Top medical scientists in Britain have again come under fire for ignoring the expertise of respected South African COVID-19 researchers after the Omicron variant was identified, as well as for exaggerating its danger. There have been diverging views on Omicron’s severity, but no doubting its transmissibility – half of Europe’s population is forecast to be infected within two months, while America has announced that it will attempt to live with COVID as a manageable disease.
On Wednesday (January 12), AFP reported Dr Anthony Fauci – chief medical advisor to the American president – as saying that with soaring cases and record COVID hospitalisations, the United States was “approaching the ‘threshold’ of transitioning to living with the coronavirus as a manageable disease”.
Eliminating COVID was unrealistic: “Omicron, with its extraordinary, unprecedented degree of efficiency of transmissibility, will ultimately find just about everybody,” Fauci said. COVID would not be eradicated, given its contagiousness, its ability to mutate into new variants and the large pool of unvaccinated people.
On Tuesday, World Health Organization Regional Director for Europe, Dr Hans Henri P Kluge, said that the Omicron variant “represents a new west to east tidal wave sweeping across the region, on top of the Delta surge that all countries were managing until late 2021”.
“The region saw over seven million newly reported cases of COVID-19 in the first week of 2022, more than doubling over a two-week period. As of 10 January, 26 countries report that over 1% of their population is catching COVID-19 each week,” he said.
The Institute for Health Metrics and Evaluation, Kluge said, forecast that more than 50% of the population in the 53-country region would be infected with Omicron in the next six to eight weeks. Data confirmed that Omicron is highly transmissible and can infect even people who have been previously infected or vaccinated, although vaccines continue to provide good protection against severe disease and death.
Kluge was “deeply concerned that as the variant moves east, we have yet to see its full impact in countries where levels of vaccination uptake are lower, and where we will see more severe disease in the unvaccinated”.
For example in Denmark, where Omicron cases have exploded, the hospitalisation rate for unvaccinated patients was six-fold higher than for the fully vaccinated over Christmas. UK data showed that 96% of pregnant women admitted to hospital with COVID-19 symptoms between May and October 2021 were unvaccinated, and a third required respiratory support.
Kluge said the “5 plus 1” pandemic stabilisers that had recently guided the COVID response remained the mantra: vaccination; third doses or boosters; increased mask use; ventilation of closed spaces; and the application of new clinical protocols.
In South Africa as of Tuesday, total cases stood at 3,534,131 and there were 5,668 new cases in the preceding 24 hours. COVID deaths stood at 92,649 and daily deaths averaged 119. By Tuesday evening there had been 28.5 million vaccination doses delivered and 16,124,481 people had been fully jabbed – 27.4% of the population.
UK's baffling response
In the UK, the “dismissive response” of the government to South Africa’s identification of the Omicron variant and assessment of its severity is “baffling”, writes The Telegraph associate editor Gordon Rayner. Is it xenophobia? Arrogance? Or an attempt at public manipulation?
“There are several things we donʼt know about Omicron,” Professor Sir Chris Whitty – Chief Medical Officer (CMO) for England, the UK government's Chief Medical Adviser and head of the UK public health profession – told the British nation in the week before Christmas 2021, “but all the things we do know are bad.”
His comment puzzled many people at the time, given that scientists in South Africa, where Omicron was first identified, had reported that it appeared to be less severe than the then-dominant Delta variant of COVID.
South Africa has a highly sophisticated genomic surveillance capability for COVID – which is why both the Omicron and Beta variants were first identified there – so the thoughts of its scientific experts surely merit attention, writes The Telegraph.
Yet Boris Johnson said last month that “the idea that this is somehow a milder version of the virus, I think thatʼs something we need to set on one side”, while Sir Chris said evidence from South Africa of a milder illness had been “over-interpreted”.
Three weeks on, Sir Chris’s determination to dismiss the encouraging data coming from South Africa seems even more baffling. Instead of the post-Christmas lockdown that had come to be regarded almost as inevitable, COVID rules were being eased. The NHS did not collapse, and the number of patients requiring ventilation remained less than a quarter of the peak a year ago.
The Telegraph continues: legitimate questions are now being asked about why Britain was so dismissive of the evidence from South Africa, and whether government scientific advisers are once again using fear as a method of control.
One of those doing the asking is Angelique Coetzee, chair of the SA Medical Association.
Coetzee was among those who reported that Omicron caused “very, very mild” symptoms compared with Delta, and she hypothesised that it “could potentially be of great help to us” by replacing the more dangerous Delta variant and helping the population to reach herd immunity at minimal cost to life. She says she was “astonished” at the panicked response to it in the UK.
“South Africa has a younger population, but we should have seen far more disease than you in Britain because of the vaccination picture." Fewer than one in three people are fully jabbed, and South Africa has only just started giving boosters. In the UK, 83% of people are double-jabbed, and 61% have had a booster.
“If you donʼt know by now that the majority of people are going to have mild symptoms, then what other evidence are you waiting for?”
A clear case of discrimination
When South Africa announced its identification of what became known as Omicron, the country was stunned by the world’s unhelpful reaction, especially that of the UK. On 26 November 2022 The Guardian reported that South Africa had angrily condemned the travel restrictions immediately slapped on it and other Southern African countries.
Health Minister Joe Phaahla said South Africa had acted transparently by alerting the world to the B.1.1.529 variant. “The reactions of countries to impose travel bans are completely against the norms and standards as guided by the WHO,” said Phaahla. “The same countries that are enacting this kind of knee-jerk, draconian reaction are battling their own waves.”
