“Something has changed on the frontline,” said Dr Brian Kent, a respiratory physician who has spent the past two years caring for Covid-19 patients in St James’s Hospital in the centre of Dublin.
“It’s not as bad as we were afraid it was going to be when it became obvious we were going to get a huge number of cases with Omicron a few weeks back. Certainly it’s very different to what it was 12 months ago.”
With Omicron causing mass infection but relatively low hospitalisations compared to previous waves, various Irish experts are debating how the country’s response to Covid-19 should change. Picture: Getty
“Something has changed on the frontline,” said Dr Brian Kent, a respiratory physician who has spent the past two years caring for Covid-19 patients in St James’s Hospital in the centre of Dublin.
“It’s not as bad as we were afraid it was going to be when it became obvious we were going to get a huge number of cases with Omicron a few weeks back. Certainly it’s very different to what it was 12 months ago.”
In previous waves, Kent was used to high numbers of breathless patients being admitted to hospital every day, their lungs inflamed, with many deteriorating rapidly to the point that they needed to be ventilated and hospitals so overwhelmed that anyone who didn’t need oxygen to survive was sent home. But this wave is different.
“We’re seeing people coming in with far less severe Covid-19, for example older people coming in with confusion or delirium, people with dehydration, but we’re seeing far fewer people needing lots of oxygen. Maybe 20 per cent of admissions now have bad Covid-19 pneumonia,” he said. “Last year, it was nearly everyone.”
This new reality is being witnessed in many other Irish hospitals.
“It’s not attacking the majority of people in the same way,” Dr Oisin O’Connell, a respiratory consultant at the Bon Secours hospital in Cork, told the Business Post.
“We’re seeing a significant reduction in aggressive pneumonitis with a lot less breathlessness, a lot less clotting in the lungs, a lot less ‘ground glass’ effect being observed in patients lungs,” O’Connell said.
“Compared to the first wave, some medics are suggesting a 15 to 50 fold reduction in ICU admissions.
“For most vaccinated adults, and particularly those boosted, it seems to be much milder,” O’Connell said.
Positive note
With Omicron causing mass infection but relatively low hospitalisations compared to previous waves, various Irish experts are debating how the country’s response to Covid-19 should change.
Already, Omicron’s wave appears to be peaking as models for the National Public Health Emergency Team (Nphet) had projected. Last week, cases appeared to begin to fall, with daily cases below 20,000 confirmed cases, after reaching 26,122 on January 8.
Positive cases have plateaued in 19 to 34-year-olds and have slowed in older age groups. And while the testing system is overwhelmed, and testing data is complicated by new rules, the positivity rate has begun to fall in both the community and hospitals.
The number of hospitalisations is beginning to stabilise and fall with the number of Covid-19 patients in hospital down from 1,063 last Monday to 1,011 last Thursday. ICU numbers have remained stable so far, even dropping slightly. And weekly deaths so far are consistent with the numbers recorded in the past three months.
While Nphet is cautious in interpreting these early signals, a media briefing last Wednesday sounded a positive note.
“As each day passes, one can be more optimistic,“ Professor Philip Nolan, chair of Nphet’s Irish Epidemiological Modelling Advisory Group, said of the peak in cases and hospital admissions. “We’ll be past it before we’re confidently able to say we’re past it.”
Nphet is now preparing guidelines for the next phase of the pandemic, which it will present to government this week, depending on how cases and hospitalisations continue to fall. A plan for easing restrictions in the short term and a vision for the long term are expected.
All of this signals a “new normal” in our tolerance for high levels of Covid-19 in the community and what it really means to “live with Covid-19”.
Already, 60,000 to 80,000 people are suspected to be infected each day – three to four times what we can confirm through testing – with more people infected in the past three months than the entire 18 months of the pandemic prior to that. Still, hospitals have not been overwhelmed as feared.
And with such high levels of infection, Nphet’s models are projecting cases to fall dramatically once they peak, to below 10,000 a day by the end of this month, 1,000 a day by the end of February, and potentially below 100 a day by March.
Could this be the end of the pandemic?
Bringing Covid-19 to heel.
