The New Year brings some stark realities about the pandemic, but it's not all doom and gloom despite the stuff-ups.
Yesterday more than 21,000 new cases of COVID-19 were diagnosed in NSW, a record. It's almost certainly an underestimate.
Presumably the majority are the new very infectious omicron variant. Over 800 patients with COVID are now in hospital in the state; that's the equivalent of nearly two major hospitals being chock-a-block full of only COVID cases choking the system.
COVID is everywhere in the region. In the Hunter there were nearly 2000 cases yesterday, another record.
We know cases are going to continue to rise, and rise fast, which means there will soon be more people in hospital (there is a one week lag) and more stress on the health system.
I don't buy we are all going to have to get COVID. And I don't buy we have to let it rip
The Prime Minister has announced new policies including a revised definition of a close contact. Frankly it's nonsense. Many people catch COVID from fleeting contact, bring it home, have no symptoms for the first few days, infect their family and then get ill. The reason for the changes is pragmatic; there isn't enough testing capacity despite having months to plan the reopening.
The new policies will result in a large rise in undiagnosed cases in the community and increase spread further. It's rationing, from poor planning. The new policies won't protect most of us. Going forward we will be largely responsible for our own testing, contact tracing, and if sick with COVID (unless very ill) self-care.
You can help protect yourself and your family. Buy N95/P2 masks and use them when out rather than cloth or surgical masks, as they give better protection against catching this airborne virus. Avoid crowded indoor venues. Have a COVID plan to self-isolate if needed. Consider a home oxygen monitor. HEPA filtration devices clear the air of virus. Make sure everyone in the family is fully vaccinated and get a booster as soon as you can. If you haven't a family GP, find one.
Rapid antigen testing (RAT) is largely replacing the gold standard highly accurate PCR tests we are used to lining up for. RATs if positive accurately indicate you are infected but you should try to get a PCR done to confirm. A negative RAT is wrong about 30 per cent of the time so repeat a day later.
To do a RAT you (or your partner) will have to swab your nose (and follow the instructions carefully as you are swabbing near your brain). The omicron variant is more likely to be found in the throat so just swabbing the nose may miss infection (there is no advice yet to swab both the nose and back of the throat). Not only are RATs hard to get and costly right now. It's not clear if and how government will record home testing results.
Omicron can partially escape the protection of vaccination. But there is good news. The omicron variant is likely milder than delta. Hospitalisations and ICU admissions are currently low from omicron. Vaccination protects against serious illness and need for hospitalisation even in the elderly, and a booster adds more protection (but nothing is 100 per cent). While many get symptoms if infected with omicron, they are usually mild and short lived (a few days) if fully vaccinated.
If you are an unvaccinated adult you are very likely at much higher risk of being hospitalised from omicron - get the jab.
Aren't we all going to catch COVID anyway so why take precautions? We should try to keep a lid on it for now, and we can.
Even if hospitalisations with omicron are rare, if case numbers are huge many will need to be admitted. There is then a big risk the health system buckles: ambulance services are overwhelmed, staff fall ill, emergency departments can't cope, hospital beds are unavailable, oxygen supplies run low, emergencies have to be diverted but alternatives are also overwhelmed, and people suffer and die from COVID and other health emergencies.
Unless we are all safe, the economy isn't safe either. And we know nothing about the risk of long COVID (symptoms for months or longer) and omicron.
There are other reasons to try and keep case numbers down - you wouldn't want to let it rip until the booster roll out and vaccination of children is complete to protect the many who are vulnerable. And omicron appears to be a higher risk to children in terms of hospitalisation than delta.
Antiviral medications used early can save lives, and new options are likely coming soon (e.g., Paxlovid).
Israel is testing if a fourth vaccine dose is helpful or not by vaccinating the population and we'll have data soon. Plus, new generation even better vaccines should be available this year.
I don't buy we are all going to have to get COVID. And I don't buy we have to let it rip. Everyone of us taking action will make a difference. Happy New Year.
Dr. Nick Talley is Editor-in-Chief of the Medical Journal of Australia
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