This week’s view of public health officials imposing even more restrictions, with a record 20,000-plus Covid-19 cases in one day, told its own story.
For the first time in several months, all major pandemic indicators are stable or improving. The case count is stable for the last 10 days. The number of Kovid-19 patients in the hospital has stabilized in the last five days after Christmas Day.
ICU numbers have been declining since November and have remained fairly stable since Christmas Day. There are fewer patients in the ICU now than on November 10.
The case positivity, which started increasing before Christmas, gradually increased after that. Over the past five days, this figure has stabilized and has failed even a bit.
These trends are subject to all kinds of warnings. The massive Omicron variant generates overloaded testing capacity so the actual number of infections is much higher than what is confirmed by PCR testing. Up to 500,000 people would have been infected in the first week of the year.
The number of COVID-19 patients in the hospital has been the main pressure point in recent weeks, but an increasing number of these patients are in the hospital with other conditions, and then found infected with the virus. For some of these patients, COVID-19 will exacerbate their condition; For others, it will be a sideshow.
According to HSE, 30 percent of patients diagnosed with COVID-19 are actually in the hospital for something else. The fact that that figure has risen from 10 percent a few months ago is evidence of a lack of testing in the community and the mild symptoms associated with Omicron.
A snapshot survey last week by the Infectious Diseases Society found that half of COVID-19 patients showed symptoms of the virus and more than 70 percent were not on oxygen therapy.
GPs are seeing a decline in referrals for testing, which adds to the indication that we have passed the peak of infection
Brian Kent, a respiratory therapist at St James’s Hospital, noted during the week, “Even among people with covid disease, only a small proportion have florid covid pneumonia with difficulties getting oxygen. “
I’ve seen that up to 40 percent of their COVID-positive patients are “because they have something else going on and they have Sars-CoV-2 in their nose, not because they’ve outgrown COVID.”
While some patients are still getting very sick, doctors in Ireland and other countries have reported that they are more likely not to be vaccinated.
Assessing what happens now is hampered by a paucity of data. The Center for Health Safety Monitoring has not published daily incident reports since Christmas Eve. The case-confirmation move based on self-administered and self-submitted antigen tests for many people means the daily case count, the main focus of the pandemic in the past two years, will now be lower than before.
drop in referrals
GPs are seeing a drop in referrals for testing, which adds to the indication that we have passed the peak of infection.
so what happens now? We know that Omicron is completely dominant in Ireland (98 percent of cases), that it moves faster than the previous variant and is less severe.
Ireland will, hopefully, follow the pattern seen along the Omicron curve in the UK and other countries. Cases should drop sharply from the current high peaks, although new, shorter periods of self-isolation could lead to a massive increase in still-contagious people. The reopening of colleges will also contribute to the spread. However, it seems likely that any of these factors will fundamentally change the direction of travel as the spring approaches.
We can’t vaccinate people every few months, because that would lower their immunity
Looking across the Atlantic, the US is experiencing an increase in hospitalizations that exceeds anything else in Europe. The most likely reasons are low vaccination rates (not applicable here) and the continued prevalence of the delta variant.
Meanwhile, in the UK, children’s admissions have tripled since the end of December. Experts are investigating this trend but think it may be the result of higher community transmission affecting a non-vaccinated group.
Age-wise hospitalization figures have not been published in Ireland this year, so it is not possible to say whether something similar is happening here. On Thursday, there were 22 children with Kovid-19 in the hospital and two in the ICU.
There has been an increase in outbreaks in nursing homes and cases in older age groups, which need to be monitored. So far, the size of the outbreaks has remained small.
At this stage, there does not appear to be any reason not to lift the current hospitality restrictions as planned at the end of the month or even earlier. The Danish government is now about to reopen cinemas and music venues as their hospital numbers dwindle, even though infections remain high.
Other than that there is no certainty. O’Micron has boomed favorably to the world but the next version may not be so benign. We can’t vaccinate people every few months, because that would reduce immunity and anyway the vaccines we’re using were designed for a different strain of covid-19.
What we really need to focus on in the coming months is long-term thinking and planning, primarily to deal with the winter surge of infections.