This is not the first time a conclusion to the pandemic has been speculated upon. Initially, in 2020, it was hoped Ireland could “flatten the curve” by that summer through an aggressive lockdown. But that end never came as the virus surged, with new levels of case numbers and subsequent restrictions reintroduced on and off as a stopgap until a vaccine arrived.
Vaccination, it was hoped, could finally bring the pandemic to heel via herd immunity, with Nphet projecting thatvaccination would bring cases to zero by September 2021.
Yet, restrictions were scaled back up again as a Delta-driven wave arrived in the autumn, and waning immunity further drove case numbers upwards before Christmas, meaning the “proposed” end of the pandemic continually slipped from the authorities’ grasp. Then, just as hopes that booster vaccines could end the Delta wave, Omicron arrived.
But now that this variant has swept through the country, could it spur the beginning of the end?
After so many false dawns, the public are less optimistic now than they were at various times of hope before.
When surveyed in weekly polls by Amarach Research, a peak of 56 per cent initially thought the worst of the coronavirus crises was “behind us” in June 2020. The following May there was a new peak of 68 per cent, only for it to plummet again.
After all these ups and downs, when surveyed last week amidst the Omicron surge, just 30 per cent thought the worst was behind us. This is perhaps because the most popular theory for how the pandemic will end – herd immunity via vaccination – hasn’t worked.
The idea was that the vaccinated majority of the herd would stop the spread of the virus, especially to the most vulnerable, Gabriel Scally, a professor of public health at the University of Bristol, said. But while vaccination has been remarkably successful in preventing severe illness, its ability to stop infection and ongoing spread was impaired by new variants.
It was hoped that vaccination would end the pandemic: while that prediction proved incorrect, it is hoped that new variants will be less virulent. Picture: Leah Farrell/RollingNews.ie
“I’ve always said this was not possible through vaccination,” Scally said. “Vaccination will drive down cases, but that’s not herd immunity. Herd immunity is when you don’t have it circulating widely. When the only cases you have are those that are imported.”
Public health experts had originally hoped that once enough people got vaccinated – hitting a certain threshold – cases would plummet. But the numbers didn’t add up.
This threshold for the level of the population needing to be vaccinated, based on the infectiousness of the virus and the corresponding protection against infection from vaccines, was originally thought to be 60 to 75 per cent.
But with the arrival of the more transmissible and vaccine evasive Delta variant last summer, it rose to roughly 90 per cent. This became an almost impossible task, even in one of the most vaccine-enthusiastic countries in the world.
Omicron’s arrival then dashed all hopes that vaccination alone could stop the spread and slow the case rise, with the waning immunity of vaccines and the rate of breakthrough infection meaning that even the vaccinated provided little obstacle to case spread, let alone completely stopping it.
“The chances of us getting herd immunity with the existing vaccines alone are non-existent,” Scally said.
Even though herd immunity through vaccination is no longer possible, there is another way Omicron could slow the spread.
Population immunity can still be achieved through infection, with natural immunity creating a new barrier in the previously infected. And the sheer scale of Omicron’s uncontrolled spread in the past month could, ironically, guarantee the majority gain enough natural immunity to finally bring Covid-19 under control without restrictions.
Already, between 20 and 30 per cent of the population are estimated to have been infected with Omicron, according to an analysis by the Business Post.
This is a multiple of the almost half a million cases confirmed since Omicron became dominant on December 20, to account for insufficient testing, and includes those undetected and the asymptomatic.
This level of infection, Nphet modellers estimate, is enough to make the wave crest as the virus runs out of people to spread to and will cause cases to fall to extremely low levels by spring.
While almost everyone getting infected within the space of a month was a shock twist to the pandemic that nobody predicted, Omicron could spell a surprising solution.
Reduced virulence
Just a few weeks ago, David Nabarro, the World Health Organisation’s (WHO) special envoy on Covid-19, said that he had “never been more concerned” about the arrival of Omicron. Now, though, he’s in a much more positive mood….
What has happened in South Africa? All the media focussed on when this first came about was SA, so where are they now? Has Covid disappeared there? Hopefully!
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“Something has changed on the frontline,” said Dr Brian Kent, a respiratory physician who has spent the past two years caring for Covid-19 patients in St James’s Hospital in the centre of Dublin.
