Darkest days could be behind us as data hint that omicron cases may have peaked

Tuesday was the Winter Solstice, our darkest day and longest night, before the sun begins its slow ascent higher into the sky again.

So it seems fitting that the latest coronavirus data is also starting to show a glimmer of light.

After weeks of relentless growth, the first signs of a slowdown have begun, with some experts speculating that England may even have peaked.

Although admissions are still rising, cases in Britain have been largely unchanged for about six days, with 90,629 reported on Tuesday, a fall of 1,115 from the previous day.

Case rates are also reassuringly low in areas with high vaccination, suggesting that vaccines and boosters are holding up well against omicron. It is still too early to be sure, but here is what the latest data is telling us.

Hospital-case ratio

The number of people ending up in hospital after testing positive for Covid has fallen to one of the lowest points in the entire pandemic, with just 1.95 per cent being admitted.

The only time it was lower was when it hit 1.8 for a day in mid-July. Last December, it was as high as 12 per cent.

This decoupling of cases from admissions could be due to a number of factors, including omicron being less severe, better immunity from vaccination and prior infection, or a younger age group being infected. 

However, it means we can expect far fewer hospitlisations and deaths than previous waves unless case numbers skyrocket.

Applying the ratio to case numbers up to December 14, and allowing for a 10-day lag, it suggests that we might expect about 1,200 admissions in Britain by Christmas, well below the January peak of 4,000.

There are fewer admissions per confirmed case

Prof James Naismith, the director of the Rosalind Franklin Institute, said: “We know that omicron per 1,000 infections will cause many fewer deaths and hospitalisations than the alpha wave. It is very likely due to the immunity from boosters, vaccines and previous infection that the number of severe disease outcomes per 1,000 infections will be lower than delta.

“What we don’t know is whether there are so many cases that even with a lower rate of severe disease per 1,000 infections, we still end up in trouble.”

London is seeing a different picture, where there has been an uptick in the hospital case ratio since December 8, with some experts arguing that the capital should be viewed as the canary in the coal mine. But London may not be representative of the rest of the country.

An epidemic of the unvaccinated?

Doctors and NHS trust leaders have complained frequently in recent days that the vast majority of hospitilised Covid patients in London are unvaccinated.

On Tuesday, Rupert Pearse, an intensive care consultant, told BBC Radio 4’s Today programme that the number of unjabbed people at Queen Mary’s University Hospital was between 80 and 90 per cent.

Telegraph data show that coronavirus case rates are 50 per cent higher in areas with the worst vaccine uptake compared to the best.

The highest case rate in the country is Acre Lane in Lambeth, south London, where 3,610 per 100,000 are infected and 32.4 per cent are unvaccinated.

In areas where more than 30 per cent of the population have not received a single dose, the average case rate is 921 per 100,000, compared to 603 per 100,000 where fewer than 10 per cent are unvaccinated.

How is omicron comparing to previous waves?

Booster take-up

Booster take-up also appears to be having a big impact. Areas with over-60s case rates greater than 200 per 100,000 have an average booster rate of 79.9 per cent. In contrast, those places with case rates below 100 per 100,000 have an average booster rate of 89.5 per cent.

Barking and Dagenham, for example, has the highest rolling rate of anywhere, with 371 per 100,000 amongst over-60s, but only 70 per cent have had a booster jab.

On the other end, King’s Lynn has a case rate of 38 per 100,000, but 90 per cent have been boostered.

London holds 15 out of 18 council areas in England where more than a fifth of over-60s are yet to be boosted.

Although some of the differences in case rates are certainly to do with demographics and location, vaccination is likely to be playing a part in the London figures, suggesting areas with higher levels will see less of a problem.

Paul Hunter, a professor in medicine at the University of East Anglia, said: “This is not entirely an epidemic of the unvaccinated, but certainly low vaccination rates in some areas are helping drive the epidemic in several areas both in infections in the unvaccinated but also high infection rates causing breakthrough infections in vaccinated.

“Certainly much of the pressure of severe disease on the health service comes from infection in the unvaccinated.”

Did cases double every two days?

Are cases peaking?

As Prof Chris Whitty pointed out recently, the faster a wave rises, the more quickly and dramatically it is likely to fall. Certainly within three weeks of the omicron variant emerging in South Africa, cases had begun to decline.

Over the weekend, the first hints of a plateau emerged in the data, with cases hovering about 90,000 for the past six days. Although we can expect to see the usual rise on Wednesday as more weekend data is added to the daily count, some experts think this levelling off could be real.

Carl Heneghan, a professor of evidence-based medicine at the University of Oxford, said: “I’m watching the specimen data and I think 15th December was potentially a peak in cases in England on that day, and that’s what I am waiting to see in the coming days.

“I think cases will go up again, but this number looks like it has stabilised. We should have a better idea by Thursday.”

It is clear now that the UK Health Security Agency model suggesting that omicron cases were doubling every two days has not come to pass, as it would mean 3.2 million infections by now.

Prof Hunter said that if the current trend continued, there would be no need for a lockdown.

“Latest data suggests that total case numbers, and therefore omicron, may already have plateaued or even peaked,” he added.

“Indeed, infection numbers may have fallen slightly in the last few days. Case numbers have been pretty level for six days now, so reasonably sure we are no longer seeing exponential growth.

“It looks as though this previous rapid increase may have slowed quite dramatically. And if that is the case, then there probably isn’t a need for a lockdown.”

So there are reasons to hope that we will not see a repeat of last winter.

Interventionist scientists calling for more restrictions have coined a new term for omicron optimism: “hopium”, a neologism seemingly descended from Karl Marx’s dismissal of religion as the “opium of the people”.

Prof Naismith said there was always a danger of being over-optimistic and acting too late, but added: “If it turns out to be mild, then acting too quickly will be seen to have damaged livelihoods for no reason. This will damage the economy and, in time, public services.

“I do think it would help if the debate emphasised the uncertainty alongside the risk of acting too late.”

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