UK Scientists: Prepare For Potentially Large Omicron Wave

UK’s SAGE says even if vaccination (including boosters) can prevent severe disease from Omicron, any significant reduction in protection against infection can result in a huge wave of infections that will subsequently lead to a spike in hospitalisations.

KUALA LUMPUR, Dec 6 — The United Kingdom’s Scientific Advisory Group for Emergencies (SAGE) has warned the UK government to prepare for a “potentially very significant” wave of Covid-19 infections and hospitalisations caused by the new Omicron variant.

The SAGE committee expects a greater reduction in protection from existing Covid-19 vaccines or previous coronavirus infection against Omicron infection than against severe disease from the variant of concern, though the extent is still unknown.

However, the group of scientists noted that even if vaccination, including boosters, remains highly protective against severe illness, any significant reduction in protection against infection could still result in a huge wave of Covid-19 infections.

“This would in turn lead to potentially high numbers of hospitalisations even with protection against severe disease being less affected,” said SAGE, according to minutes of its meeting last November 29.

“The size of this wave remains highly uncertain but may be of a scale that requires very stringent response measures to avoid unsustainable pressure on the NHS. If vaccine efficacy is substantially reduced, then a wave of severe disease should be expected.”

The minutes of the SAGE meeting stated that the heavily mutated Omicron variant is “highly likely” to escape immunity, either natural immunity from previous infection or vaccine-induced immunity, though the exact levels haven’t been identified yet.

“The evidence comes from the number of reinfections already seen, and from the presence in the Omicron genome of a combination of mutations that are either already known to be associated with immune escape or which are found in areas that structural studies suggest will affect antibody binding,” said SAGE.

“All known antigenic sites for neutralising antibodies are potentially disrupted, which has not been seen in combination in any previous variant.”

SAGE experts added that the mutations in Omicron, which results in a degree of immune escape, would likely lead to a significant reduction in the effectiveness of monoclonal antibodies.

However, efficacy of antiviral drugs is expected to remain unaffected.

The UK scientists noted that booster vaccinations are able to provide strong antibody responses and short-term protection against severe Covid-19 infection, hospitalisation and death from the majority of the variants. 

Therefore, SAGE strongly recommended to widen the coverage of booster and primary vaccination as an “important defence” against the coronavirus, besides updating vaccines, depending on the degree of immune escape. 

“It is too early to have robust data on the severity of disease caused by infection with Omicron, or how this varies by age, vaccination or immunity status, or other characteristics.”

SAGE told the UK government that border control measures can effectively reduce the number of introductions of Omicron cases and delay a subsequent wave of infections. 

This can provide some time to increase vaccination coverage and to update vaccines if necessary, although border controls cannot completely prevent the entry of new variants into the country.

SAGE stated that adherence to precautionary measures, including wearing face masks, maintaining hand hygiene, a good ventilation system, and an effective testing and contact tracing mechanism, remains highly relevant to prevent a new Covid-19 wave or spread of infections. 

“Even if measures are introduced immediately, there may not be time to fully ascertain whether they are sufficient before decisions are needed on further action,” said SAGE, also recommending work-from-home policies to reduce contact.

“The situation could develop quickly over the coming weeks and decision-makers may need to act while there is still a high level of uncertainty including considering the potential need for stringent response measures.”

Omicron has spread across dozens of countries around the world. The United States’ Centers for Disease Control and Prevention reportedly said that the variant has been detected in at least 16 states in America so far. 

The UK Health Security Agency said Saturday that 160 cases of Omicron have been reported in the UK.

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