Omicron and the Pandemic’s Course Ahead
The emergence of the Omicron variant could prolong the Covid-19 pandemic, which was previously expected to end in 2022. Collaboration is needed to prevent Omicron from emulating the deadly Delta wave in 2021.
The spike in Covid-19 cases and deaths due to the widespread transmission of the Delta variant in mid-2021 finally subsided and Indonesia has since enjoyed a sloping pandemic curve in the last trimester. However, the emergence of the new Omicron variant could reverse the pandemic’s positive trend in 2022.
Data as of Tuesday (28/12/2021) from the Covid-19 task force show that Covid-19 cases in Indonesia fell 99.6 percent for 23 consecutive weeks. This means that Indonesia was just 0.4 percent short of becoming free of daily Covid-19 cases.
The sloping transmission curve was also seen in the positivity rate, the ratio of positive results among all people tested, which only reached 0.19 percent.
Entering December, new Covid-19 cases averaged less than 200 cases per day, the lowest since 7 April 2020. The daily toll was below 10 deaths, and even went down to a single death recorded on 28 Nov. 2021, the lowest since 17 March 2020.
During the Delta-driven second wave, the daily toll reached 2,069 deaths on 27 July, while new daily cases hit a record 56,757 cases on 15 July, with a positivity rate of more than 35 percent.
Also read:
> Omicron Cases Increase, Children at Risk
We still remember the calamity during the July-August period. Hospitals were overwhelmed, health workers helplessly overworked, oxygen was alarmingly scarce. As a result, many patients succumbed to the virus in hospital yards, on the streets, and at home before they could receive medical treatment. Even when it came to burials, there was a backlog of corpses waiting to be buried.
The current downward trend in the pandemic curve has come in on the tail of horrifying scenes, our relatives and close friends among those who had succumbed.
The official figures of Covid-19 cases and deaths in Indonesia were certainly much lower than the actual numbers. A serological survey conducted in Jakarta between 15 and 31 March 2021 found that 44.5 percent of those tested had been infected with SARS-CoV-2, the virus that causes Covid-19, but that 81.6 percent of these cases had missed prior tests (Kompas, 10/7/2021).
In addition to revealing the high number of infected people in Jakarta, which came to light before the Delta wave, the survey also indicated low detection due to limited testing and tracing, despite Jakarta having the highest Covid-19 testing capacity in Indonesia.
The indications of the survey results found ground. Field monitoring conducted by Kompas found that the deaths per capita in several villages in Java in July 2021 was 10 times higher than the average of the previous five years (Kompas, 4/8/2021). Most of the deceased were not recorded as victims of Covid-19.
It is interesting to note that the raging Delta wave was a blessing in disguise, with many infected patients developing immunity, which resulted in a declining caseload trend, apart from the impacts of the public restrictions.
Portrait of workers' mobility while waiting in line waiting for the arrival of Transjakarta Buses at Harmoni bus stop, Jakarta, Thursday (30/12/2021). Entering the end of 2021, the Government again reminds the public to increase awareness by reducing mobility due to the discovery of local transmission of the Omicron variant.
Like a fire gradually dying down for loss of a fuel source, the Delta wave died down because most people had developed immunity from previous infections, apart from vaccinations.
A number of studies have shown that either vaccination or a prior infection helps protect an individual against Covid-19, for example as stated in a publication in the journal Emerging Microbes & Infections (Zang et al, 8 Dec. 2021).
Thanks to improved community immunity, either due to a previous infection or vaccination, Indonesia, along with many other countries, experienced a period of decline.
The world was preparing to enter an endemic period by easing restrictions when Omicron brought infections back at an alarming rate.
Also read:
> Vigilance for Omicron Variant Heightened
> Omicron Variant Transmission Expanding
Since it was first detected in South Africa on 23 Nov., the newly identified Omicron variant has now spread to 115 countries at a speed that exceeds its predecessors.
