The current Omicron wave

July '22

We seem to be reaching the top of the current Omicron variant wave.

Daily new cases in the UK look to have exceeded that of the previous peak (early April) and should hit a little over 350,000 cases per day by the end of the week before starting to fall back.

We currently have just under 4,500,000 of the population infected — nearly 7% of the population. Note that we’re only halfway through the wave so as many people again are likely to become infected. Furthermore, that figure of 7% doesn’t include those that were infected earlier in the wave and who are now recovered. It is likely that around a fifth to a quarter of the population will have had a Covid infection during the current wave.

So much for the vaccines offering herd immunity.

Of course, we have seen low levels of hospitalisations and deaths given the sheer number infected, though it important to add that in absolute terms we’re still seeing more hospitalisations than seen at any point between spring 2021 and the final week of that year. I’m sure people will respond with the recent official line that most hospitalisations are now with not of Covid — but, of course, during 2020 and 2021 there never was any meaningful differentiation between hospitalisations with/of Covid so we can’t be sure if anything has actually changed in this regard.

I also note that we’re in the middle of summer when upper respiratory tract infections are less likely to result in serious disease.

What happens next is crucial — will the rate of infections fall back to the previous background rate of around 1,500,000 concurrent infections, will it fall further to a lower plateau, or will we see a new higher plateau? I fear it will be the latter. The level at which Covid levels have been flattening out between waves suggest that we might be seeing high levels of immunological tolerance to Covid in the population. This would lead to higher levels of infection (because of tolerance) but lower levels of severe Covid (which occurs due to an immune over-reaction rather than due to the virus itself) — however, it would also be associated with higher levels of damage that arises directly from the viral infection (or possibly autoantibodies to the virus that attack the body), resulting in higher incidence of related conditions (which appear to include thrombotic related disorders, cardiac inflammation and possibly neurological effects). Note that these latter conditions are unlikely to be attributed to Covid.

Whether any immune tolerance exists is very worthy of investigation; if it were the case then an obvious question would be whether the vaccines (or over-vaccination) increased this risk. However, there appears to be little enthusiasm in those funding scientific research to explore this aspect of our immune response.

We should see the next Covid wave arrive in October. Given the season this should also have fewer hospitalisations/deaths even if the size of the wave is of similar magnitude to the current Covid wave (this is unclear at present, but I’d consider it to be likely based on past Covid waves). The size of the autumn wave should indicate how severe a problem Covid might become during winter ‘22/’23. There is a complication in that there are signs that we’ll see an early influenza outbreak come to the UK this autumn — if it coincides with the next Covid wave there could well be a significant level of hospitalisations.