SEOUL – As the ultra-transmissible Omicron strain of Covid-19 quickly spreads in the West, Asia is bracing for the worst – just as the first wave of studies indicate the variant has milder symptoms than its predecessor strains.
While the scientific and media communities have focused sharply on Omicron’s transmissibility, the nascent research shows what had been suspected since its identification: That the mutati0n is considerably – perhaps very considerably – less dangerous than prior variants.
Still, Omicron’s surge is putting immense strain on policymakers as they seek to balance the personal and economic freedoms of Covid-weary publics with prudent risk assessment and pandemic containment.
It is also casting a fresh spotlight on the issue of vaccine inequality as the Global North promotes booster third shots to stay ahead of the variant, at a time when many in the Global South lag in receiving even a first jab due to lack of availability.
While identified Omicron cases are still in the low hundreds in East Asian countries, its extreme transmissibility suggests this situation cannot last.
This is presenting policy challenges for authorities in Beijing, Hong Kong, Seoul and Tokyo, while illuminating the differences in the pandemic management approaches taken by China and its neighbors.
Lower risk, higher transmissibility
A trio of early studies published this week has come up with good news – albeit with caveats. All have found Omicron to be less dangerous than previous variants of Covid-19, though the studies differ by degree.
The most conservative analysis was produced by researchers at Imperial College, University of London, who have tended toward pessimistic models of virus risk since the early days of the pandemic.
Their study found an approximate 40% reduction in the risk of being admitted to a hospital for a night or more compared with the Delta variant.
An Edinburgh University study was more upbeat, suggesting there was a 65% lower risk of being hospitalized with Omicron – although it was based on only a few cases.
And in South Africa, where the variant was first discovered, a study was even more optimistic, suggesting Omicron patients were 70-80% less likely to need hospital treatment.
However, the study warned that there was no difference in outcomes for those few patients who were hospitalized with Omicron.
Asia Times reported on November 30, just as the Omicron variant was becoming known, the mutation was highly likely to be a milder form of the virus, given that it first appeared in southern Africa.
Due to the high rates of HIV and AIDS in that area, and associated populations with compromised immune systems, the virus would either generate a mass slaughter, or would present with milder symptoms.
Virtually all evidence since, both anecdotal and medical, has indicated that the variant does, indeed, present with milder symptoms. Moreover, epidemiologists point out that one common trajectory for viruses is for them to become less lethal but more transmissible over time.
Omicron certainly appears more transmissible. On Wednesday, the UK’s new daily infections passed the 100,000 milestone, a record even for a country that has been among the hardest hit by Covid-19.
The variant made up more than 73% of the cases in the United States as of Saturday, and 90% of all cases in certain areas, according to the latest data by the Center for Disease Control and Prevention released on Wednesday.
Reports indicate that has hospitals preparing for a surge of Covid-19 cases over the Christmas holiday. Nearly 70,000 Americans were hospitalized with Covid-19 as of yesterday, according to data from the Department of Health and Human Services, up from around 45,000 in early November.
This all puts politicians and health authorities in a bind. Do their policies lean toward the lower percentage risk inherent in the variant, and so maintain conditions of public and economic freedoms? Or do they lean toward the risk of huge numbers of serious patients being generated by the variant’s extreme transmissibility, and so reimpose tougher social distancing guidelines?
This bind is reflected in overall policy. Covid-19 is not particularly deadly, with a 1.9% death rate among those infected. But the other issue is scale. A worldwide caseload of 277 million infected, so far, has left behind a grim toll of 5.38 million corpses.
Coming at a time when many nations with high vaccination rates thought they had navigated their way out of the pandemic, and had lifted restrictions accordingly, Omicron has ignited a massive push for booster shots in prosperous nations.
In the UK, more than 1 million shots were administered on Wednesday, according to government data, meaning that 30 million people – 56% of the population – have now received booster shots.
But while multiple developing states are still struggling to administer first-round inoculations, the WHO has spoken out firmly against this new trend, which is spiking vaccine inequality.
“Blanket booster programs are likely to prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate,” WHO Director-General Tedros Adhanom Ghebreyesus told a news briefing on Wednesday.
Asia goes hull-down
Meanwhile, Asia is awaiting Omicron’s full arrival with trepidation.
Japan confirmed its first Omicron case on November 30, in a man who had arrived from Namibia. As of Wednesday, the number of Omicron infections nationwide had reached 160 – including the first case of community transmission by three people who had not traveled abroad.
South Korea has identified 246 Omicron cases nationwide, with 12 identified on Thursday, mostly from a cluster case in the country’s northeastern province of Gangwon, according to health authorities.
Both Japan and South Korea, have, after slow starts, instituted highly effective vaccination programs that have outpaced those of many Western nations. Current data show that 81.5% of South Koreans are fully vaccinated, as are 78.8% of Japanese.
But a spike in cases and seriously ill patients in South Korea, likely driven by relaxed social distancing instituted in November, in combination with increased indoor activities with the onset of the cold season, and fear of the Omicron variant in Japan, have led both Tokyo and Seoul to roll back the easing of Covid-19 related restrictions.
Japan banned foreign visitors from entering the country on November 30, a measure that remains in force. Prime Minister Fumio Kishida has demanded health authorities secure extra hospital beds for those infected with Covid-19.
On December 16, South Korea halted its “Living with Covid-19” scheme, a phased program that would have seen the country return to conditions of full normality by the end of January. Quarantine passes are now required for entry to multiple locations, gatherings are limited to four people and bar and restaurants must close by 9 pm.
Spooked by high numbers of seriously ill patients, and with ICUs reportedly at about 80% capacity, health authorities are working to locate 10,000 more beds for the seriously ill.
Even so, despite the super-transmissible variant entering their gates, neither country has yet enacted a lockdown response. But things are different in China.
Governments in Western Europe, North America, Japan and South Korea are promoting policies under which conditions of normalcy are pursued for the convenience of businesses and citizens. But in a jittery Beijing, where the 2022 Winter Olympics will kick off on February 4, a more extreme containment approach, widely dubbed “zero Covid,” is in place.
As of late Wednesday, after a cluster of 127 infections was identified, about 13 million people in the city of Xian were barred from leaving their homes except to buy necessities. Entry and exit from the city have been suspended and non-essential businesses closed.
Another outbreak in the highly industrialized east-coast province of Zhejiang has resulted in hundreds of factories being shuttered. Last month, Disneyland in Shanghai was shut down after a single case was reported, leading officials to conduct more than 100,000 Covid-19 tests.
Whether such a maximal approach can be maintained over the long term is being questioned.
“I don’t think it’s sustainable for China to expect to have zero tolerance for cases because it’s only a matter of time before China is overwhelmed with cases,” Lawrence Gostin, a professor of global health law at Washington’s Georgetown University, told US media outlet Voice of America. Eventually, the country, “is going to have to open up to the world,” he told VOA.
Omicron has already arrived in Hong Kong, which has instituted some of the world’s strictest quarantine requirements for incoming travelers. Questions are now being raised about when travel between the city and the mainland can restart – though how long that will matter is unclear. Cases of Omicron have already been reported in Guangzhou, the nearby metropolis over the border.
Elsewhere in the region, as of Thursday, Thailand reinstated mandatory Covid quarantine for foreign visitors and scrapped a quarantine waiver, due to concerns over the spread of the Omicron variant.