A scientist’s opinion: Interview with Dr Ole Heuer on Omicron

Interview with Dr Ole Heuer, Public Health Emergency Manager for the Covid-19 pandemic at the European Centre for Disease Prevention and Control (ECDC).

What do we know about the severity of the symptoms associated with the Omicron variant?

Ole HeuerOle Heuer: By 21 January 2022, there were more than 150000 reported Omicron infections in the European Union and the Euro Area (EU/EA) territory, a higher number of cases than ever seen before, with the presence of the variant in all EU/EA countries. However, in previous waves, we first observed an increasing tendency in the number of infected people, soon followed by a corresponding increase in mortality. Now, with Omicron, we are seeing a much higher increase in the number of cases than before, but this is not followed by an increased death rate.

Although hospitalisations due to Omicron appear to be rising, Intensive Care Units (UCI) occupation does not appear to increase. However, even if the infection proves to be milder, the sheer number of cases needing assistance might overload the healthcare systems. To prevent this from happening, vaccines are the most efficient means to try to control the spread of the pandemic and its effects.

In terms of policy, what can we do in Europe to avoid another hard lockdown like those we experienced last year, or would that actually be the right thing to do?

Ole Heuer: Countries are now better prepared to deal with new infections than in the first waves of the pandemic. They have now built up their monitoring and reporting systems, hospital capacity, logistics for testing. Vaccinations are in place. Furthermore, they know about the economic consequences of hard lock-downs. Therefore, they will want to avoid doing it again. Control measures should be combined with the most important tool at our disposal: vaccination.

Does it make sense to increase border controls to stop the spread of new variants?

Ole Heuer: So far, Omicron has been reported in all EU states, and it has been expanding at a previously-unforeseen speed. Therefore, it would not be effective to try to control the spread by introducing new travel restrictions. A different situation would be if a newly-detected variant is confined to a geographical area. Then, we could delay spread by limiting travel from that area. The spread may however go undetected for a while. For instance, soon after the variant was first detected in UK, several countries limited travel to/from the UK just to discover that the variant was already present within their borders. To be able to contain multinational spread we would need to identify new variants very early and very fast by sequencing almost every isolated case. At the early state of the pandemic, this was practically impossible. By now, many countries have built up this capacity.

Is vaccination-based Covid-19 prevention possible at a global level?

Ole Heuer: Since the virus does not respect borders, disease prevention is not a problem that can be tackled within Europe or within a single country. These are global problems that require a global solution. Therefore it would be best if high vaccination rates could be reached at a global level. That being said, even within Europe there are big differences in vaccination rates, so efforts to increase vaccination should be made in all countries.

What can we expect for 2022? And is there an end to Covid-19?

Ole Heuer: We are seeing peaks of infections at different times in different countries. Then, assuming there is some seasonality in the occurrence of the virus, we may see a decrease during the summer like in previous summer periods. Since Covid-19 seems to be here to stay, we need to get as many people vaccinated with the booster as possible to prepare for the next winter season, where another peak might appear. However, we also need to be vigilant of the possibility of new variants appearing.

Covid-19 is full of surprises. For instance, the Delta variant dominated the scene for months, until Omicron suddenly appeared and within a few weeks became the dominant strain in some countries. Therefore, I do not expect that Covid-19 will disappear this year, and we will probably need to pay attention to it for years to come.

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