Oz for Dummies: Week 51, 2021

(December 20–26) Omicron, Omi-gone soon? / Pandemic normality in the land of Oz (and Europe) / Another lost AMA case …

Omicron has been messing up Xmas good and it does so in many parts of the world, leading to thousands of flight cancellations and hundreds of thousands of stranded passengers, stressing mightily the health-care systems because of various — often not particularly sensible — testing requirements, and leading to various restrictions, or outright cancellations, of end-of-year festivities. A useful primer for domestic traveling restrictions here.

/ Omicron, Omi-gone soon?

The driver behind these developments is a recent variant of the SARS-CoV-2 virus, Omicron. We are far from understanding what exactly it is and does. Alas, this much is clear. It is now widely agreed that Omicron is much more transmissible than the Delta variant, with this Norwegian study estimating the median incubation time to be a mere 3 days, compared with previous reports for Delta and other previously circulating non-Delta SARS-CoV-2 (4.3 and 5.0 days, respectively).

There is a reduction in the risk of hospitalisation relative to the Delta variant, with the decline due to the fact that Omicron cases are more likely than Delta cases to be among people who have been previously infected or vaccinated, conferring substantial protection against severe disease. How much of a reduction, and how much less of an intrinsic danger does Omicron represent relative to Delta? That depends on many things and the jury is still out on reliable numbers. What’s clear is, you are a certifiable idiot if you do not get vaxxed …

A couple of Financial Times folks have a good summary here on the severity of Omicron and one of them has a good twitter wrap-up on severity data here. An encouraging sign is that numbers in South Africa where the Omicron variant was first identified seem to have peaked about a week ago and that South Africa has seen relatively few hospitalizations and hardly any deaths caused by Omicron. Omi-gone? Of course, the SA population (life expectancy currently less than 60 for men and less than 65 for women) is very different, so inferences about the Australian situation should be made very hesitantly and with caveats.

/ Pandemic normality in the land of Oz

In the land of Oz identified cases are growing dramatically. This was the situation in NSW and Victoria as of Friday:

The NSW numbers for Saturday were roughly the same but a considerable part seems due to lower testing numbers (~150k vs ~110k).

The dramatic increase in cases in NSW during the last week triggered calls for reintroduction of restrictions and the Perrottet government gave in a couple of days ago: Masks indoors are back again, as are density limits, and QR codes. The latter are a highly controversial strategy that imposes high costs on those that are pinged as potential contacts; it has affected airlines and health-care providers massively. Less controversial is the federal government’s decision last week to shorten the time between second jab and booster to fourth months and further to three by the end of January 2022.

It is noteworthy that case numbers in states such as Queensland and South Australia have also shot up markedly, with these two states having reported between 600–800 cases for Friday and Saturday, and the trajectory suggesting that they will reach reported four-digit territory within a couple of days.

While during the last two weeks numbers of cases have exploded by a factor of more than 10 into previously unimaginable (well, unimaginable for Australians) territory, it is noteworthy that hospitalizations, ICU referrals, and deaths — while they have increased — have at most doubled so far, suggesting that the findings from South Africa might be a leading indicator for Australia after all.

It is in any case refreshing to hear the new Queensland CHO talk some sense:

‘‘This Omicron variant is extremely contagious [and] not only is the spread of this virus inevitable, it is necessary.’ he told reporters.

In order for us to go from a pandemic phase, to an endemic phase, the virus has to be widespread.

‘You all have to develop immunity and there’s two ways you can do that, by being vaccinated or getting infected.

‘Once we’ve done that, once we all have a degree of immunity, the virus becomes endemic, and that is what is going to happen.’

Hazzard, the NSW health minister, has since echoed that view.

Meanwhile, a dwindling set of decision makers still pursue the eradication strategy, namely, Western Australia (McGoWAnLalaland), China, Hongkong, and Taiwan. McGowan shut down WA after an unvaccinated backpacker somehow managed to find his way into Perth and the party scene there. Even if WA manages to keep Omicron out of the state — highly unlikely in my view — it remains completely unclear what its transition strategy is. At some point even McGowan will have to acknowledge the reality and follow Queensland.

/ Pandemic normality in Europe

Europe has seen a surge of COVID-19 cases — a useful summary of the measures being taken across the continent can be found here. France just hit 100,000 new cases yesterday — almost triple the current case numbers in the land of Oz adjusted for population size — but you see none of the hysteria here although various restrictions have been implemented or are sure to be implemented.

Interestingly, while there has been considerable debate in Germany about tightening restrictions, case numbers there have fallen for more than a week.

As it is, Germany is now, on a per-capita basis, about even with Australia, with the mass of cases concentrated in Saxony and Thuringia.

/ Another lost AMA case …

The NSW president of the AMA, in response to the NSW health minister’s trial balloon, opined in the Sydney Morning Herald this week, “No minister, we can’t charge the unvaxxed for COVID care”. She called any such payment rule unethical. I beg to differ.

For starters, the fact that you would have to pay does not mean that you would not have access to medical services. It just makes you pay for a particular act of stupidy — not doing the right thing and getting vaxxed when you have no good reason not to — that clogs the health system and prevents others from getting the care they deserve. Hopefully, of course, any such payment threat would nudge people in re-doing their cost-benefit analyses before it is too late.

Dr McMullen needs to read up on externalities and trade-offs. She is the one who advocates unethical behavior.

And that’s the wrap for week 51 of 2021.

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Greetings from Paris and a bientot!