As widely predicted, new variants of COVID-19 continue to emerge. Omicron was first reported from Southern Africa on 24th November, and designated as a new variant by World Health Organization on 26th November. It is now clear that Omicron was circulating elsewhere prior to this time, and is now present in most areas of the globe. Given the short time since first description, at this time of writing there remains considerable uncertainty around epidemiological and clinical implications and also its effect on children. Nevertheless, the rapid growth of Omicron infections within the UK, and increasing evidence that it can better evade immunity from previous infection or vaccines, has led UK SAGE SPI-M to warn that the effective R value is likely to rise, with a risk of increased hospitalisations. Further they suggest that more stringent measures will be required to get R below 1. We note that Delta cases have also been rising (albeit much more slowly) in recent weeks.
While, given all the uncertainties, it is impossible to know exactly what measures are necessary to control the new Omicron variant, it is nevertheless clear that it is important to take immediate measures to slow the spread of infection so that society and the NHS are not in danger of being overwhelmed, to learn more about Omicron, and to then take scientifically informed decisions as to what further measures are (or are not) necessary.
Accordingly, we propose that, as a minimum, the following measures start to be implemented immediately, recognizing that different measures will begin to have impact at different timescales.
Short term impact:
- Reduce number of contacts through working at home where possible and strong advice to avoid non-essential social contacts
- Require negative LFTs for entry to indoor public spaces/mass events and strongly advise them for all social encounters
- Require masks in all indoor public spaces/mass events
- Require self-isolation for all positive cases and their close contacts. Provide easily accessed and comprehensive support packages to make this possible.
Medium term impact:
- Use the Christmas break to ensure that all classrooms have adequate ventilation/air filtration
- Develop a system to ensure that all public facilities monitor and advertise their ventilation status – and provide funding to facilitate this
- Replace the red-list travel system with an agreed international system of pre- and post-travel testing and supported quarantine.
Long term impact:
- Build the systems to enable rapid and effective roll-out of vaccinations to all and, once approved by the MHRA, consider as a matter of urgency roll-out to under 12’s.
Finally, in considering the domestic response, we must recognize that the present crisis is, at least in part, a product of global inequalities in vaccination. We therefore call, as an immediate priority, for the UK to stop blocking vaccine patent waivers and, in addition, to provide the transfer of technology and expertise that will enable vaccine production in all regions of the world.