And by buckle up, I mean BOOST-UP. And take other sensible precautions, especially leading up to the holidays.
Nerdy Girl Jenn (🇺🇸 in 🇬🇧 ) writing from not-so-sunny England, home of the strangest shaped epidemic curve ever seen (Figure 1). Delta has been raging here since June and never went away.
Omicron has a significant foothold here, currently estimated at over 30% of current cases in the UK and doubling every 2-3 days 😳. In London where Omicron is a whopping 60% of the cases, Omicron cases are adding to, but not displacing Delta…yet (Figure 2).
I got boosted today, which made me really and truly happy. Happy because even before Omicron, it was becoming clear that a 3rd dose gives us an immune response above and beyond the best that 2 doses ever offered, see here.
Omicron has upped the ante, making boosters a necessity rather than a luxury for most. Lab-based studies continued to come out this week showing significant loss of neutralization against Omicron from two doses of various vaccines—but this is mostly restored by a 3rd dose.
Preliminary Omicron data from the UK (in real people, not a lab dish) support these neutralization studies, finding a large drop in vaccine efficacy against infection for 2 doses of Pfizer or Astrazeneca that is largely restored by a 3rd dose. The reduction in efficacy was worse for Astrazeneca, but a booster mRNA dose raised this back up regardless of the vaccine used in the primary series. The UK data also showed a higher risk of re-infection after prior infection for Omicron compared to Delta, consistent with Omicron having an advantage in immune evasion.
Today confirmed cases in the UK reached their highest number EVER in the pandemic.
So, we’ve got some major March 2020 vibes going on here, with many events being cancelled and people returning to working from home and retreating into smaller social circles. Most people seem to know at least someone if not several people who are currently infected.
The government has also launched a *massive* booster campaign, making everyone 18+ eligible as early as 3 months after their 2nd dose and pushing to get this done by January 1st. So far over 35% of the entire UK population has received a booster dose–compared to only 16.5% in the U.S (Figure 3).
These numbers, combined with the lower overall vaccine coverage in the U.S. has me nervous for my homeland over the next couple of months. I don’t have a functioning crystal (or Magic-8) ball, but the UK has often offered a preview of what’s coming in the US several weeks later.
It’s not fun to think about hunkering down again this winter. We all REALLY hoped COVID-19 would be in the rear-view mirror by now.
Despite that sinking feeling many of us now have, we ARE in a better place. The vaccines have saved millions of lives and will continue to do so. Figure 4 shows the lower hospitalizations and deaths in the UK relative to the same number of cases in previous waves. The difference is remarkable, but a huge Omicron wave would still bring increasing waves of hospitalization and death to an already backlogged and stressed healthcare system. Given current vaccination rates, this toll would be much worse in the U.S.
We need to boost up, but NOT GIVE UP on the ground game of first and second doses for those who don’t yet have them. We hear your stories of patient and persistent conversations with family, friends, and colleagues. If you think everyone who wants to be vaxxed is already vaxxed, think again—currently ~350,000 FIRST doses are being given DAILY in the U.S. We wish it were higher (or better yet that there weren’t so many left to be vaxxed), but the fact is we’re building that immunity wall higher every day. #WeCanDoThis
Should you be taking extra precautions, even if you are boosted? If exponential Omicron growth is knocking on the door your community as it may be now or soon, every averted infection can make a big difference. Even if you feel your own disease risk is low, when cases are high we need to be ever more mindful of social responsibility to reduce the spread to those who are more vulnerable.
Now is the time to:
💥 Reduce your social interactions in the lead up to the holidays, so you can more safely gather with those who mean the most.
💥 Mask up in crowded indoor settings.
💥 Use rapid tests regularly if possible and before indoor unmasked gatherings, especially with people at higher risk for severe disease.
💥 Pay attention to ventilation- outside, open doors & windows, & HEPA filters all help.
💥 Get that booster…or first dose!
This winter may be bumpy, but the Nerdy Girls are here for you, on both sides of the pond.
Links:
Pfizer and Omicron neutralization
“Omicron: Why do boosters work if two doses struggle?”
UK Omicron Report (summarized by Meaghan Kall)
“Are normal precautions (masks, distance, ventilation) less effective against new variants?”
Previous Postcards from the UK:
