The UK has become a testing laboratory to determine the most effective strategy to keep the omicron variant under control with as few restrictions as possible. Right now the country maintains four different strategies to manage the pandemic, one for each British territory, but it is England – where 56 of the 68 million Britons live – the one that generates the most interest, as it is the least restrictive for social life. and because it places the burden of the battle against the new wave of the virus on vaccination, especially in the third-dose campaign.
The Government of Boris Johnson considers the degree of vaccination with the third dose as the fundamental factor that will determine the impact of the omicron, especially, given the high percentage of covid patients in the ICU who are not vaccinated. In London, four out of ten admitted have not received a dose, so, given the soaring level of transmissibility of the variant, the Executive still hopes to be able to convince the reluctants to avoid saturation of the National Health Service (NHS, in its acronym in English) and the imposition of new restrictive measures, such as those already implemented in Scotland, Wales and Northern Ireland after Christmas Day.
The British prime minister’s bet not to move a tab before the end of the year invites cautious optimism, since it is based on the epidemiological data that his scientific advisers have shown him this week on the impact of the omicron, which already represents 90 % of cases in England. Although daily cases are still above the 100,000 barrier and the most recent, on Tuesday, have smashed a new record, 129,471, the important thing for the Executive is that hospitalizations are far from the highs of the beginning of the year.
The problem is that, although hospital admissions are lower than in previous waves, the large number of infections from the omicron variant has a severe impact on the workforce. Health workers are not exempt from the obligation to isolate themselves when they are positive and, although the Government has reduced the period from ten to seven days, many hospital managers already warn that the absences of personnel related to the omicron “could be a greater challenge than the number of serious patients ”that they have to treat. Some centers have already had to relocate employees to ensure essential services and, if the trend continues, even a relatively minor increase in cases threatens the functioning of the NHS.
The decision on how to manage these parameters is ultimately political, and Boris Johnson is aware of the unpopularity of enacting additional restrictions, not only among the public, but in a Conservative Party that once again looks askance at its leader. Hence, for now, keep up the pulse before deciding whether or not to tighten restrictions to curb admissions in London hospitals, the epicenter of the new variant. If in the reports of the three key days of the Christmas period (Christmas Eve, Christmas and December 26, the popular Boxing Day) had exceeded 400 hospitalizations, England might have had to prepare for changes before December 31st. But in the end the highest figure in one day was 390 on December 23.
The number of covid patients in London hospitals has increased by 45% in one week and is doubling every two, but the numbers are well below the peak of early 2021, as the current just over 2,600 admitted represents less than a third of the almost 8,000 that came to be on January 18. The trend even improves in the country as a whole, since despite the increase of 27% in hospitalizations in one week (the 1,281 registered on Christmas Day in England represent a record since February), the volume of hospitalizations represents barely a quarter of the maximums registered 11 months ago: 8,240 currently, compared to 34,336 in January 2021.
The health authorities also highlight the rise of the so-called “secondary covid”, that is, that of asymptomatic patients who are admitted for other ailments and test positive once in the hospital. The data does not differentiate between this phenomenon and those who are admitted due to the virus, but according to the head of NHS Providers (the organization that represents hospitals and mental health services and ambulances in England), the highest percentage of covid patients would have discovered that they had it by chance, after having undergone a test in the hospital, where they were not initially due to covid.
Health centers are not detecting, for now, a significant increase in respiratory problems related to the coronavirus, nor the need to massively increase the use of oxygen, as had happened in January with the alpha variant, which had triggered the pressure of ICUs. The danger, however, has not been completely left behind, due to the social interaction inherent in the Christmas period, in which the intergenerational mix is higher, a phenomenon that the Government intends to monitor closely in the coming days to determine if there is a notable growth in admissions among older age groups.
Another encouraging sign from the most recent data is that they appear to support the findings of the study published last week by the UK Health Safety Agency (UKHSA) on the severity of omicron. The report, the most detailed on the new variant so far, concludes that its risk of hospitalization is up to 70% lower than that of the delta, which would corroborate the recent diagnosis of Andrew Hayward, one of the leading epidemiologists in the Kingdom. United, that the omicron threat could be lowered “from a hurricane to a severe storm.”
The data, in any case, will have to be monitored daily, in parallel to the evolution of vaccination, Johnson’s great hope to avoid new restrictions and save an overwhelmed NHS a new winter of discontent. In addition, the analysis requires extreme caution, given the particularities of the Christmas holidays, which imply that in key days substantially fewer tests are carried out, while in others the capacity and availability is overwhelmed, as has already happened in recent days in England.