Here we see charts of the same ten western tourist countries of Europe (refer to my Travel Warning: Excess Summer Deaths in Europe, 5 Oct 2022). It is important to note from the outset that ‘reported death’ figures have become increasingly unreliable. And reported cases are now unreliable indicators of the size of a covid outbreak; they do indicate the timing of covid waves, however, albeit with increasing time lags relative to the date of infection. The most reliable data is ‘excess deaths’. (Indeed Michael Baker has recently taken to citing this measure; see NZ Herald 16 October Covid19 Omicron outbreak; Another Wave.)

The Mediterranean tourist countries most popular with English-speaking visitors are shown first. All charts are to the same scale. We start with Greece this time.

Greece is one country that, using reported covid data, did not seem to be impacted much until the very end of 2020. However excess deaths in 2020 do suggest that there was a summer wave of Covid19; in addition, Greece was suffering excess deaths from influenza in the beginning months of the covid pandemic. The chart for Greece is quite dramatic-looking in 2022, with a significant death-wave in July (almost certainly continuing into August). We note that, re cases, July is worse than August; this represents the peak of American tourism into Greece, with intra-European vacations peaking in August.

Moving west to Italy, we see again the substantial covid death wave in July 2022. And we see, more clearly than Greece, the most recent (autumn) wave. This may be the wave of greatest impact, worldwide. Moving on to Spain, we see that the July death wave there is Spain’s highest covid death-wave since March 2020. And, by looking at reported cases, this July wave of excess deaths is clearly attributable to Covid19. (Note that 1,000 daily deaths per 100 million people is the same as 10 daily deaths per million; equivalent to 50 daily deaths in New Zealand. Indeed some of these deaths may be New Zealand tourists in Spain.)

Finally for South Europe, in the far southwest we see that Portugal had a bigger autumn wave of Covid19 (May) than elsewhere, while also catching the July wave early. Its July 2022 peak is as big as (or bigger than) its three 2020 peaks.

Looking at West Europe’s ‘big three’, the UK has had smaller summer peaks than the Mediterranean countries, probably because the ratio of visitors to residents is much lower than in (say) Greece and Italy. But we do see a clear rise in cases in June, meaning that the actual rise in cases will have been in May, when the summer tourism season in Britain gets underway. And excess daily deaths have averaged three in a million since May, equivalent in New Zealand to 2,700 pandemic deaths over a six-month period. We also note that these deaths occur in a context where many of the most vulnerable people had died in earlier covid waves.

France represents the high point of the immunity gradient, where many cases translate to relatively few domestic deaths; but where visitors can expect to be especially vulnerable. We see clear covid death peaks in April (when the French tourist season is well under way) and again in July, the peak month for English-speaking tourists. And, like Italy, we see that the latest wave is well underway.

Germany has seen a bigger covid death wave in the later summer; and we note that reported cases in Germany precede deaths, which is what happens in a country with an efficient reporting system. The latest wave of cases is prominent in Germany; deaths will come this month and next, not unlike 2021.

Now the mountain tourist areas, attractive in summer to people who like to walk (and to travel about by train) rather than to swim and sunbathe. Austria shows a pattern very similar to Germany, with a very marked October wave of cases. Austria, like Germany, was a leader in the autumn wave of 2021. Switzerland shows the same patterns as Austria, though with less amplitude. Norway is the most muted of these destinations. Yet its excess deaths are higher relative to reported cases than most of the other countries shown here. Reliable once for its excellent record-keeping, Norway seems to have lost interest in Covid19. My sense is that their autumn deaths will be much as they were in 2021. For Norwegians, October and November 2021 represented their biggest death-wave of the pandemic.

It is important to note that October is a peak month for air travel from Europe and North America to Aotearoa New Zealand. As I have previously noted (see Covid Waves in Europe, Lesson for New Zealand 26 July, and Covid Demography: New Zealand in context of North and West Europe 19 August), New Zealand can expect a late spring or summer covid wave. New Zealand, which has no regular summer seasonal pattern of high deaths, may well in a few months see its highest peak of excess deaths for the whole of the pandemic. Indeed, as has been announced by New Zealand’s Ministry of Health today (RNZ), Covid19 is waxing once again.

As has been the case in 2022 so far (but not in 2020 and 2021) New Zealand’s covid deaths most likely will be nameless and faceless statistics. Out of sight – as reporters, politicians and public servants take their holidays – and out of mind.

*******

Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

Within a month of the first community exposure to omicron in Aotearoa New Zealand, the variant has already become the dominant strain of covid-19.

We are yet to see the rapid and steep rise in new omicron cases that has been predicted. This could be because of asymptomatic transmission, but it is equally likely because public health measures included in the first phase of the “stamp it out strategy” have been effective.

For now, managed isolation and quarantine (MIQ) at the border is successfully stopping hundreds of cases from entering the community.

While MIQ may soon change in purpose, border restrictions may not lift until the Omicron wave passes.

The country-wide return to red settings under the covid-19 protection framework has bought New Zealand time to learn from experiences abroad. The most challenging phase is yet to come but New Zealand could be well placed to tackle it.

The best way forward is to limit widespread transmission for as long as possible. This reduces opportunities for the virus to replicate, which is when mutations occur, potentially extending the pandemic.

What we know about omicron
Omicron is more transmissible than earlier variants. New Zealand can expect a rapid and steep rise in infections, especially as we’ve already had several potential superspreading events.

As shown below, omicron quickly replaces earlier variants.

