the border reopening, because it will now make little difference to the trajectory of the omicron epidemic in Western Australia.

The most important thing was that we bought precious time to get third dose levels up.
What does worry me is the growing narrative that the threat posed by COVID-19 is over.

It is not.

In many ways, this is the beginning of the pandemic in Western Australia, not the end.
We’ve been warned there will be more variants & more waves of COVID-19. This will test any health system & require some degree of restrictions going forward.

This is what living with COVID-19 actually means, and I suspect it will come as a shock to many.
People who wanted a return to 2019 should’ve backed a global elimination strategy while it was still possible.

Not that long ago, about two-thirds of infected people didn’t transmit the virus to anyone. The world’s governments squandered that opportunity.
Perhaps the world will get a second chance at elimination, or at least the opportunity to keep transmission at low levels.

Second generation vaccines are in development, which may better prevent infection and transmission and be more resistant to variants.
But there’s still much that can be done with the tools we have today. Improving indoor air quality with better ventilation and HEPA filtration could put a big dent in transmission and make the buildings in which we live and work safer.

This is a #VaccinesPLUS strategy.
Western Australians must now be prepared for a new, higher baseline of mortality.

Even with our high levels of vaccination, the virus will scythe down the vulnerable - and some completely healthy people too.

Exactly how great the toll will be is up to us.

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More from @DrZoeHyde

Feb 13
Is the pandemic really over? What’s likely to happen over the next 12-18 months? The UK’s Scientific Advisory Group for Emergencies (SAGE) outline four possible scenarios ranging from optimistic to pessimistic.

Here’s what they describe…🧵
gov.uk/government/pub…
In the best case scenario, the vaccines retain their effectiveness against new variants (which do not show increased transmissibility or severity). Antiviral drugs stop people from getting really sick and these drugs remain effective. Only minor seasonal/regional outbreaks occur.
In the central optimistic scenario, waves of infection continue to occur, driven by waning immunity and/or new variants. There will be good & bad years; some variants will cause more severe disease. Immunity protects most people but resistance to antiviral drugs begins to appear.
Read 10 tweets
Feb 7
COVID-19 can cause lasting damage to the cardiovascular system, even in “mild” cases that didn’t require hospitalisation during the acute phase of infection.

A new study shows we’re going to see more heart disease, strokes, blood clots & other problems.🧵
nature.com/articles/s4159…
The authors have a warning for governments letting the virus spread:

“Governments and health systems around the world should be prepared to deal with the likely significant contribution of the COVID-19 pandemic to a rise in the burden of cardiovascular diseases.” (Continued 👇.)
“Because of the chronic nature of these conditions, they will likely have long-lasting consequences for patients and health systems and also have broad implications on economic productivity and life expectancy.”

Apart from lost quality of life, COVID-19 is going to be expensive!
Read 4 tweets
Feb 5
I suspect a single-dose booster won’t be enough against the omicron strain, because it’s changed so much it’s almost like a new virus. One dose wasn’t enough against the original strain, either. Two doses seems more realistic.
Our best bet for bringing the pandemic to a end may be nasal spray vaccines.

Early experiments suggest these may be more resistant to variants and do a much better job of preventing infection and blocking transmission than the current generation of vaccines.
But vaccines alone aren’t going to end the pandemic.

Vaccination is extremely important but we also need to make some changes to the way we live our lives. Hopefully many of these changes can be unobtrusive, such as improving ventilation & using HEPA technology to clean the air.
Read 5 tweets
Jan 25
Western Australian schools will get CO2 monitors and a HEPA air cleaner in every classroom as part of a world-leading reopening plan.

High school students will need to wear masks, as will primary school students if cases rise. 😷
amp.abc.net.au/article/100779…
If a child tests positive, they and their family will need to isolate, as will all of their classmates.

This is a sensible policy that will prevent widespread transmission in the community and therefore help to keep schools open in the long-run.
@MarkMcGowanMP, @CHO_WAHealth, and @sueellery have delivered a good plan, but there’s still room for improvement.

Masks should be encouraged for primary school students, and the Government should consider supplying schools and parents with comfortable, high-quality KF94 masks.
Read 5 tweets
Jan 1
Concerning new UK data show protection against hospitalisation is greatly reduced for the omicron variant. About 6 months after 2 doses, effectiveness is reduced to 52%.

Note this is a combined analysis of all vaccines - some may be higher, some lower.
assets.publishing.service.gov.uk/government/upl…
The good news is that a third vaccine dose brings protection against hospitalisation up to 88% for the omicron variant.

Protection against hospitalisation caused by the delta variant remains at a very high level, for both two and three doses.
A study from South Africa recently estimated that two doses of the Pfizer-BNT vaccine offers 93% protection against hospitalisation caused by the delta variant, and 70% for the omicron variant.
nejm.org/doi/full/10.10…
Read 6 tweets
Dec 30, 2021
The omicron variant is NOT mild.

Hospitalisations are 40-45% less likely than with the delta variant (imperial.ac.uk/mrc-global-inf…), but the delta variant is >2x more severe than the original strain (cmaj.ca/content/193/42…).

The omicron variant is AT LEAST as bad as the 2020 virus.
But the omicron variant is far more transmissible, and our vaccines don’t work as well against it.

This means that an omicron variant epidemic will infect far more people than a delta variant epidemic would.
In practical terms, this means the omicron variant is MORE dangerous than the delta variant.

I modelled what would happen if either of these variants were allowed to spread in Western Australia with only a *double-dose* vaccination level of 90% (i.e., hardly any third doses).
Read 6 tweets

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