A number of countries with local transmission of Omicron have reported high daily Covid-19 cases, including countries with the highest vaccination rate, such as the United States, South Korea and the United Kingdom.
Omicron factor
Studies show that Omicron, which has more than 30 mutations in the spike protein, is much more contagious than Delta. Omicron's ability to evade antibodies gives it a reinfection capability of up to 5.4 times higher than Delta. Antibodies formed by vaccines or previous infections will diminish over time.
The good news is that a study by scientists from Imperial College London, released on 22 Dec. 2021, supports the findings by South African doctors that hospitalization for patients with an Omicron infection was much less likely than those with a Delta infection.
It says that the risk of people with Omicron requiring hospital treatment has declined 20-25 percent compared to those with a Delta infection, while the need for hospitalization has fallen 40-45 percent.
For infected patients who had no previous infections or were not vaccinated, the risk of hospitalization was 11 percent lower for Omicron than for Delta.
We are required to accelerate the vaccination rollout, especially for the elderly, the coverage for whom remains the lowest.
The study states that two vaccine doses are not sufficient to provide a high level of protection, so booster injections are needed. Researchers also found that having a previous Covid-19 infection can reduce the risk of hospitalization from Omicron by about half.
With this latest development, the need for booster vaccines is inevitable. Amid calls from the World Health Organization (WHO) on fair distribution of vaccines, a number of rich countries, such as the US and a number of European countries, have ramped up their booster vaccinations. In fact, Israel is currently prepared for second booster injections.
Even if it becomes a necessity, boosting vaccine doses provides a dilemma for Indonesia, where the coverage of the second dose of vaccine is only around 40 percent of the population.
On the one hand, we are required to accelerate the vaccination rollout, especially for the elderly, the coverage for whom remains the lowest.
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The Tangerang City Health Office conducted a random swab test at the Poris Plawad Terminal, Friday (12/24/21). Random swab test as an anticipation of the spread of Covid-19, especially the Omicron variant that already exists in the country.
On the other hand, a UK Health Safety Agency report released on 23 Dec. says that the effectiveness of booster vaccines against Omicron diminishes more rapidly than against Delta.
The data shows booster vaccine efficacy against Omicron dropped significantly after 10 weeks. This trend can make us highly dependent on booster vaccines, like a case with the influenza vaccine, which must be dealt with regular injections.
So, a sustained domestic vaccine production is a demanding provision for living with Covid-19 in the future.
While the evidence suggests Omicron is no more lethal than Delta, we shouldn't underestimate the risk. The danger of infectious diseases like Covid-19 can not be assessed simply from how high the fatality is.
An uncontrolled swell of transmissions could lead to the collapse of health facilities, thus hampering the treatment on various other diseases. Moreover, Omicron may be less lethal, but Covid-19 remains dangerous when it infects those who carry comorbidities.
A number of countries, such as the US, are currently experiencing a spike in Covid-19 cases among children, which shows that Omicron is smart enough to find its infecting way with children having yet to build antibodies.
Also read:
> World Races Against Omicron Variant
> The Emergence of Omicron Exposes World Vaccination Gap
Unstoppable increase in Covid-19 cases in the community will open up opportunities for new mutations to occur, which can be more dangerous. Of course, we expect Omicron to be the last variant of contagious virus and its lighter impact can usher to an endemic era, as it once happened with the 1918 Spanish flu pandemic.
While we hold hope for better future, we must be prepared for the worst. It is mandatory for those of us who have already been infected with Omicron to help prevent the transmission curve from rising.
During the two years of living with Covid-19, we have certainly learned that there is no single solution to prevent the spread of the pandemic. Apart from vaccination drive, testing and tracing must be pursued massively and consistently. Community participation in implementing health protocols will also be of great significance.
People must realize that the pandemic is not over yet. While still potentially posing another bout of Covid-19 calamity, the year of 2022 should provide a new hope as well that we can come out of the pandemic, for which all components of the nation must participate in dealing with Omicron.
This article was translated by Musthofid.
