People infected with Omicron have been a third as likely to end up in hospital in South Africa compared with those infected by the Delta variant, according to the most comprehensive analysis so far.
Even after accounting for the benefits of increased immunity in the population, scientists estimated the variant to be almost a third less virulent than the original Wuhan strain.
The findings come from a healthcare provider responsible for 3.7 million patients in South Africa and are based on the first three weeks of their Omicron wave. They suggest that some of the effects of greater spread could be offset by a lower chance of hospitalisation.
Dr Ryan Noach, the chief executive of Discovery Health, said that although the data was preliminary, they were confident they were seeing a less severe wave than they might have expected. “This is clearly a highly contagious variant,” he said. “What’s encouraging at this stage is a flatter trajectory of hospital admissions, indicating a likely lower severity of the illness.”
For every 1,000 infections, 44 people ended up in hospital in South Africa in the first wave, 101 in the Delta wave and 38 in Omicron. He and his colleagues estimate after correcting for vaccination status, age and prior infection that Omicron is a third less severe than the original Wuhan strain of coronavirus, which itself is less serious than Delta.
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Other scientists said, though, that there have been so many prior infections in the region that it was very hard to know if the variant was genuinely less intrinsically virulent.
In other developments:
• Restrictions could last up to two months, according to health chiefs, as Boris Johnson warned that a “huge spike of Omicron” was coming.
• Pfizer said that a new anti-viral pill was on course to become a “critical tool” against Covid, with trial results showing an 88 per cent fall in the risk of hospitalisation and death.
• More than a third of backbench Conservatives said they were prepared to defy the government and vote against plan B restrictions today.
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• The health secretary, Sajid Javid, said people would soon need a booster jab to get into nightclubs and large events under a vaccine passport scheme.
• There was a shortage of lateral flow tests on the government website.
• Businesses will receive furlough payments if the prime minister orders pubs, bars and restaurants to close.
• The price of last-minute trips to Europe was cut by up to 50 per cent.
In a further boost, Dominic Raab, the justice secretary, insisted today that the coronavirus vaccination campaign meant “people can look forward to spending Christmas with loved ones in a way that we couldn’t last year”.
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However, ministers will not rule out further restrictions such as the closure of pubs and restaurants to tame the Omicron variant. “These issues are always discussed but we have got plan B. That’s what we think is required over the Christmas period,” Raab said.
Officials are understood to be drawing up options for further restrictions that could be implemented before New Year’s Eve, but no decisions have been made.
However, health chiefs said this morning that Covid restrictions were likely to be needed for a month or two. Susan Hopkins, chief medical adviser to the UK Health Security Agency (UKHSA), warned of a “very difficult four weeks ahead” as the new variant surged across the country.
She told MPs on the Science and Technology Select Committee this morning that the size and length of the peak would depend how cautious people were and said that if people cut down on social contacts “ideally the wave goes a bit slower than rapid increases over the next two to three weeks, which could cause major challenges” for the NHS.
The UKHSA estimated that 200,000 people were infected with Omicron on Monday, far more than previously known to have caught Covid-19 in a single day and suggesting that the variant has already outpaced Delta.
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• Analysis: Does Britain really have 200,000 new Omicron cases a day?
Boris Johnson is said to have told ministers that he would throw “the full weight of government” behind a turbo-charged booster campaign as he defended the new restrictions. He said that a “huge spike of Omicron was coming” and that the measures were “balanced and proportionate, helping to reduce transmission while we ramp-up the booster programme”.
NHS leaders have warned that they are unlikely to meet Johnson’s target of giving everyone a booster by the end of the month. People are queueing for hours at vaccine centres to receive the booster, which increases protection against Omicron to about 75 per cent. Councils, fire brigades and police have been asked to offer any staff trained in delivering jabs.
Vaccination centres were told last night to be ready to run 24 hours a day and through Christmas as ministers insisted that boosters take precedence over routine care. Hospitals and GP surgeries were ordered to redeploy staff to support what Amanda Pritchard, head of NHS England, called “an immediate, all-out drive” on boosters.
