And so this is Christmas
For weak and for strong,
(War is over if you want it)
For the rich and the poor ones,
The road is so long.
– John Lennon
“The problem on Christmas Day is you walk in to your family’s household, and grandma and grandpa are there, your parents are there, your aunt who has cancer is there, the kids are there… virtually everybody can catch Omicron, we risk turning Christmas day into a simultaneous super spreader event all across Sydney in thousands of households. That’s the problem.” – Dr Dan Suan on YouTube on 20 Dec 2021.
We post this warning from a doctor who works with Covid patients in Sydney about a possible super spreader event when people gather together at Xmas and end of year events in 2021. Dr Suan highlights Sydney but his warning could apply anywhere in Australia. We caution that there are some assumptions made in the video about Omicron where sufficient information is not yet available to test the doctor’s prognosis thoroughly.
Personally I am happy to forgo Christmas … at the very least I think it should be an outdoor event where possible. On Saturday 18 Dec 2021 I tried to get a booster from my local medical centre but they were understaffed and put me off till 12 January 2022 (and perhaps even are running short of vaccine?). There are many questions unanswered. How much are local medical centres being paid to administer the vaccines? What is the data that Health Ministers rely upon when they predict future cases? Why do we have individual doctors coming out, but the profession remains quiet? – Ian Curr, 20 Dec 2021.
Sydney’s sleepwalking into a catastrophic disaster in January, if we don’t do something about it right now. I’m a clinical immunologist. That’s what I do. I’m also an immuno-pathologist. And I work at one of Sydney’s biggest hospitals, and I did a PhD in the immune system response to vaccination. We’ve all had a difficult pandemic. From my chair, I’ve been involved in public health, I’ve looked after COVID patients and run a COVID board, I’ve helped to try and study why some people get severe COVID. And, of course, as an immunologist, we’ve been involved in the vaccine rollout, and dealing with side effects and problems with the vaccine.
My point is that I have a very interesting perspective, I can see the pandemic, from the public health population level, all the way down to the molecular level. And it’s very important.
I’m going to tell you three things about Omicron, then I’m going to tell you a story about Christmas. And then we’re going to decide together, what we want to be ending that story to look back. Our first problem with Omicron is that it is much more contagious than delta, or anything else we’ve seen before the mutation in the virus means that it is able to stay in the air much longer. And the consequence of that is that one person can infect many more people.
If you’re in a room with another person, and they have Omicron … They’re breathing talking, there is Omicron in the air. That’s the take home message.
The second problem with Omicron is that it can infect virtually everyone. So when we’re thinking about the problem, the question from a population perspective is who’s at risk of catching Omicron? The answer to their question to me is almost everybody in here. The only people that are really, really protected from Omicron infection are people who have a normal immune system and have been tripled vaccinated. That group of people are quite protected from infection from Omicron. Everybody else does not. So if you’re immuno-compromised and you’ve got three doses I don’t think you fall into a well-protected category.
If you’ve only had two doses, I don’t think you fall into a well-protected category. We’ve seen a omicron breakthrough. There’s infection in vaccinated patients we have seen. And, of course, the kids under 12 are completely unvaccinated.
So my point here is that even though we’ve hit 95%, double-vax, right, which protects us against Delta, virtually the entire Sydney population is at risk of catching Omicron. That’s a problem.
The third problem is the one we’ve been debating for days, which is severity. It’s very important in science, to be honest, when we don’t know. The Omicron outbreak is so early, we’re not 100% certain what the impact of Omicron is on disease severity.
Our best estimate at the moment is that the vaccines drops from giving you about 90% protection from severely severe disease, hospitalization and death, down to about 70%. Now, that seemed like a lot, until you run the numbers.
So I’ll just give you a hypothetical there were 2,400 cases of COVID today.
Let’s just round that to 2000. Now, if nobody was vaccinated, 2000 people infected, we would expect 10% or 200 people to come down with Omicron. Okay. If you’re fully vaccinated, if the entire population has the vaccine, that number comes down from 200 to 20. Because you could have a 90% reduction in severe disease and that’s one section. If the vaccines lose efficacy, they dropped from 90 to 70%. Then that number goes up to 60, from 20 to 60 people. So out of 2000 people, we now have an estimate of say 60 people needing to come to home. Now that does not sound like a lot. But Minister Hazzard this week told us that Omicron is pretty so quickly. Right? And so many people are at risk of catching that we may end up with 25,000 cases a day by January, by mid January. (What data does the Minister base that on?)