“It’s not as bad as we were afraid it was going to be when it became obvious we were going to get a huge number of cases with Omicron a few weeks back. Certainly it’s very different to what it was 12 months ago.”
With Omicron causing mass infection but relatively low hospitalisations compared to previous waves, various Irish experts are debating how the country’s response to Covid-19 should change. Picture: Getty
“Something has changed on the frontline,” said Dr Brian Kent, a respiratory physician who has spent the past two years caring for Covid-19 patients in St James’s Hospital in the centre of Dublin.
“It’s not as bad as we were afraid it was going to be when it became obvious we were going to get a huge number of cases with Omicron a few weeks back. Certainly it’s very different to what it was 12 months ago.”
In previous waves, Kent was used to high numbers of breathless patients being admitted to hospital every day, their lungs inflamed, with many deteriorating rapidly to the point that they needed to be ventilated and hospitals so overwhelmed that anyone who didn’t need oxygen to survive was sent home. But this wave is different.
“We’re seeing people coming in with far less severe Covid-19, for example older people coming in with confusion or delirium, people with dehydration, but we’re seeing far fewer people needing lots of oxygen. Maybe 20 per cent of admissions now have bad Covid-19 pneumonia,” he said. “Last year, it was nearly everyone.”
This new reality is being witnessed in many other Irish hospitals.
“It’s not attacking the majority of people in the same way,” Dr Oisin O’Connell, a respiratory consultant at the Bon Secours hospital in Cork, told the Business Post.
“We’re seeing a significant reduction in aggressive pneumonitis with a lot less breathlessness, a lot less clotting in the lungs, a lot less ‘ground glass’ effect being observed in patients lungs,” O’Connell said.
“Compared to the first wave, some medics are suggesting a 15 to 50 fold reduction in ICU admissions.
“For most vaccinated adults, and particularly those boosted, it seems to be much milder,” O’Connell said.
Positive note
With Omicron causing mass infection but relatively low hospitalisations compared to previous waves, various Irish experts are debating how the country’s response to Covid-19 should change.
Already, Omicron’s wave appears to be peaking as models for the National Public Health Emergency Team (Nphet) had projected. Last week, cases appeared to begin to fall, with daily cases below 20,000 confirmed cases, after reaching 26,122 on January 8.
Positive cases have plateaued in 19 to 34-year-olds and have slowed in older age groups. And while the testing system is overwhelmed, and testing data is complicated by new rules, the positivity rate has begun to fall in both the community and hospitals.
The number of hospitalisations is beginning to stabilise and fall with the number of Covid-19 patients in hospital down from 1,063 last Monday to 1,011 last Thursday. ICU numbers have remained stable so far, even dropping slightly. And weekly deaths so far are consistent with the numbers recorded in the past three months.
While Nphet is cautious in interpreting these early signals, a media briefing last Wednesday sounded a positive note.
“As each day passes, one can be more optimistic,“ Professor Philip Nolan, chair of Nphet’s Irish Epidemiological Modelling Advisory Group, said of the peak in cases and hospital admissions. “We’ll be past it before we’re confidently able to say we’re past it.”
Nphet is now preparing guidelines for the next phase of the pandemic, which it will present to government this week, depending on how cases and hospitalisations continue to fall. A plan for easing restrictions in the short term and a vision for the long term are expected.
All of this signals a “new normal” in our tolerance for high levels of Covid-19 in the community and what it really means to “live with Covid-19”.
Already, 60,000 to 80,000 people are suspected to be infected each day – three to four times what we can confirm through testing – with more people infected in the past three months than the entire 18 months of the pandemic prior to that. Still, hospitals have not been overwhelmed as feared.
And with such high levels of infection, Nphet’s models are projecting cases to fall dramatically once they peak, to below 10,000 a day by the end of this month, 1,000 a day by the end of February, and potentially below 100 a day by March.
Could this be the end of the pandemic?
Bringing Covid-19 to heel.
