Omicron: things are moving quickly and looking better…but we’re not there yet

My last post on Omicron was on 22/12/2021, 15 days ago, which seems like a lifetime ago! Back then, there was a great deal of uncertainty about how Omicron would manifest clinically, and how this would translate into hospitalisations and deaths. We now known more, but there is still considerable uncertainty. The latest technical briefing from UKHSA provides additional epidemiological updates. And the latest ONS study on prevalence in the UK gives us some eye-watering figures: in the week ending 31/12/2021, 1 in 25 people in England were infected with COVID-19, and 1 in 15 people in London. There’s a lot of it about. Overall, the outlook is looking better, but it’s going to be a very bumpy ride for those working in healthcare over the next month or so.

A key finding of the latest briefing is confirmation that the risk of presentation to hospital with Omicron infection is approximately half that for Delta infection, and the risk of admission to hospital from the ED was about a third for Omicron vs. Delta. Furthermore, the risk of hospitalisation with Omicron is reduced >80% for those who are triple vaccinated vs. unvaccinated.

We now know that the sheer volume of Omicron infection out there (1 in 15 people in London…) has resulted in an increase in hospitalisations with COVID-19. But there is more ‘incidental’ COVID-19, and fewer patients deteriorating, requiring critical care, and dying from COVID-19. However, combined with the usual winter pressures, hospitals are struggling to provide enough beds for the care they need to provide – and are making contingencies in case the beds dry up completely.

When we get over this wave, it will be time to ask what is the future of mass testing for COVID-19 (a quick Twitter poll this week suggested the jury is out on this – see above), do we continue with routine asymptomatic testing for COVID-19 in hospitals, and is there a point at which we go “back to normal”?

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