Why Omicron may overwhelm the NHS

What we know from the imperfect data we have is that Omicron is vastly more infectious but less virulent than the Delta variant. If the UK Health Security Agency is right in its modelling estimate that as of last Sunday, there were already 200,000 cases of Omicron in the country, compared to 60,000 confirmed and 40,000 suspected cases, we cannot exclude a mass pandemic of Omicron infections in the new year. At this rate, even a much milder virus would still overwhelm our hospital capacities.

A study by Discovery Health, a South African private health insurance administrator, based on 211,000 positive test results, showed that the hospitalisation rate of Omicron is 30 per cent less than the previous variants. Just to get an order of magnitude for these numbers: if we round the Delta variant hospitalisation rate to 2 per cent, then a reduction by one third would translate to a hospitalisation rate of around 1.3 per cent. If infections double, that’s still more hospitalisations in absolute numbers for Omicron compared to Delta.

The study also showed that two shots of the Pfizer/BioNTech vaccine offered a 70 per cent protection against hospitalisation. For a vaccine, this is still a high degree of protection, but European hospitals could still be overwhelmed if millions get infected.

We should be careful with the data from South Africa. Stephane Bancel, the CEO of Moderna, said South Africa may not be a good predictor of the variant’s virulence in other parts of the world because the country has a much younger and healthier population than European nations and the US. It’s also worth noting that Bancel, in his public pronouncement, was much more cautious than the more bullish people from Pfizer/BioNTech. The South African study also showed that the Pfizer vaccine only offers around 30 per cent protection against infection.

The South African data is interesting, but not directly applicable to the situation in Europe. There is a much broader spread of vaccines here between Pfizer, Moderna, AstraZeneca and Johnson & Johnson, not all of which offer the same rate of protection against the virus. If the UK projections about the spread of Omicron are even remotely right, the country could face a de facto lockdown, not brought about by officially mandated stay-at-home rules, but through missing employees at work.

A University of Oxford study released this week is also much more cautious than BioNTech. Blood samples from people with two shots of the Moderna vaccine showed a 30-fold drop in antibodies. The results were similar for the Pfizer and AstraZeneca vaccines. In some cases, vaccinated people had no antibodies against Omicron whatsoever.

It is as yet unknown whether the vaccines offer protection against severe disease. It is reasonable to assume that they do, but it will take a few more weeks of data to arrive at more precise estimates.

In continental Europe, meanwhile, Omicron is not yet on the public radar screen, where it is seen as mostly a British problem. Germany is now registering a fall in officially recorded infection rates, but death rates are still running at 400 to 500 a day, much higher than during previous waves.

The booster campaign in Germany is finally getting off the ground, but is unlikely to reach critical mass before Omicron infections start to mirror those in the UK. It is fair to assume that the UK is a few weeks ahead in the infection cycle, but it is also much further ahead in the booster campaign. While the booster campaign is now gathering speed in Europe, the campaign to vaccinate those who have refused vaccinations so far is falling off. When Omicron hits Germany, it will hit a less vaccinated population.