Anger grew in South Africa, which had been hoping for a much needed holiday season reprieve from a COVID-induced tourism slump, The Guardian wrote. The country was on the UK’s red list for much of 2021, despite having lower infection numbers for much of this period, and had only been removed in October.
Professor Tulio de Oliveira, the internationally respected director of the Centre for Epidemic Response and Innovation, tweeted on 25 November: “We have been very transparent with scientific information. We identified, made data public, and raised the alarm as the infections are just increasing. We did this to protect our country and the world in spite of potentially suffering massive discrimination.”
And in another tweet: “The world should provide support to South Africa and Africa and not discriminate or isolate it.”
Soon afterwards, interviewed by The New Yorker, De Oliveira slated the events that unfolded after the new variant announcement. “The UK, after praising us for discovering the variant, then put out this absolutely stupid travel ban, and it has hoarded vaccines for the last year. It’s trying to put the blame on vaccine hesitancy. It’s looking for a reason to fault Africa.
“And we are honestly tired of this – after not having access to vaccines, having to pay more expensive prices, having to get in the back of the queue, and still doing some of the best science on COVID in the world, because not only did we identify this variant, but we identified the Beta. We also helped the UK to identify the Alpha.”
Foreign scientists have been ignored before
It is not the first time government scientific advisers have allegedly been dismissive of what colleagues in foreign countries have been saying, Rayner continues in The Telegraph.
On 21 February 2020, the village of Voʼ Euganeo, near Venice, went into strict quarantine after the countryʼs first recorded death from COVID, and almost all of its residents were tested. Around 40% of those who tested positive had no symptoms, strongly suggesting asymptomatic transmission was occurring.
Some members of the Scientific Advisory Group on Emergencies (Sage) say they raised concerns about asymptomatic transmission with Sir Patrick Vallance, Chief Scientific Adviser, and with modeller Prof Neil Ferguson, only for their concerns to be dismissed.
The two men say the warnings were not ignored, yet Boris Johnson has always insisted he would have done things differently if he had understood sooner that COVID was transmitted asymptomatically (Britain resisted lockdowns for a further month after the Italian data was published).
Does Coetzee think xenophobia has played a role in Britainʼs dismissal of her advice, The Telegraph asked? “No – but I think there was arrogance from the politicians in the UK. Also, Boris Johnson was going through a bad time because of the criticism of his Christmas parties, so maybe there was a political reason for all this.
“People in the UK, including those advising the government, donʼt seem to understand what the clinical picture is. The scientists are not sitting with patients in front of them. I am a GP and Iʼm looking at a list of 116 patients I saw, of whom only three were admitted to hospital, one of whom was not fully vaccinated and two of whom were high risk because of obesity, diabetes and so on.
“You have to empower people by telling them what is going on, but I get the feeling that some of the UK scientists didnʼt want to use the word ‘mildʼ, they only want to use the word ‘severeʼ.”
According to The Telegraph, her suspicion appears to be borne out by the language used by the SPI-M-O modelling committee, which on 7 December said: “Currently, there is no strong evidence that Omicron infections are either more or less severe than Delta infections.”
Sage has also avoided the use of the word “mild”, noting on 16 December that “it is still too early to reliably assess the severity of disease caused by Omicron compared with previous variants. Although a preliminary analysis from South Africa suggests that this wave may be less severe than previous waves, a comparison of … cases within this wave suggests less difference between variants.
“Some severity estimates should start to become available in about a week … even if there were to be a modest reduction in severity compared to Delta, very high numbers of infections would still lead to significant pressure on hospitals.”
Linguistic manipulation has been 'entirely deliberate'
Laura Dodsworth, author of the book A State of Fear: How the UK Government Weaponised Fear During the Covid-19 Pandemic, says the “linguistic manipulation” was entirely deliberate, writes Rayner in The Telegraph.
“The omission of the word ‘mildʼ is not an accident,” Dodsworth says. “The problem for the government is that once you have started using fear as a tactic, there is nowhere left to go, so you have to keep on using it, and you have to keep on quoting worst case scenarios.
“But each time you do it, the tactics become less successful because people become wise to it. Once you have seen the smoke and mirrors, you canʼt unsee it.”
Modelling published by SPI-M-O on 15 December suggested a “high-level scenario” of infections, peaking at between 600,000 and two million per day with the current Plan B restrictions between late December and January, with up to 6,000 deaths per day, peaking between mid-January and mid-March.
In fact, reports The Telegraph, infections are currently averaging around 180,000 per day and may have already peaked in some parts of the country, with deaths averaging just more than 150 per day.
Even when fresh data backed up what the South African scientists had been saying, Sage was dismissive, noting in its 20 December minutes: “The number of infections and hospitalisation in Gauteng [a province in South Africa] appears to be declining. The reasons for this are not clear, and it cannot be assumed that this will be sustained.”
Mark Harper MP, chairman of the anti-lockdown Covid Recovery Group, said ministers had once again been guilty of blithely following expert advice rather than interrogating advisers and looking at the picture in the round.
“The whole history of the pandemic shows that ministers need to ask better questions,” he says, “challenge the advice and really get their heads around what they are being told so they can weigh it up against all the other factors they need to consider in the best interests of the country.”
The gloomiest predictions for the Omicron wave now seem certain to have been wide of the mark. The problem for the government is that if a more dangerous, vaccine-resistant variant arises, it could prove difficult to persuade an increasingly cynical public to do as theyʼre told.
See more from the MedicalBrief archives:
State of play with Omicron – The discovery, the spread, the politics, and the science
Omicron variant: Clinical severity and hospitalisation profile in South Africa
WHO: Omicron more transmissible but not necessarily milder
Science under attack in UK for ‘apocalyptic’ COVID-19 claims