So if 2,000 people give you 60 admissions; 25,000 people will give you 750 admissions. Go back to Delta. When we had the Delta wave the the peak hospital admission in that outbreak was 1200 people in NSW and now I’m talking about 750 people a day, in two days, that’s 1500, and so forth and so forth, you can start to see the problem, even if Omicron is slightly less severe, right, which there’s no good evidence for. And even if vaccination does what we needed to do, which is to reduce the severity, the loss of that efficacy caused by the variant is still going to cause a massive problem.
Omicron may be slightly less severe. But if the outbreak is huge, and you put those two things together, the big problem wins, we will still have a huge number of people needing to be hospitalized, and it will overwhelm the hospital system. This time, it won’t just be Westmead and Liverpool (hospitals), it will be all hospitals across Sydney.
So that’s the problem. It’s a problem of pure math. Those three facts have a vast impact on the story I’m about to tell you, we have six days until Christmas morning. If we continue to behave like we have been in the last two weeks, you can see how steep the Omicron case curve. So you can expect if we keep our behavior the same, that curve to continue to climb. 2,400 cases today really means that there are several 1000 more people already infected, they just haven’t tested positive.
So if we don’t change our behavior, we could get to Christmas morning with 8,000 or 10,000 or more Omicron positive people in the community, if possible. On Christmas day most of us plan to get together with family and friends. The people who are passing Omicron to each other at the moment, are probably younger, healthier people … but being more social. And they’re probably not symptomatic. A lot of them will be asymptomatic.
The problem on Christmas Day is you walk in to your family’s household, and grandma and grandpa, there are your parents, your aunt who has cancer, there are the kids that … virtually everybody can catch Omicron, we risk turning Christmas day into a simultaneous super spreader event all across Sydney in thousands of households. That’s the problem. That’s the problem.
If everybody catches overcrowding on Christmas Day, then there will be a hospital-based disaster by early January, because all the infections happen at the same time. And we know what happens when a huge number of people attempt to try to get a hospital but at the same time, they can’t get the care that they need. And the death toll starts to climb far higher than it should be. If there’s a big Omicron outbreak, your health care workers will also be infected.
In the UK 10% of hospital staff are down. Right. And so we were attempting to deal with this potential ouotbreak in January it will most likely be with the context that a lot of staff are at home isolated because of other problems. Kids appear to be more affected by Omicron in the original description in South Africa 10% of the children 10% of the admissions to hospital for children, including kids under five.
Now, the honest truth is that it’s too early for us to know what proportion or what number of kids we might expect how many who have Omicron to come to hospital. But we know it’s going to be higher than the other areas. And we know that all the kids in the 12 island we’re going to have a huge outbreak. But you make a decision not to do anything. In that scenario, we can expect a huge outbreak, hospital based disaster in January. And the most likely outcome is the government will be forced to go back to lockdown. The UK is already struggling.
The hospitals are full … 10% of the staff are down … they’e running out of ambulances. Denmark has a problem. It’s starting to see European countries increase restrictions. America with its very low vaccination rate is about to have an Omicron catastrophe. I’ll tell you the same thing I told you in March 2020, there is no crystal ball. There’s only a direct relationship between our actions of the community and the outcome of Sydney in NSW
- Anytime you’re indoor, you should be wearing a mask. This is an extremely contagious able very to reconsider your events for the upcoming week.
- The first thing you have any symptoms you must get tested. You must get tested and isolate.
- If you test positive, unfortunately the government has removed contact tracing. So you now have to do your own contact tracing, you are New South Wales Health contact tracing. You’ve got a ring everybody that you were in contact with, and tell them to go and get tested.
- If you do your booster, for goodness sake, go and get it done right now.
- You need to talk to your family about Christmas. You need to think about who’s coming, are there elderly people coming, or their vulnerable people coming. You need to talk about how to make your Christmas COVID safe. Can you move it outdoor? That’s much safer? Can you find a way for all of you to be tested before you meet? Either via PCR test, or a rapid antigen test? Or both? If you’re high risk.
You need to really think through how to use technology and how to use the things that we know work. Right. Masking, distancing, to protect your family at Christmas.
And final point, I asked myself how we could possibly do any more. We’ve been through so much. Everyone has sacrificed so much. We’ve worked so hard. And what I’m telling you is that we’re at risk of throwing it all away now. Because the Omicron is so contagious, and can escape attacks.
Dr Dan Suan
MBBS FRACP FRCPA PhD Clinical Immunologist
Notes of YouTube by Ian Curr. Please address any errors or important omissions in the comments down below.