The new strain is spreading like wildfire around the world. We can take steps to stop it ruining the Aotearoa summer.
"It is Christmas Eve. Ashley Bloomfield calls you to say there is community transmission in Christchurch. What do you do?" The opening question in the Newshub election debate in September 2020, put by Patrick Gower to Jacinda Ardern and Judith Collins, served up a scenario that holds over a year on, just a few days away from Christmas. This time, things are a bit different. Critically, vaccination rates are high among people 12 and over. But the storm cloud is different, too: Omicron.
The last week has seen the new variant, first identified in South Africa in late November, beam around the world like light from a mirror ball. Omicron has brought record daily case numbers to Britain, lockdown to the Netherlands. It has driven a surge in case numbers in New South Wales, which recorded 2,566 new Covid infections yesterday. In short, the new strain is taking over – it has been detected in more than 70 countries. It would be more were it not for the limitations on genome sequencing in some parts of the world.
Given the novelty of Omicron, experts warn against over-confidence in drawing early conclusions. There are a few things we know, however. It's incredibly contagious, with an estimated reproduction rate of almost four, which means frightening exponential growth. Part of the reason for that is it infects the vaccinated at higher rates than any previous iteration of this coronavirus. That doesn't make vaccination unnecessary – on the contrary, vaccination very clearly protects people from the worst illness, hospitalisation and death. But the mounting evidence is that a third dose, aka a booster shot, is the best defence against Omicron. Encouragingly, it does not result in more severe disease. There is some hope that it may produce milder disease on the whole, though the jury is out on that, given the multiplicity of other factors at play.
Even if it is milder, however, the mind-boggling speed of transmission presents a grave threat to the population at large and the limited resources of strained health systems. Even if the flames are smaller, drop a thousand live matches at every corner of the forest and you're dealing with an inferno.
Omicron is in New Zealand, too. The quarantine system at the border just means it's not yet in the community. All 22 cases are isolated, though three took a bus trip to a Rotorua MIQ hotel then back to the Jet Park quarantine facility. Experts reckon it's almost inevitable that it leaks at some point into New Zealand society. But what steps might we take to limit or slow the chances of that happening? And how can we get ready to throttle it if it does?
Early research suggests a third dose substantially increases your protection against Omicron. Photo / Sylvie Whinray
Boosterism
As so often in the two-year wrestle with Covid, the challenge is to buy time. And so it is with Omicron – in this case, it's about minimising its spread (or, even better, keeping it out of the country) until as many of us as possible have had a booster shot. Early research suggests a third dose substantially increases your protection against Omicron (and it does against delta, too).
"The good news is that at least two studies so far show that a third booster dose of mRNA can improve neutralisation titers against Omicron," said Dr Fran Priddy of Vaccine Alliance Aotearoa New Zealand – Ohu Kaupare Huaketo. "Until we understand how pathogenic Omicron may be (ie how deadly) it is critical to complete two-dose vaccinations, accelerate the booster campaign, and also to consider whether the six-month booster interval should be shortened."
At the urging of experts, it is likely that cabinet will soon shorten the gap between a second regular dose and a booster to five or even four months. If it's six months since you had your second dose, however, you needn't wait – go get boosted as soon as possible.
The red light
When the Covid on Christmas Eve prospect was put to the party leaders in the last election campaign, the question centred on whether a lockdown was inevitable. Today, with more than 90 per cent of the eligible population double-vaccinated and Auckland having emerged from 15 weeks of lockdown, there is a strong reluctance to go that way again.
It hasn't been ruled out – Chris Hipkins, the Covid minister, has repeatedly noted that the alert level system, and the lockdown options it offers, remains in the bottom drawer if needed. But even in the face of Omicron, the likelier response is the red light setting.
If Omicron were to emerge in the community, there's a strong chance that cabinet would move to put the country into that tightest of the traffic light modes, which puts strict limits on gathering numbers. Some experts would like ministers to delay the planned New Year's Eve shift of Auckland and other parts of the country from red to orange. Experts are calling for a heightened emphasis on hospitality and other gatherings embracing outdoor environments.
Sue Crengle, co-leader of Te Rōpū Whakakaupapa Urutā, the National Māori Pandemic Group, told RNZ: "We should use a heightened level of restrictions, especially if [cases emerge] in regions where there are high numbers of Māori and there are lower vaccination rates."
The MIQ system has on the whole performed well. Photo / Sylvie Whinray
Omicron
The managed isolation and quarantine system has on the whole performed well, but Omicron's transmissibility presents a new challenge. Epidemiologist Sir David Skegg told RNZ this morning: "I think it is urgent now for the Government to review our MIQ procedures and see where things can be tightened to reduce even further the risk that Omicron spills out into the community."
The Government also faced "difficult decisions" around length of stay in MIQ, said Skegg. That included potentially switching back from seven to 10 days in a facility, and whether to push back the plan to let fully vaccinated New Zealanders travelling from Australia skip MIQ altogether and isolate at home as of January 17. "If that goes ahead it will spread in New Zealand very quickly," he said.
Pre-departure tests
The requirement that people travelling to New Zealand produce a negative test within 72 hours of departure was recently tweaked, Skegg noted, from PCR-only to permit some antigen tests, which aren't always as accurate. He'd like to see it revert to PCR. Given the potential for people to catch the new strain between the test and flying, there's a case, too, to consider an extra layer, in the form of a rapid antigen at the airport.
The Covid-19 testing centre in Henderson in September. Photo / Dean Purcell
Test test test test test
When delta was detected in Auckland in August, triggering a nationwide lockdown, the virus had already been bouncing around for some days, perhaps as long as a fortnight. Had everyone with a sore throat, sniffle or fever gone for a test over that period, it might just have been snuffed out. With Omicron, the importance of getting tested if you have any symptoms, however mild, whether or not you're vaccinated, could hardly be higher.
Omicron is fast, so those who are chasing it down need to be, too. It's a huge ask after an exhausting few months, but the contact tracing operation will need to be crouched in the starter's blocks throughout the holiday period – if Omicron does rear its head, we may only have a matter of hours to get on top of it. You can help by scanning in everywhere and always.
Reduce your risk
If you're travelling around Aotearoa over summer, there are a number of precautions you can take to help limit the risk of transmission, especially if you're visiting more vulnerable parts of the country that are less well served by the health system. Te Matatini o te Hōrapa have set those out in this post, which was written with delta in mind, but is just as – if not more – relevant for Omicron.
