July 5, 2022

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RIVM: Perhaps more good news about omikron

RIVM: Perhaps more good news about omikron

Even before the first delta wave went off, Omikron threw a wrench into the works. The result is a closure and a massive promotion campaign. It is a race against time. Are the elderly and frail enough protected before the number of omicron infections starts to rise?

Jacco Wallinga, director of the CDC and RIVM designer Jacco Wallinga, asked about this in an interview with NOS. The good news: There are initial signs that things may not be so bad.

Lockdown and crackdown: Will that be enough together to prevent a wave of hospitalizations?

Walinga: “The problem with such a new variant is that you’re going to get a wave anyway. The idea of ​​the scales is that that wave is a little bit delayed. That gives you more time to consolidate, and you hope the wave gets smaller. But it remains a wave, it doesn’t go away.”

“A boost alone isn’t going to get you there. It really does reduce the risk of hospitalization, and we know that for sure. But we don’t know yet how well it protects against further spread. We think it also has an impact on that, so that’s going to be helpful.”

Imperial College London released the first major European study of the omicron this week. It states that omicron is less pathogenic than delta. good news?

Walinga: “Of course that would be good news. But we’d like to see his confirmation based on more data and from different countries, before I jump in with excitement. But that’s a good sign, it makes me happy.”

In models it was assumed that delta and omicron are equally pathogenic. With the information from London, will the January peak now be significantly less high?

Walinga: “The number of hospital admissions that we calculated per day can then be divided by two. But the uncertainty is still very large, and so is the rate of increase. So even with this halving, it is doubtful that it is within the capacity of hospitals, not only in Holland but also in other countries.”

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According to Walinga’s account, without measures, there could be 4,000 people in intensive care at the same time in January. That could be 2,000 in the new models, which is still much more than the 1,400 coronavirus patients at the height of the first wave.

But there may be another unexpected gain: There is some evidence that people with oomicron are contagious for two or three days, rather than four or five days. “It’s rarely mentioned. But if it was, that would be good news,” Walinga said. “In this case, the virus will not spread faster because it is more contagious (so the R number is not higher), but because people are more likely to pass it on to others.”

The result: Omicron leads to a faster increase in the number of infections, but the peak is no higher than the delta.

Suppose person A infected person B after two days, who infected person C after two days, and then infected person B two days later. Three people were injured in six days. In the Delta, it takes at least twelve days to infect three people. With Omicron, the infection may increase faster, but the number of infected is the same.

It may have happened in Gauteng Province, South Africa. The number of infections increased rapidly in a short time, but the peak was no higher than in the Delta, and the epidemic subsided more quickly.

In combination with a milder course of the disease, the omicron can also be an “improvement” compared to the delta. But then, all the quadrants should point in the right direction.

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Less effective measures have been taken in neighboring countries. Is this because it has strengthened over time there, or will those other nations soon follow?

Van Diesel: “I think the last thing. We’re already seeing that different countries are taking additional measures, or medical experts calling on politicians to do it, in Germany and Denmark and Germany and Belgium.”

I have previously suggested that the timing of the reinforcement in the Netherlands may be ideal.

Van Dessel: “The basic idea is that the effect of a booster on an omicron may only be temporary, weeks to months. That means if you’ve given it before, you have to boost again. You see signs of that in Israel where some of the population gets the IV vaccination. The shorter the infection time, the better.

Should we reinforce again in the Netherlands in the summer as in Israel?

Van Dissel: “It really depends on how this wave appears. Of course everyone wants a very clear point on the horizon. But there are also situations where the point on the horizon is constantly changing, and we have to adapt to that.

But is there an conceivable scenario in which we don’t consolidate every six months or every year?

Van Dissel: “That still looks like a crystal ball, to me. We’re now on the eve of an omikron increase. We’re going to learn a lot from that. What if another variant comes next?”

“And when you vaccinate, you want to get a vaccine that is as specific as possible. In fact, the immunity of this vaccine is good, but it targets a virus that no longer exists. Because the virus still has many of the old properties there is still protection, but with the next variant it can be less “.

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At the press conference on Saturday you said the virus had put on a different coat. This created the impression that the vaccine was no longer working, while there was still protection against hospitalization.

Van Diesel. “Of course. It’s a comparison you’re doing at that moment to show that the immune system needs to recognize. If the virus changes its properties in this way, the antibodies have a hard time recognizing it properly.”

Now you can put it in black and white.

Van Dissel: “Of course. If the coat changes color, it does not mean that the antibodies cannot recognize the shape of the coat. (…) After two vaccinations, protection against hospitalization by omikron is still between 60 and 80 percent. This is less than delta , but not zero either.”

At the end of September, OMT advised to abandon the 1.5-meter rule, and introduce the corona corridor instead. This was later reversed. How realistic is it to release 1.5m again next year?

Van Dissel: “It depends on how omikron progresses. And I think what we increasingly realize is that omikron isn’t over yet. As long as large parts of the world haven’t been vaccinated yet or have been infected, the prospect of being the next alternative. requires a different perspective in the long run. Unless we can adapt vaccines faster, and this is already happening more and more smoothly, you want to be able to go back to measures like 1.5 metres.”