Suddenly the streets were quiet again on Sunday. The so-called Omikron variant of the coronavirus is spreading so quickly that the cabinet held emergency consultations on Saturday and inserted a press conference announcing a hard lockdown that took effect immediately at five o’clock the next day. All educational institutions, shops that do not sell food, catering, gyms, hairdressers, museums and cinemas had to close their doors. The urgent advice to receive only four visitors at home has been reduced to two. Only during the holidays can that be extended to four.
“It is inevitable, we can’t wait,” said outgoing Prime Minister Mark Rutte (VVD), who also spoke of “perhaps the heaviest moment” from the corona crisis. Jaap van Dissel, director of the Center for Infectious Disease Control at RIVM and chairman of the Outbreak Management Team, which advises the cabinet on measures, was present to explain why the measures are needed now. “The national doctor”, Rutte called him. According to Rutte, he had to explain: “Guys, listen, there is something serious going on.” Whenever Van Dissel spoke, Rutte nodded in agreement next to him.
Exponential growth
The question is whether this plan was successful: Van Dissel quickly fell into scientific jargon that is difficult to understand for a wide audience. The underlying message was: there is still too much uncertainty, and waiting longer with stricter measures would mean huge risks.
Because Omikron is spreading much faster than Delta, the variant that has caused almost all infections since last summer. So much faster that Omikron can cause many more hospital admissions in a short time, even if the new variant turns out to be less sickening on average.
That’s because of the way viruses grow, namely ‘exponentially’. Each virus variant has a fixed ‘reproduction number’. Suppose an infected person infects an average of 1.5 people. If there are 1,000 infected people, 1,500 new people are infected after one round of infection. If they also infect an average of 1.5 people each, there will be 2,250 new infections. After five rounds of infection, there are already more than 7,500 new infections. In total, 20,000 people have now been infected.
With a reproduction number of 2, growth is much faster: after one round of infection it is about 2,000 infections, the next round about 4,000, after five rounds it is about 32,000. In those five rounds, a total of more than 60,000 people were infected.
Because a more contagious variant grows so quickly, many more people will end up in hospital – even if that variant is less sickening. Back to the calculation example: suppose that 2 percent of all infected people end up in hospital. With the less contagious virus, more than 400 people would end up in hospital. With the more contagious variant, that percentage is halved: only 1 percent ends up in hospital. But in the end there are more than 600 – more, because so many more people get infected.
It is that black scenario that the OMT presented to the cabinet in recent days. “The problem now is that a wave threatens to approach us that you do not yet see in the figures,” said Rutte. “And if you didn’t intervene now, it would be too late.”
Big setback
Last week, research from the United Kingdom and Denmark showed that Omikron is indeed much more contagious. Because the number of corona patients in hospitals has risen to enormous heights in recent weeks (due to the Delta variant), there is no room to absorb another blow. Not even now that the number of admissions is falling due to the evening lockdown that was instituted at the end of November. There are still as many corona patients in hospital as last winter. And then there is also a staff shortage. Many hospitals have postponed other, sometimes urgent, treatments and surgeries.
Hoping that Omikron is so much less sickening that, despite the rapid exponential growth, it still causes fewer hospital admissions would be a huge gamble, said Van Dissel. Omikron spreads faster, because the built-up defenses of vaccines and a previous infection offer much less protection against this variant. “That is a major setback, that sets us back a bit,” said Van Dissel. He therefore underlined the importance of the booster.
Also read: The rise of the Omikron variant: five causes
According to RIVM calculations, Omikron will displace the now prevailing Delta variant sometime between Christmas and the turn of the year. The share of Omikron in the infections doubles every two days.
In South Africa, where Omikron was first reported, there are fewer hospital admissions. But early research results from the UK suggest that Omikron is as sickening as Delta. Van Dissel emphasized that there are “a lot of uncertainties”. “It can also be lucky, but unfortunately we have not had that often with the corona crisis.”
Rutte indicated that the cabinet was shocked by the dire reports that it first received from the OMT about Omikron a week ago. Rutte: “We were all really blown out of the chair.” Friday there were again worrying forecasts. It explains the haste with which the lockdown was introduced.
If additional measures were not taken, more than four thousand ICU beds could be needed for Covid patients at the peak. The assumption in those calculations is that Omikron is as sickening as Delta, which is not yet certain. In any case, the maximum IC capacity is far exceeded. That is 1,350, and then several hundred beds are also occupied by other patients. Intervening from the Christmas holidays – which had left another week – would have meant that around 2,000 ICU beds for Covid patients would be needed. The accelerated lockdown that has now been implemented has not been calculated, but the message is: every day counts.
Phone calls unanswered
The new lockdown is mainly intended to “buy time”, said Van Dissel: it seems that a booster shot significantly increases protection against Omikron. De Jonge wants every adult to receive an extra shot by January. The hope is that relaxation can be made again when the booster campaign is over. It remains to be seen whether the boosters really manage to sufficiently dampen the number of hospital admissions. Moreover, it is not yet clear how many people actually want to have a booster shot.
The booster campaign is also not going well yet. The Netherlands is at the bottom of the lists of vaccination rates in European countries. There is no shortage of vaccines. De Jonge called the number of people who can do the injections and the shortage of manpower at call centers an ‘inhibiting factor’. On Saturday alone, he said, a quarter of a million phone calls to make arrangements went unanswered.
The cabinet is also holding on to all uncertainty: it could also be that Omikron is not too bad. “You can assume that a virus such as corona also has a certain development,” said Rutte. “There are also theories that say: Omikron is a harbinger of a somewhat flared virus.” He later admitted that there is no certainty about that. “At the moment we do know that it is very contagious and that it still makes people sick. That has enormous consequences for healthcare, which we cannot handle.”
A version of this article also appeared in NRC on the morning of December 20, 2021
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