from Mirror 12/1
Omicron has rapidly changed the Australian coronavirus landscape and I read
somewhere that we are now the world leaders in rate of change of incidence of COVID-
19…not a particularly good thing to be a world leader in.
It was a bit over a month ago that it was a hardly known “variant of interest from South
Africa” and now official figures are over 50,000 cases in Victoria. The real figure,
however, due to lack of RAT kits (and recording of positive RAT results…see below) and
clogged up swabbing PCR queues, is likely 5-10 times that or even more. For the first
time, everyone seems to know someone who is either has it or is a close contact and is
self-isolating. Businesses have been massively hit with staff shortages and supplies of
some common foods are starting to run short.
Omicron does seem to cause less severe disease than the last variant, delta, although it
is important to remember that there has been limited time to assess this properly. In
South Africa preliminary figures show that it is 80% less likely to lead to hospitalisation
than previous variants. But it is greatly more infectious…hugely more infectious!…and
that is why the hospital numbers (which surely are of more interest than the daily
numbers) continue to rise and why NSW is preparing for a tripling of their hospital
admissions by next month.
Keeping up with current guidelines and directives is hard when things change so much
from one week to another. And there is a lot of mis-information circulating again. So let
us confine discussion here to what we do know about RATs, Boosters, and what we can
do/are doing locally.
There has been much talk about Rapid Antigen Tests (RATs).
What are they? In essence, a RAT involves either a saliva or nose swab, performed at
home (does not need any health practitioner involvement) which will deliver a result
within 15-30 minutes. Rapid antigen tests are very accurate when used by people with
symptoms or people who have come into contact with COVID-19. It is now mandatory
that if you do have a positive RAT, that you report it. (Ring 1300651150 or go to
test.) This will enable more accurate following of the pandemic and help the
macro-management by the Health Departments, State and Federally. If you have
symptoms or are a close contact and have a positive RAT you do not require a
nose/throat PCR test. If you do not have symptoms and are not a contact and you test
positive then it is recommended you get a PCR to confirm the result.
All this can be quite confusing and there is an up-to-date (6/1) chart reproduced from
health.gov.au (enter ‘COVID-19 Test and Isolate National Protocols’) following this
article which, although initially looking a bit busy, is easy to follow and answers many
We are told that within the next 2 weeks RATs will be made available free of charge to
certain groups. Ten free RATs will be available every 3 months to Pensioners, Health
Care card holders, Vet Affairs card holders, Low Income and Commonwealth Senior card
holders. But please do not ask for them yet! They are in massive demand and no one has
yet seen the promised supply avalanche! (And watch this space as we are likely to
follow what is happening overseas where in many countries, they are free for
Booster shots are in full swing as a result of the rampant Omicron. The 5-month gap has
been shortened to 4 months and will be 3 months ‘as soon as practical’ (ATAGI).
Why Boosters and do they work?
There is a lot we know and a lot we are still learning. For instance:
‘A recent pre-print study from the UK suggested that protective effectiveness against
symptomatic COVID-19 due to the Omicron strain was not observable after 2 doses of
the AstraZeneca vaccine and was only approximately 35% at about 4 to 6 months (from
15 weeks onwards) after 2 doses of the Pfizer vaccine’ (health.gov.au).
That’s a pretty stark statement (although it goes on to say that ‘protection against
severe disease is generally higher than against symptomatic infection’).
The good news is that ‘strong evidence suggests that booster doses of COVID-19
vaccines may enhance protection against symptomatic disease due to the Omicron
variant and that the protective effectiveness against symptomatic disease was estimated
at about 70–75% after receiving a Pfizer booster dose’ for both people who previously
had AstraZeneca or Pfizer initial vaccination courses (health.gov.au again).
ATAGI expects that booster vaccination alone will not be sufficient to avert a surge due
to Omicron. However, maximising booster coverage by expanding eligibility and
encouraging high uptake, in combination with enhanced public health and social
measures, may prevent a large surge in case numbers, hospitalisations and deaths.
At Foster Medical Centre we have started the children 5-11 vaccinations since Monday
10/1. Ring the clinic for an appointment. We have re-instigated the Saturday booster
sessions and last Saturday did 312 vaccines which took the total our clinic has given to
13,408 vaccines! We will be running the Saturday clinics for at least the next month or
so….book in, they are filling fast.
Recently we have had to restrict both vaccines and Respiratory clinic testing to only our
own patients as demand far out strips supply, both in vaccines but also in
personnel…we have lost staff from COVID-related issues like every other business. It
was very disturbing that a few of our staff have been abused by some elements of the
public who were dissatisfied with being turned away. This is obviously never OK and
cannot be condoned. Hopefully with the return of many of the visitors to our area things
will settle to a new COVID-normal. Again.
We are also looking after many more COVID-positive patients who are well enough (as
the vast majority are) to remain at home, so far almost exclusively virtually.
A few thoughts to finish with.
It is worth remembering that transmission in the home is the most likely form of
transmission. Being prepared for the time (which is an ever-increasing possibility)
when someone in your household either gets COVID or is a contact and needs isolating
(We recommend abc.net.au: “Omicron has arrived, here’s how to prepare for a COVID-
19 case in the home”.)
And, public health measures work. See Priscilla’s article and the graph which shows the
numbers skyrocketing when these were relaxed. You can protect yourself by wearing a
well-fitting mask, by avoiding excessive crowds, by hand hygiene and by getting
Our wish was for a New Year free of COVID and related issues.
Maybe next year?
Dr Phil Worboys