Omicron’s transmission advantage is thought to be due to its ability to evade immunity (acquired through infection or vaccination) and quickly infect the upper respiratory tract.

The risk of reinfection also appears higher than for delta, particularly in the unvaccinated and those with lower viral loads during previous infections.

Symptoms to watch out for
Omicron symptoms include a runny nose, headache, fatigue, sneezing and a sore throat.

However, New Zealand’s high vaccination rates mean some people may not have any symptoms at all. The danger here is that they will still be able to pass on the virus to others, unaware they have omicron.

Given a choice, would you rather enter a room with Delta or Omicron?
Modeller, Professor @MichaelPlankNZ uses this scenario to explain differences between the #Covid-19 variants, while UC Health’s Dr @hobbs_PA reminds us Omicron isn’t ‘mild’. @UCNZMaths https://t.co/4dgnOSZUJC

— University of Canterbury (@UCNZ) January 31, 2022

It is best to assume that any symptoms, especially a sore throat, are covid-19 until proven otherwise through a test.

For omicron, this may require saliva swab tests as recent evidence suggests they are more sensitive than nasal swabs because the viral load peaks earlier in saliva than nasal mucus.

By testing and isolating, we can avoid spreading it to others who may be at higher risk of severe illness.

Compared to delta, omicron has caused lower hospitalisation and death rates in many countries. This may be because it reproduces in the upper respiratory tract instead of the lungs.

Omicron is also meeting populations with immunity acquired through previous infection or vaccination.

In New Zealand, 67 percent of eligible people have now received their booster, which offers high levels of protection from hospitalisation and death. Boosted individuals are up to 92 percent less likely to be hospitalised with omicron, compared with unvaccinated people.

Vaccination is especially important in New Zealand as we have had minimal prior exposure to covid-19 in the community.

Where to from here
Omicron is a “double-edged sword”. It is vastly more transmissible but less severe. However, it is not a mild infection and there is no guarantee the next variant will be less severe.

In a poorly controlled outbreak, a small percentage of a large number of cases risks overwhelming healthcare systems, increasing inequities and disrupting essential services.

This should still be true even now (with the right measures)
The kicker is that with omicron, lots of HCW sickness will drop the capacity line lower. This will be much more pronounced for the fast red surge than the slow blue wave so in fact the red surge is worse than modelled pic.twitter.com/5hfk4uSMCt

— Alex Kazemi (@KazemiAlex) January 12, 2022

Healthcare workers are already over-burdened and exhausted from previous outbreaks, which have distracted from other services and exacerbated entrenched inequities.

There are several things each of us can do:

• Anybody eligible should prioritise getting boosted
• we should all continue using the COVID-19 tracer app
• we should keep indoor spaces well ventilated by opening windows and doors
• mask wearing remains important, especially where physical distancing is difficult.
• and anybody who feels unwell, should get tested and isolate.

Vaccinating children
As children return to school, we need equitable vaccinations and ventilation.

Data out of Australia indicate children aged five to 11 tolerated the vaccine well, with fewer side effects than adults.

Unfortunately, our analysis, along with other evidence, documents a concerning trend with lower childhood vaccination rates for Māori and Pasifika, as well as large variation between regions.

This is concerning as some countries, including the US, have seen increases in childhood hospitalisation rates for covid-19. In the UK, one in eight pupils have missed school as covid-related absences rise.

The success story of the delta outbreak
Unfortunately, there’s been little time to celebrate the rather remarkable demise of delta. Even as Auckland opened up, hospitalisations and case numbers dropped.

Summer will have helped as people spent more time outdoors. However, public health measures such as border closures, managed isolation and quarantine and contact tracing have no doubt helped stamp out much of delta, allowing a relatively normal summer holiday period for many.

Continuing to keep delta low also means we should not have to deal with a “double epidemic”.

This success may also fill us with some hope that, just perhaps, we might be able to avoid the worst of omicron during this next phase of the pandemic response, with robust and continually refined public health measures in place.

Dr Matthew Hobbs is senior lecturer in public health and co-director of the GeoHealth Laboratory, University of Canterbury; Anna Howe is a research fellow, University of Auckland, and Lukas Marek is a researcher and lecturer in spatial data science, University of Canterbury. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

South Seas Healthcare Trust chief executive Lemalu Silao Vaisola says people are tired of covid-19 rather than complacent after two years of the pandemic.

He said he had seen fatigue set in which could explain the low uptake of the booster shot in the Pacific community.

“People are just covid-fatigued where everything is all about self-isolation, traffic lights and the lockdowns.

“I think it is just fatigue, people are just tired. So I don’t know if it is complacency, but it’s been ongoing and two years is a long time to go through changes.”

Lemalu said the South Seas Healthcare team were preparing now for omicron to hit communities just like they had done in the past two years of covid-19.

He said the team intended to use the Manukau Insititute of Technology campus for a booster vaccination drive to get rates up.

“We’ve still got the MIT sites that’s during vaccinations and we’ve got a drive through vaccination for increasing the boosters and five to 11 [year olds] and on top of that we’ve been training our staff in terms of outreach into the homes.”

Front and centre
Lemalu said his organisation was front and centre fighting the delta strain and the experience stood them in good stead.

“We’ve got a good template to respond, but again every variant so far provides its own set of challenges,” he said.

“I’m happy that we’ve sort of almost had two years experience that will position us to hopefully be ready for this, but like I said before it’s different from what we are seeing overseas.

“We plan for the worst and hope for the best.”

He is encouraging Pacific families to get a booster shot.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz