Richard North, 16/12/2021  

It occurred to me the other day that, if you take the "dem" out of "pandemic", all you are left with is panic – which is precisely where we are at the moment. Or, as a headline in the Telegraph puts it, "We're almost certainly overreacting to the omicron variant".

It was that feeling which led me to write yesterday's piece, a feeling that the official response has become so grotesquely surreal that the only logical response is mockery.

Yet, we now have something to add to Susan Hopkins, who had the Omicrons starting by doubling up every two to three days but now poised to infect "a million people a day" by the end of December.

To this concoction, we can conjoin Jenny Harries head of the UK Health Security Agency. She calls the Omicrons "probably the most significant threat" since the start of the pandemic, warning MPs to expect a "staggering" growth rate over the coming days.

And still they come rolling in. Amanda Pritchard, chief bureaucrat in charge of NHS England, predicts that the Omicrons could lead to a higher number of Covid patients being hospitalised than at the peak of the pandemic. The seven-day rolling average for daily admissions in England is currently 752, she says, but hospitalisations could exceed the numbers seen last winter. The record high was 3,812 on 9 January.

The ladies may have been spooked by the report that Omicron has overtaken Delta as dominant coronavirus variant in London. But they should be aware that a third of people resident in London are completely unvaccinated, a proportion which is three times as high as the rest of the country.

In fact, so bad is the situation in the capital that the 14 areas with the country's lowest vaccination rates are all London boroughs and, in Westminster, forty percent are without vaccinations, "probably due" to the ethnically diverse population and the level of poverty in parts of London.

There is also the suggestion that the more transient population lacks the personal links to GP surgeries that have helped ensure strong take-up in other parts of the country.

Nevertheless, in every five-year age band, London has the worst vaccination rates. For example, 88 percent of over-90s are vaccinated, compared with 97 percent in the South West.

At the other end of the scale, 34 percent of those aged 12-15 have had a jab in London, rising to 50 percent in the East of England. One of the biggest gaps is among those aged 18-24, where London's rates at 58 percent are 19 points behind the 77 percent seen in the South West.

With that amount of fresh meat in a densely urban cluster presenting itself to an organism which is said to be 70 times more infective than previous strains, it is hardly surprising that there will be an initial surge, with cases increasing at an exponential rates.

However, such rates of increase are never sustained, each distinct outbreak always following the classic bell-shaped curve, the rate of new illness stabilising and then moving into decline.

Furthermore, it is entirely wrong to assume that a more infective organism will exhibit the same levels of virulence as predecessor strains. More likely, in fast-mutating viral pathogens, there will be a correlation between increased infectivity and reduced virulence. Evolutionary pressure favours that combination as the most successful viruses tend to be those which do the least amount of damage to their hosts and thus keep them in circulation.

Already, there is an amount of information which suggests that people infected with Omicron have been a third as likely to end up in hospital compared with those infected with the Delta variant.

And while these results from South Africa are not directly applicable to the epidemiological expectations, they lie within the realm of expected behaviours, where symptoms in London are being equated with the common cold.

Current experience can thus can be treated as a reliable indicator of the profile of the Omicron epidemic taking shape in the UK. But such thinking is clearly not percolating into the minds of the government "top team", including Comrade Whitty who is telling people to scale back their Christmas plans, warning that a big rise in hospital admissions from Omicron is now "nailed on".

This brings us back to the Telegraph piece mentioned above, co-authored by Carl Heneghan - a professor of evidence-based medicine at the University of Oxford – and Tom Jefferson, a senior associate tutor at the University of Oxford.

The pair observe that "competent responses" to new variants can hardly be expected when data are interpreted and acted on at lightning speed, moving on to complain that, even though we are two years into the Covid-19 pandemic, the authorities have not settled on a proportionate method of containing it.

Considering that this same "top team" delivered entirely the wrong initial response to a SARS outbreak, counselling that it should be treated in the same way as pandemic flu – only to have their bacon saved by the unexpectedly rapid development of vaccines – it is hardly surprising that they have learned little from their experience.

Thus – perhaps with more tact that I could muster – Heneghan and Jefferson suggest that we "must ask ourselves whether we are reacting appropriately" – the inference being that we are seeing a repeat of the same structural incompetence that has dogged the entire management of this epidemic.

Given that the onset of winter usually brings with it an increase in respiratory diseases, the pair assert that the latest surge is not surprising. But, they add, what is unexpected is our reaction.

Here, they refer to the South African data, which report fewer patients in intensive care, less severe disease and shorter hospital stays. And they too remark that none of these data seem to be getting through to those in charge of the UK’s response.

Having failed to prepare a proportionate plan to deal with the inevitable surge in Covid and other respiratory pathogens, they say, policymakers are now ignoring real-world data and ploughing ahead with the reintroduction of restrictions. With absolute precision, they also comment that "this tunnel vision is partly due to our 30-year obsession with influenza".

Counter-narrative, Heneghan and Jefferson then go on to say that it is over-simplistic to blame our current problems with capacity and lack of readiness on the appearance of a new variant. We cannot, they say, simply boost our way out of the systemic failings in our thinking.

Their view is that "excessively pessimistic models" distract from the real problem at hand, and the societal disruptions these models cause are exasperating current problems for the nation's health and wellbeing, rather than easing them.

They thus conclude that it is vital that "we now return to basing our responses on good intelligence, clear thought and strong evidence". If we are not careful, they say, "we will find ourselves in a cycle of restrictions based on the predictable rise in respiratory pathogens".

Here, they are far too gentle. With the Oaf at the helm, we have yet to see responses based on "good intelligence, clear thought and strong evidence". Nor, with the present crew at the helm, are we likely to. The "dem" is well and truly out of the pandemic and we are in for a torrid time. But the Omicrons are the least of our problems.

Also published on Turbulent Times.

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