Deliveries of vaccine doses to units will be doubled today and centres were told to put up tents and portable buildings to get through as many jabs as possible. Omicron is more transmissible than previous variants and better at evading vaccine protection. Data last week showed two doses offered minimal protection against the strain but a third jab could be up to 75 per cent effective against symptomatic infection.
• Q&A: How will the booster jab programme work?
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Despite the vaccine mobilisation, NHS leaders fear they are being “set up to fail” by Johnson’s promise of a million jabs a day and a goal of offering all adults a booster by the end of the month. They said the booster programme may not be finished until well into the new year.
There were 397,532 boosters reported yesterday and the rolling average now stands at 425,869, about half the record daily total of 844,285 in March. It means 18 million people in England are yet to have a third jab. Johnson acknowledged that to hit his target “we’ll have to attain a pace and a number of daily booster doses that will exceed anything that we’ve done before”.
After Johnson made a televised commitment on Sunday night that all adults in England “will have the chance to get their booster before the new year”, NHS leaders clarified that they were not promising to jab all remaining adults in the next two and a half weeks.
They said the health service can only commit to offering people the chance to make appointments by the end of the year, with large numbers of jabs expected to be administered in January. Some may even run into February if people are slow in coming forward.
The report from South Africa also found that, as expected, the efficacy of vaccines is significantly weakened in the face of Omicron.
The effectiveness of two Pfizer shots in reducing infection fell from 80 per cent to 33 per cent. Their efficacy in presenting severe illness, though, held up better — dropping from 93 per cent to 70 per cent.
Professor Glenda Gray, president and chief executive of the South African Medical Research Council, said that this should be reassuring. “It’s important to note that the vaccines are designed to protect against hospital admission and death,” she said. “It’s very heartening to see these results, and that we still have a vaccine effectiveness that’s greater than 50 per cent.”
Other scientists warned that it was still very early in the wave to be confident in the findings.
Dr Michael Head, senior research fellow in global health at the University of Southampton, said: “The real-time data relating to Omicron is, alas, coming thick and fast, so today’s information can easily be superseded by new evidence this time tomorrow.”
Dr Paul Burton, chief medical officer for the American vaccine maker Moderna, told MPs on the Science and Technology Committee that it was too early to know whether Omicron resulted in less severe disease.
He also warned that Delta and Omicron may circulate at the same time, leading some people to be infected with both. The danger, he said, was that genetic material might be shared between the strains, giving rise to new variants. “Where individuals become co-infected, this gives the opportunity for these viruses to further evolve and mutate, which is a concerning and worrying situation,” he added.
He added: We certainly don’t have to panic. We have many, many tools at our disposal. We’ve learnt so much about this virus over the last few years and we can continue to fight it. But I think Omicron poses a real threat.”
Separately, Pfizer said that a new anti-viral pill was on course to become a “critical tool” against Covid, with trial results showing an 88 per cent fall in the risk of hospitalisation and death when it was given within five days of the onset of symptoms.
The treatment, called Paxlovid, had also worked in laboratory studies against the Omicron variant, Pfizer said.
“This underscores the treatment candidate’s potential to save the lives of patients around the world,” Albert Bourla, Pfizer’s chief executive, said in a statement.
The study included nearly 2,250 unvaccinated volunteers who were at a high risk of severe disease and who were given either Paxlovid or a placebo. They were in line with interim trial results released last month.
The latest figures all showed that people given Paxlovid had only a tenth of the viral load five days after treatment started compared to the placebo group.
Pfizer said that 0.7 per cent of patients who received Paxlovid were hospitalised within 28 days of entering the trial, and none died. By contrast, 6.5 per cent of patients who received a placebo were hospitalised and 1.3 per cent died.
Paxlovid is a combination of two drugs. One, called PF-07321332, is designed to block the activity of an enzyme that the coronavirus needs to replicate. The other element, called ritonavir, prevents PF-07321332 being broken down too quickly in the body, allowing it to remain active for longer.
