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Omicron. “An avalanche of business is not far off”

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The announcement that a new variant of Omicron already dominates London and could now be as high as 50% of new cases was a wake-up call yesterday, as national estimates put 200,000 people currently infected in the UK every day. At a time when there are signs that the new variant appears to be associated with milder symptoms than Delta, Boris Johnson said the idea that Omicron is milder needs to be shelved and focused on how quickly it changes. The day before, UK Education Minister Nadhim Zahavi had already formulated the scenario as follows: “Let’s do a little math exercise: by the end of December, we had reached a million infections. 1% is 10 thousand serious cases that could be in the hospital. In three days – two million, in three days – four million, in three days – eight million. It’s a risk, even if it’s lighter, say 50% lighter than Delta, when the numbers are big it’s a small percentage of a very large population, ”he said on Sunday.

In i, epidemiologist Manuel Carmo Gomez agrees that this is an important message at a time of uncertainty, when the high transmissibility of a new variant seems to be the only closed element. “The fact that he has tremendous permeability has already been noticed. With regard to the clinical characteristics of our population with high vaccination coverage, but also older, we do not know if it will be identical to that observed in South Africa, where there is a younger population and a lot of immunity acquired through natural infection. We have to wait one to two weeks. Now let’s imagine a better scenario in which Omicron is not very pathogenic and usually causes a significantly lower hospital admission rate than Delta, ”says a professor in the Faculty of Science at the University of Lisbon. “If that happens, in the medium term, we can all be immunized with Omicron naturally, and it could even be the end of the pandemic, we don’t know. But despite the fact that they are less pathogenic than Delta, we can see that the number of infections can grow very quickly, as cases increase like an avalanche. And when we work with a small percentage of severe cases with a huge number of infections in a short period of time, it can cause a tremendous burden on the hospital, especially when we know that it is winter and the pressure is already high. “

He warns that the likelihood that the country will face this avalanche of cases in the coming weeks is “very high.” “Nobody can be sure. The UK expects this in the second half of December, I would say it will appear on the horizon several weeks ahead of us, ”says the epidemiologist, who emphasizes that for better perception, it will be necessary to understand how much this option is already circulating in Portugal.

Today, new data comes from Dr. Ricardo Jorge’s National Institutes of Health, but sequencing is always delayed by one week (data will be published until December 4th). Sporadic cases have already been identified in the Central Region last week and the sources I have heard do not indicate community spread, but the experience in the UK, where the new variant is currently estimated at 20% of cases, shows that there is a week, there was a fraction of it. There is another element that makes it difficult to draw conclusions: the countries that reported most cases of the new variant, in addition to the UK, Denmark and Norway, have the most complete sequencing programs. “On the one hand, we will be able to see what data is coming from these higher circulating countries in terms of hospitalizations and severity,” notes Carmo Gomez, considering, however, that if circulation in other European countries is already approaching similar levels for residents of the United In the Kingdom, this is similar to wanting to “stop the wind with your hands” as it is necessary to maintain current measures and raise awareness of the increased risk of infection during Christmas and the arrival of expatriates.

No rules for UK travelers London is currently the first European capital to claim the dominance of Omicron over Delta, which so far has had this behavior in South Africa.
I tried to find out with the government and DGS if, with this announcement, the arrangements for arrivals from the UK will be revised in line with those in effect for travelers from seven South African countries from the end of November, taking into account 14 days of isolation on arrival in Portugal, but there was no answer.

For Carmo Gomez, border closures are not appropriate, but she believes it is important to remain vigilant and encourage testing, as was done for those who came from southern Africa.

Ao i, Vice President of the National Association of Public Health Physicians Gustavo Tato Borges, argues that it is fair to extend the 14-day isolation rule that applies to African countries to the United Kingdom and other European countries. with a wider spread of the option, pending the definition of the rules, but emphasizes that as Omicron becomes dominant, this type of measure will no longer be effective and there is a need to strengthen protections at the national level.

We expect high vaccination coverage in Portugal, more than 10 percentage points higher than in the United Kingdom (69% versus 86%) – together with reinforcement and vaccination of children – to help slow the rise in cases even in the face of the Omicron option Gustavo Tato Borges stresses that if a country is faced with an exponential growth scenario, even if it is more favorable, it will need to reorganize the work of public health teams that cannot fight tens of thousands of infections a day.

Even today, as the latest DGS report showed, contacts are no longer tracked in all cases, with 68% of contacts being tracked in the last week, up from about 81% at the end of November. “We know that Omicron will dominate, otherwise it’s unrealistic to think. If we have a sharp increase in the number of cases, I think we will have to start evaluating symptomatic cases much more and tracking contacts with these cases and reducing the observation of asymptomatic cases, otherwise we will not have enough manpower to respond to everything, ”warns he’s Gustavo. Tato Borges.

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