10 2GM Wednesday December 22 2021 | the times
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Sir Jeremy Farrar, director of the Well-
come Trust and a former government
adviser, said yesterday that ministers
were facing the most “difficult and un-
certain” period of the pandemic since
the coronavirus made its first march to-
wards Britain nearly two years ago.
He urged them to wait a day or two
before introducing new regulations.
Transmission of the Omicron vari-
ant is “eye-wateringly high”, he added,
but it is not yet clear what that will
mean for the NHS. The coming days
will provide more data, but what are the
most important questions and when
will we have answers?
how high will cases go?
Some scientists are buoyed by signs
that the rise in infections fuelled by
Omicron may have slowed since the
middle of last week. The rolling average
of new daily cases rose by 9 per cent on
Friday; yesterday it fell by 5 per cent.
Alastair Grant of the University of
East Anglia believes last Wednesday’s
record of 102,875 positive samples now
looks unlikely to have been broken
since. “I think we’ve turned the corner,
unless testing behaviour has changed
radically. I suspect we are seeing a com-
bination of the effects of boosters and
increased caution. The large-scale can-
celling of Christmas parties that the
hospitality industry is reporting will in-
evitably have an effect.”
Some in government are much more
cautious, pointing out that people may
be avoiding tests, either because of
shortages of kits or so as not to have to
isolate during Christmas. The propor-
tion of tests coming back positive is still
very high.
But Professor Paul Hunter, an advis-
er to the World Health Organisation,
said the apparent lack of further explo-
sive growth might have given the gov-
ernment some breathing space. Boris
Johnson’s “wait-and-see” approach is
justified, he said.
Sage documents released last week
had suggested that the epidemic was
doubling every two days, perhaps even
more quickly. That should, by Hunter’s
reckoning, have meant more than
200,000 daily cases on Monday. The
reported figure was 91,743. “So where
have all those cases gone?” he asked.
“It’s possible that something is
changing with the epidemiology of
Omicron — it’s possible that it’s not
growing at the rate that it was.”
are people locking themselves
down?
Boris Johnson is cautiously optimistic
that people are reducing their social
contacts, hoping this will slow the
spread of infection. Certainly, pubs and
restaurants are reporting that business
is down anywhere between 25 per cent
and 70 per cent. Thousands of parties
have been cancelled.
However, Google mobility data sug-
gests far less of a change. Activity at
workplaces is still 22 per cent below the
pre-pandemic peak, basically un-
changed since Johnson announced the
plan B advice to work from home.
Activity at retail and recreation
venues, including pubs and shops, is a
mere 6 per cent below pre-pandemic
levels. This is actually slightly less than
the 9 per cent decline seen when plan B
was announced — probably a
consequence of people doing their
Christmas shopping.ford, said: “We have taken preliminary
steps in producing an updated vaccine
in case it is needed.”how is south africa doing?
South African scientists are increasing-
ly confident that cases have peaked in
Gauteng, the region at the centre of the
country’s Omicron outbreak — only a
month after the first known specimen
of the variant was collected there.
Daily hospital admissions reached a
high of 525 in Gauteng on December 6.
By December 17, they had fallen to 301,
a 35 per cent decrease from the same
day a week earlier. “It looks a very sharp
increase in cases, an early peak and
then — hopefully — a sharp decrease,”
said Dr Waasila Jassat of the National
Institute of Communicable Diseases.
Hospitalisations reached only half
the level that were seen during the
country’s Delta wave, despite a
comparable number of cases, she
added. Omicron deaths appear to have
peaked in Gauteng at 32 on December- The region had frequently been re-
cording more than 200 a day during its
Delta wave.
“Among those who have been admit-
ted to hospital, there’s a lower propor-
tion who are severe, a lower proportion
who need oxygen, a lower proportion
who are treated in ICU... and also a
shorter duration of stay,” Jassat said. We
saw a 24 per cent mortality rate among
those admitted to hospital in the second
and third waves — and 5 per cent mor-
tality in the fourth [Omicron] wave.”
The care given in hospitals had
remained the same for Delta and
Omicron. She also said there had been
no increase in orders for oxygen from
hospitals during the Omicron wave and
very little rise in excess deaths. “So
every measure is showing us a similar
picture,” she added.
The biggest study so far of Omicron
in South Africa found that, adjusting for
various factors, including age, adults
infected with the Omicron variant were
29 per cent less likely to need hospitali-
sation than during the country’s first
wave. The study, by Discovery, a privateClues to solve the
Omicron puzzle
emerging slowly
what will hospitals face?
