Yet again, a new phase of the pandemic in the UK. First there was the prodrome of general awareness of a new virus in China, with the uncertainties, and false re-assurances, evaporating away to leave the reality of the first wave. Deaths. Lockdowns. New uncertainties. How does it spread? Should I wash my shopping? Should we wear masks? The answer to the latter I found was no — I was refused access to a blood donation centre because I declined to take my mask off.

Cases fell, and second phase arrived. A summer of ‘eat out, help out’ commenced, when you could nervously try the new normal. I watched Tenet in two masks — they were required in the newly opened cinemas. I ate breakfast in a hotel with ineffective plastic screens between tables. It felt like the eye of a storm passing, and, to some, the storm receding. It hadn’t.

Phase 3. A gradual worsening, some due to our prior help at eating out, the arrival of Delta, and the shaft of light of vaccines. A battle between vaccination and the virus, with many deaths. A cold, dark lockdown. Then a summer of confidence courtesy of science. The fourth phase has been an uneasy accommodation with SARS-COV-2, with high cases, and lower deaths. The virus is not yet endemic, but arguments are. Worse case predictions, post freedom day, were thankfully wrong.

Now we have the fifth phase. A new variant (Omicron) has arrived, sufficiently different to Delta to raise concerns about possible reduced effectiveness of the vaccines, with a potentially far higher level of transmission. Cases in South Africa have rapidly increased, and UK cases appear to be rising (134 today). There is not enough data to make any strong claims about whether it is mild or severe.

This time it is a race between boosters and a possible Omicron wave of unknown potential to cause harm. The UK target is to give 25 million doses before the end of January, to raise the wall of vaccine-induced immunity to minimise the potential harms from this round of uncertainties. Liz Breen and I have an article assessing if this target can be met at The Conversation. We are optimistic on that front.

The key ingredients for a successful booster programme have thus been promised – vaccine stock, vaccination sites and staff resources. If they can be made available in a timely fashion, then replicating the vaccination drive of the first half of 2021 is possible – as is meeting the government’s January target. Encouragingly, vaccination rates were already improving before these changes

Everything else is up in the air, and the gradual clarity on Omicron over the next few weeks will tell us whether this phase is an easy or a hard one. Until then, this comment from a Bloomberg article — that has been shared widely as evidence Omicron is mild — is probably a good default position to hold.

“The only ones putting their hand on their hearts and telling the world don’t worry, this is going to be mild, haven’t learned enough humility yet in the face of this virus.”

Photo from Fusion Medical Animation