This is not the first time a conclusion to the pandemic has been speculated upon. Initially, in 2020, it was hoped Ireland could “flatten the curve” by that summer through an aggressive lockdown. But that end never came as the virus surged, with new levels of case numbers and subsequent restrictions reintroduced on and off as a stopgap until a vaccine arrived.
Vaccination, it was hoped, could finally bring the pandemic to heel via herd immunity, with Nphet projecting thatvaccination would bring cases to zero by September 2021.
Yet, restrictions were scaled back up again as a Delta-driven wave arrived in the autumn, and waning immunity further drove case numbers upwards before Christmas, meaning the “proposed” end of the pandemic continually slipped from the authorities’ grasp. Then, just as hopes that booster vaccines could end the Delta wave, Omicron arrived.
But now that this variant has swept through the country, could it spur the beginning of the end?
After so many false dawns, the public are less optimistic now than they were at various times of hope before.
When surveyed in weekly polls by Amarach Research, a peak of 56 per cent initially thought the worst of the coronavirus crises was “behind us” in June 2020. The following May there was a new peak of 68 per cent, only for it to plummet again.
After all these ups and downs, when surveyed last week amidst the Omicron surge, just 30 per cent thought the worst was behind us. This is perhaps because the most popular theory for how the pandemic will end – herd immunity via vaccination – hasn’t worked.
The idea was that the vaccinated majority of the herd would stop the spread of the virus, especially to the most vulnerable, Gabriel Scally, a professor of public health at the University of Bristol, said. But while vaccination has been remarkably successful in preventing severe illness, its ability to stop infection and ongoing spread was impaired by new variants.
It was hoped that vaccination would end the pandemic: while that prediction proved incorrect, it is hoped that new variants will be less virulent. Picture: Leah Farrell/RollingNews.ie
“I’ve always said this was not possible through vaccination,” Scally said. “Vaccination will drive down cases, but that’s not herd immunity. Herd immunity is when you don’t have it circulating widely. When the only cases you have are those that are imported.”
Public health experts had originally hoped that once enough people got vaccinated – hitting a certain threshold – cases would plummet. But the numbers didn’t add up.
This threshold for the level of the population needing to be vaccinated, based on the infectiousness of the virus and the corresponding protection against infection from vaccines, was originally thought to be 60 to 75 per cent.
But with the arrival of the more transmissible and vaccine evasive Delta variant last summer, it rose to roughly 90 per cent. This became an almost impossible task, even in one of the most vaccine-enthusiastic countries in the world.
Omicron’s arrival then dashed all hopes that vaccination alone could stop the spread and slow the case rise, with the waning immunity of vaccines and the rate of breakthrough infection meaning that even the vaccinated provided little obstacle to case spread, let alone completely stopping it.
“The chances of us getting herd immunity with the existing vaccines alone are non-existent,” Scally said.
Even though herd immunity through vaccination is no longer possible, there is another way Omicron could slow the spread.
Population immunity can still be achieved through infection, with natural immunity creating a new barrier in the previously infected. And the sheer scale of Omicron’s uncontrolled spread in the past month could, ironically, guarantee the majority gain enough natural immunity to finally bring Covid-19 under control without restrictions.
Already, between 20 and 30 per cent of the population are estimated to have been infected with Omicron, according to an analysis by the Business Post.
This is a multiple of the almost half a million cases confirmed since Omicron became dominant on December 20, to account for insufficient testing, and includes those undetected and the asymptomatic.
This level of infection, Nphet modellers estimate, is enough to make the wave crest as the virus runs out of people to spread to and will cause cases to fall to extremely low levels by spring.
While almost everyone getting infected within the space of a month was a shock twist to the pandemic that nobody predicted, Omicron could spell a surprising solution.
Reduced virulence
Just a few weeks ago, David Nabarro, the World Health Organisation’s (WHO) special envoy on Covid-19, said that he had “never been more concerned” about the arrival of Omicron. Now, though, he’s in a much more positive mood….
What has happened in South Africa? All the media focussed on when this first came about was SA, so where are they now? Has Covid disappeared there? Hopefully!
A normal summer you say ? 😀
Omicron- a great bunch of lads.
“Im inevitable” covid.
“And I’m……a few pints in with lads” Snap!!!!
Seems really positive atm, mad couple of years