Professor Mark Woolhouse of Edin-
burgh University said the trajectory of
hospital admissions would probably
give the earliest really useful signal of
what is in store. It takes about ten days
from infection for somebody to become
ill enough to need hospital treatment.
“The worse the wave, the sooner we’ll
have the data, because there’ll be more
data, but we’ll learn more every day.”
Ministers are looking closely at
trends in London, where hospital ad-
missions have doubled in three weeks
and are still climbing. There is some
suggestion that fewer patients are
needing intensive care, with numbers
in ICUs not yet surging. However, it
takes longer for a person to deteriorate
to the point where they need intensive
care, making it a less useful indicator
when decisions are needed quickly.
A further 245 admissions were
reported in London yesterday, and
some scientific advisers believe that the
NHS will be “in trouble” if the number
tops 400 before the end of week. How-
ever, this data may not be available
before early next week.
Reading the figures is also complicat-
ed by the question of how many admis-
sions are due to Covid, as opposed to
patients being treated for other things
but also testing positive. James Ward, a
mathematician, points out that much
of the recent growth is in those who
tested positive a week or more after
arriving in hospital, a sign that they
picked up Covid while on the ward.how effective will the
boosters be?
Omicron blunts the effectiveness of
vaccines but boosters help. Two doses
of AstraZeneca give no real protection
against infection, though they are still
likely to help guard against severe dis-
ease. However, a Pfizer booster jab,
given after a primary course of either
two AstraZeneca or Pfizer shots raised
the level of protection against sympto-
matic infection to about 70 per cent to
75 per cent, according to the UK Health
Security Agency.
The precise numbers will matter. If
Omicron’s immune escape reduces
vaccine effectiveness against hospitali-
sation from, say, 96 per cent to 92 per
cent, that would effectively double the
number of vaccinated individuals who
are not protected from hospitalisation.
But it will take time to work this out,
perhaps several weeks.
Moderna bosses made this point
when they unveiled their booster shot
data this week. It produced a 37-fold
increase in antibodies that were effective
against Omicron, compared with people
who had received only two doses.
Stephen Hoge, the company’s presi-
dent, said the data was “quite reassuring
that we’ll be able to rely on this vaccine
to address the near-term surge of Omi-
cron cases — but ultimately we will de-
pend upon emerging public health data
to confirm that effectiveness in the real
world.” That may take weeks.
Oxford University and AstraZeneca
have begun work on an Omicron-
targeted version of their vaccine. Sandy
Douglas, a research group leader at Ox-The national picture
How many people have Covid-19?
There were 90,629 new cases reported
yesterday, bringing the total so far to
11,542,143 or 172.8 for every 1,000 people
63.1% increase from seven days ago
(based on seven-day moving average)How many are in hospital?
There are 7,801 patients in hospital being
treated. 859 patients are on ventilators. An
additional 847 patients have been
admitted, up 2.2 per cent in the seven days
to December 17 when this data was last
updatedHow many have died?
Yesterday, there were 172 deaths reported,
bringing the total number of deaths in the
past seven days to 808. The rolling
average number of daily deaths is 115.4, up
from 114.4 a day a week agoHow does 2021 compare?
There were 11,930 deaths from all causes
recorded in England and Wales in the week
to December 10, of which the coronavirus
accounted for 6.4 per cent. The number of
weekly deaths was 1,235 higher than the
five-year average for the same time of yearHospital admissions
Seven-day
averageDaily cases
Seven-day
averageDeaths
Seven-day
averageApr Jul Oct Jan Apr Jul Oct05,10,15,2020/21 20,Oct Jan Apr Jul Oct01,2,3,4,Oct Jan Apr Jul Oct020,40,60,80,Oct Jan Apr Jul Oct05001,1,National
R number
1.0 to 1.Five-year averageHow Britain compares
Percentage of population who have
received at least one vaccine dose
(total doses administered in brackets)Daily
(Dec 20)
First dose
39,Boosters
(daily)
897,Second
47.1mSecond
50,Total
29.9mFirst dose
51.5mPeople
vaccinated
in UKSource: Our World in Data (latest figures available) and gov.uk.
Note: Selected countries. Figures as of 6pm yesterdayUAE 99.0% (22.2m)Portugal 89.1% (18.8m)
Malta 84.9% (1m)83.5% (83.5m)
Canada 82.8% (65.4m)
Italy 79.4% (106.3m)
Australia 78.9% (41.4m)Ireland 77.9% (9.1m)
France 77.7% (118m)
UK 75.8% (128.5m)SpainRhys Blakely Science Correspondent
Chris Smyth Whitehall Editor
London restaurants have become a lot emptier, with claims that some have lostNews Coronavirus