The London School of Hygiene released a modelling paper describing some estimated effects on the UK of the Omicron wave. Mostly, it’s a lot of “the error bars on all these are giant, and we don’t have any clear idea what’s going to happen except that there will be a giant wave of infections by mid-Jan, unclear how that translates to deaths”.
If you assume no new measures and no behaviour change in the UK, you get a ridiculously enormous wave of infections that might peak with half of everyone getting infected, and that causes peak hospitalizations anywhere from 0.5-2x the UK’s previous peak from the alpha wave back in January (74k additional deaths on the high end, in the not-actually-possible-even-in-principle scenario).
Again, these scenarios aren’t really possible (since no behaviour change is assumed), but they are useful for getting a sense of what Omicron could be like and the likely timings of things in the UK.
What’s more useful for general readers is the paper’s table of assumptions about vaccine efficacy vs Omicron—this was released just after results showed VE of Pfizer + Pfizer booster against symptomatic infection is 75%,
LSHTM Vaccine Efficacy Assumptions
And here’s the result from that Pfizer study:
Pfizer Booster VE Study
I think the paper’s results are based on trying to guesstimate just what properties are reasonable/vaguely consistent with what we’ve seen. The highlights in yellow are the ones that will matter in the long run for most readers—efficacy for 3-dose courses on low and high assumptions about Omicron immune escape and Booster efficacy.
The range for Symptomatic Illness efficacy is 46.9 − 80.3 %, though as I said the recent Pfizer study said the efficacy was 71.4% and 75.5% protection vs. symptomatic disease for people who received AZ and Pfizer primary courses, 2 weeks post their boosters. Don’t know if that means we can bias ourselves towards the upper end of that range or not (1.9, 4.0, 5.0 times lower for the low, study result, high estimates of VE vs symptomatic infection).
The range for Hospitalization/mortality efficacy for a booster is 83.7-96.9%, or a 6.1 to 32.3 -fold reduction in mortality risk vs someone who isn’t vaccinated against omicron. Again, adjust accordingly based on your age, sex and health vs the UK population average. Also note this isn’t taking into account Omicron being intrinsically less severe, which it might well be.
The lower VE numbers here might be the plausible end of a range, or might just be the authors covering all possibilities, no matter how remote or absurd.
Fingers crossed, the apparently good efficacy of a booster that wasn’t intended for anything like Omicron means that it’s giving you generally broad-based immunity that will work going forward against whatever next crazy variant evolution throws at us.
I keep seeing extremely hard-to-judge theories thrown around, generally by suspicious types, about vaccine-granted antibodies being uniquely brittle and setting us up for the emergence of immune evasive variants—for example here.Dominic Cummings recently alluded to a similar idea—vaccines only targeting the spike protein (even though that was the best way to make a highly effective vaccine), means variant evolution can more easily evade vaccine antibodies than if they were broader.
AFAIK this is something that was considered during vaccine development (the reasoning was that there’s fewer possible ways for the spike to change while keeping the covid virus still functioning, so targeting the spike would hopefully work against future variants), but which is in principle a problem for the future. Obvious caveat—you still get T-cell immunity no matter what’s going on with the antibodies, which is the underlying reason why all the assumptions in the above table are high for severe disease immunity, and since we’ll eventually end up in a scenario where most of the world has T-cell immunity to Covid from vaccines or infection, that will put a limit on the damage future waves can cause
First off, if you happen to live near/in London, Guy’s hospital by London Bridge station is doing walk-in Boosters for anyone over 18 with >3 months since 2nd dose.
The London School of Hygiene released a modelling paper describing some estimated effects on the UK of the Omicron wave. Mostly, it’s a lot of “the error bars on all these are giant, and we don’t have any clear idea what’s going to happen except that there will be a giant wave of infections by mid-Jan, unclear how that translates to deaths”.
If you assume no new measures and no behaviour change in the UK, you get a ridiculously enormous wave of infections that might peak with half of everyone getting infected, and that causes peak hospitalizations anywhere from 0.5-2x the UK’s previous peak from the alpha wave back in January (74k additional deaths on the high end, in the not-actually-possible-even-in-principle scenario).
Again, these scenarios aren’t really possible (since no behaviour change is assumed), but they are useful for getting a sense of what Omicron could be like and the likely timings of things in the UK.
Paper Summary
What’s more useful for general readers is the paper’s table of assumptions about vaccine efficacy vs Omicron—this was released just after results showed VE of Pfizer + Pfizer booster against symptomatic infection is 75%,
And here’s the result from that Pfizer study:
I think the paper’s results are based on trying to guesstimate just what properties are reasonable/vaguely consistent with what we’ve seen. The highlights in yellow are the ones that will matter in the long run for most readers—efficacy for 3-dose courses on low and high assumptions about Omicron immune escape and Booster efficacy.
The range for Symptomatic Illness efficacy is 46.9 − 80.3 %, though as I said the recent Pfizer study said the efficacy was 71.4% and 75.5% protection vs. symptomatic disease for people who received AZ and Pfizer primary courses, 2 weeks post their boosters. Don’t know if that means we can bias ourselves towards the upper end of that range or not (1.9, 4.0, 5.0 times lower for the low, study result, high estimates of VE vs symptomatic infection).
The range for Hospitalization/mortality efficacy for a booster is 83.7-96.9%, or a 6.1 to 32.3 -fold reduction in mortality risk vs someone who isn’t vaccinated against omicron. Again, adjust accordingly based on your age, sex and health vs the UK population average. Also note this isn’t taking into account Omicron being intrinsically less severe, which it might well be.
Related, some guessing about which of the evasion scenarios we’re in
The lower VE numbers here might be the plausible end of a range, or might just be the authors covering all possibilities, no matter how remote or absurd.
Fingers crossed, the apparently good efficacy of a booster that wasn’t intended for anything like Omicron means that it’s giving you generally broad-based immunity that will work going forward against whatever next crazy variant evolution throws at us.
I keep seeing extremely hard-to-judge theories thrown around, generally by suspicious types, about vaccine-granted antibodies being uniquely brittle and setting us up for the emergence of immune evasive variants—for example here. Dominic Cummings recently alluded to a similar idea—vaccines only targeting the spike protein (even though that was the best way to make a highly effective vaccine), means variant evolution can more easily evade vaccine antibodies than if they were broader.
AFAIK this is something that was considered during vaccine development (the reasoning was that there’s fewer possible ways for the spike to change while keeping the covid virus still functioning, so targeting the spike would hopefully work against future variants), but which is in principle a problem for the future. Obvious caveat—you still get T-cell immunity no matter what’s going on with the antibodies, which is the underlying reason why all the assumptions in the above table are high for severe disease immunity, and since we’ll eventually end up in a scenario where most of the world has T-cell immunity to Covid from vaccines or infection, that will put a limit on the damage future waves can cause