By Sridhar Venkatapuram
The arrival of Omicron on UK shores resolutely shut down notions that the pandemic was over (for Brits), and that Christmas 2021 would be better than 2020. The latest COVID chapter and fourth wave in the UK began in mid-November 2021, when scientists in South Africa identified another new variant (B.1.1.529) from a sample collected on 9th November in the Gauteng province. While mutations in coronaviruses are expected, what matters is if the changes are significant enough to impact the transmissibility and disease severity (pathogenicity) in the negative direction. The significant mutations in the South African sample and initial epidemiological reports were considered by the WHO’s Technical Advisory Group on Virus Evolution and led the WHO to classify the new variant as a variant of concern (VOC) on 26th November, and named it Omicron.
Following the announcement, the UK government quickly banned direct flights from South Africa as well as surrounding countries. British and Irish citizens and other legal residents could enter the UK but would need to stay in official quarantine hotels for 10 days at their own cost. Acting quickly to restrict foreign nationals travelling from Southern African countries was seen by many to be right and likely to buy some time. However, for the past two years, it has been hotly debated whether closing down national borders to foreign travellers is necessary even if it is an insufficient policy to contain ‘foreign’ infections. One day after the ban was announced, two cases of Omicron were identified in the UK. Banning travellers from Southern African countries was done partly because Omicron raised a potential nightmare scenario for the UK government, like for other governments.
If the new variant was more transmissible, more harmful, and evades existing vaccines, then the UK would be back to square one like in early 2020. A number of questions needed to be answered very quickly. Does the Omicron variant evade existing vaccines, especially the most commonly administered Astra-Zeneca vaccine? Is it more transmissible and/or is it more harmful than the Delta variant? Given the roughly two-week time lag between infection and severe disease, there was the further issue of how the potential spread of Omicron would intersect with people gathering over Christmas holidays. The most important question of all for government leaders was, of course, will the spread of Omicron require imposing social lockdowns again? Doing so would be catastrophic for the economy and for many political careers.
In the following six weeks, the UK government kept track of Omicron research especially coming out South Africa, and made some key policy decisions under much uncertainty and in light of rapidly increasing Omicron cases in the UK. Firstly, it expedited a third dose of vaccinations (booster) for the over 50s and other eligible adults while also pushing harder for the vaccine hesitant to get their first or second dose, all still provided free of cost. Initial research showed that Omicron was many times more transmissible as well as that vaccinations were losing protection three months or so after each dose creating ‘breakthrough’ infections. Second, as a result of quickly rising infections, on 8th December, Prime Minister Johnson announced the implementation of ‘Plan B’ in England for six weeks. This meant that people should work from home if possible, wear masks in public spaces, show proof of vaccinations to enter certain venues and events, and so forth. Plan B was initially drafted in September in case Delta virus infections rise in the winter season, but were now being implemented because Omicron was quickly spreading. Yet, even in early December, experts believed that Plan B would buy time, but they would not rule out that another lockdown might be needed after Christmas holidays. Third, the government removed the travel ban from Southern African countries. This may have been done largely for political reasons as such bans seemed to be punishing African countries for sharing scientific knowledge that could benefit the world.
Four weeks after the initial Omicron cases were identified in the UK, Omicron became the dominant virus, and the daily case numbers were the highest they have been during the entire pandemic and were still rising. While the higher transmissibility of Omicron was now established, it was also becoming clear that hospitalisations and deaths were rising but not anywhere close to early waves and pre-vaccination levels. Booster shots were restoring waning protections, and vaccinations were protecting people from severe disease and death. And so, after the holidays, the government decided to stick with Plan B, and further encourage boosters and initial vaccinations.
While there is enormous relief all around that the causal chain between infection and severe disease and death is weak, the rising number of infections and deaths still present a number of challenges for the UK. While hospitalisations are fewer than first wave, there are still so many that some hospitals are unable to cope. Increasing infections also mean that large numbers of healthcare workers are isolating and unable to work, leaving healthcare services of all kinds to face pressure. Rising infections also means that sick people staying home is potentially affecting basic public services as well as private companies. The last six weeks have likely also hurt certain industries such as restaurants, hotels, and travel because of cancellations.
For many UK citizens, the first weeks of 2022 has been a confusing period as they try to navigate daily life given the mixed messages they are receiving from the government, experts, and the media. The daily cases are again at the highest they have been during the pandemic and rising. The people have been used to understanding rising cases as an indicator of things getting worse, and potentially requiring ‘circuit-breakers’. But the government seems to be saying that things are going okay and no drastic actions are necessary. At the same, the anti-vaxxers are saying that their scepticism of vaccines and pharmaceutical companies is proving true as Omicron shows that it is possible that a dose is required every three months. And, what about other variants? Could it be there are more harmful variants spreading in the world outside the UK? And, what will happen if they do turn out to be more harmful, and the vaccines don’t work?
Despite the current quiet in public spaces and worksites because of the holidays and Plan B, the coming weeks and months are likely to contentious and unpredictable. The number of scandals involving the PM are growing and his position is being questioned. The NHS is experiencing significant pressure from Omicron, workforce sickness and attrition, backlogs, and more. And in a variety of workplaces, people are feeling pressure to show up at work despite increasing risk of become sick and uncertain effects of long-COVID. There is also the issue of children, the impact of the disease on them, and their vaccinations. How the government will prioritise these and other issues and deal with them is anybody’s guess.
The views expressed above belong to the author(s).