There is increasing evidence of the high transmissibility of Omicron, and in 2022 will likely replace Delta as the dominant variant.
This scenario again raised the fear of the hospital system being overwhelmed. For many ordinary people, the last thing they want is decision-makers to resort back to the 2020 simplistic lockdown, increased restrictions, and closing borders.
Fortunately, as 2021 comes to a close, the counter-measures available to tackle Omicron includes some familiar as well as new and better solutions:
- Face masks, social distancing, and good ventilation of high-risk indoor settings remain an essential prevention foundation.
- Vaccination. Rolling out boosters and extending vaccination coverage to those five and above sooner rather than later.
- Contact tracing – with increased cases, the role of "smart"technology needs to be adopted and scaled up. Purely relying on human labor is not sustainable.
- Testing – the gold standard and robust PCR tests need to be augmented with rapid antigen test (ART). The latter tests complement instead of replacing the former. Suppose ART is easily accessible, affordable, and used regularly. It will be a strong companion rather than replace PCR tests. Users with some education can do these themselves (for example, at home or work, learning institutions, conferences, and events venues). In many countries, to normalize the use of ART, a supply of these ART kits is being sent to people's homes.
Treatments. Greater access to a growing range of hospital-based treatments (corticosteroids, convalescent plasma, antiviral drugs, monoclonal antibodies, anticoagulation drugs) improves care and survival rates for the severely ill. However, the development and early introduction of “oral” antiviral drugs (Molnupiravir and Paxlovid) appropriately used could potentially be a game-changer to relieve pressure on hospitals. The efficacy of these pills requires them to be taken within five days of the start of symptoms. These ideally should be prescribed by general practitioners and relies on rapid test results and monitoring of symptoms.
Home recovery model (HRM) for asymptomatic and those with mild symptoms. A successful HRM requires clear, appropriate, and adequate: a. eligibility criteria, b. operating model, c. support (both health and non-health)
Final word The professional frontline workforce, after nearly two years, is exhausted. Businesses that survived are hanging by their fingernails, and Covid fatigue in the general population fuels growing anxiety and threatens social cohesion. With Omicron's arrival, it is unsustainable to keep doing more of the same.
In 2022, whether it is Omicron or the next highly transmissible variant, all of the above-suggested counter-measures will only work if decision-makers get out of a "crisis fire-fighting" mode.
Breaking out of this mold means having a more agile and comprehensive integrated strategy and increased capacity and capability to implement with pace.
Any increase in capability and capacity must include the private sector, civil society, communities, and ordinary people. There may be early teething issues with the "recruits," but the ongoing burden on the professional frontline workforce is not sustainable without their involvement. Some countries are well underway in embracing this broad approach, while others continue with their futile paternalistic “we know better” approach.
CHUAH Jin Chai 蔡 仁材 Wellington, NEW ZEALAND 15th December 2021