This was published 2 years ago
Opinion
We got lucky with Omicron, but next time could be a different story
By Richard Holden and Steven Hamilton
The Omicron outbreak has been bad – far worse than projections made as recently as December. In just the first month of the year, 1558 Australians died due to COVID-19. At the peak of the wave nationally, 5391 Australians were in hospital with 424 in intensive care. And yet these outcomes are far better than any of us could have dreamed of during the initial outbreak almost two years ago.
The reason, of course, is vaccines. Millions of ordinary Australians – more than 92 per cent of those aged over 12 – understood the importance of vaccines for them, their families and their communities. And the government deserves credit for getting its act together, however belatedly, to secure adequate supplies and get them into people’s arms.
Thomas Hyslop, 10, gets his first COVID-19 vaccine dose in Sydney in January.Credit: Flavio Brancaleone
But there’s no doubt much of our success against Omicron was due to accidents of timing. Our vaccine rollout was delayed by government bungling. The Delta outbreak provided a strong impetus for Australians to get jabbed. And against that backdrop, Omicron arrived just after many had recently been vaccinated or boosted.
The trouble now is that even if we are on the downhill stretch of this particular outbreak, the pandemic is far from over. There will be new variants; there will be new waves, particularly as we head into winter. And when they come, it looks increasingly unlikely we’ll benefit from the kind of recent wartime effort that stood us in such good stead under Omicron.
In our race to get double-dosed, a false impression took hold that the rollout is a sprint rather than a marathon. Having run our hearts out for the first leg, we now seem a bit too fatigued to finish the race. The rollout is a marathon because the effectiveness of the vaccines wanes, new variants mean they will be less effective in each successive wave, and evidence is now clear that at least one booster is needed for more lasting protection.
The latest data from Britain shows that while two doses of Pfizer is more than 95 per cent effective against hospitalisation under Delta, that drops under Omicron to 55 per cent after three months and 35 per cent after six months. But a booster raises this to 75 per cent after three months and with less waning likely beyond that. And Pfizer and Moderna are trialling new vaccines updated for Omicron that should be even more effective. Public expectations and policy need to be reset for the long haul.
More than two-thirds of Omicron infections in Britain are among people who have previously been infected with COVID-19.Credit: Bloomberg
Yet already mutant strains of complacency and fatalism have taken hold. For instance, many say of Omicron: “we’re all going get it at some point”. But that’s problematic for two reasons. First, if 20 per cent getting it in six weeks kills more than 1500 people and generates the lowest consumer confidence since 1992, then imagine what 100 per cent would do. Second, Omicron poses a five-times-higher risk of reinfection than Delta, with two-thirds of new infections in Britain having had a prior infection. So it’s not “Will I get it?” but “How many times will I get it this year?”
A second common source of fatalism is the misconception that vaccines don’t prevent transmission. Chris Kenny of The Australian recently pleaded that we “bring to light a fundamental debate so often ignored in the public square – the relative transmissibility of COVID-19 from vaccinated and unvaccinated individuals. It goes to the heart of whether the unvaccinated pose a risk to anybody but themselves.”
To transmit the virus one first needs to be infected with it. Even under Omicron, the boosted are 70 per cent less likely to be infected than the unvaccinated. So before we even have a debate about further reductions in transmissibility once vaccinated, we’re already at a 70 per cent reduction. The answer to Kenny’s question is “Yes”: people who are unvaccinated or unboosted put themselves at risk, but they also put others at risk.
Much of the fault for our sense of complacency and lack of urgency falls at the feet of our governments. Somewhat staggeringly, while chief health officers across the country continue to report daily death statistics that demonstrate just how critical boosters are, the definition of “fully vaccinated” has still not been updated to include one. Even the federal government’s regular vaccine rollout updates treat boosters as a minor addendum.
Months into the rollout, just 51 per cent of eligible Australians have received a booster, with that number even lower in NSW at 48 per cent. Meanwhile, the Australian Technical Advisory Group on Immunisation waited more than a month after its American counterpart, the Centres for Disease Control and Prevention, to recommend boosters for 16- and 17-year-olds. Not to mention the well over a million five- to 11-year-olds who have headed back to school without even a first dose, let alone a second or third.
With Omicron, as terrible and as tragic as it has been, we got lucky. But if our funk persists, we shouldn’t expect to be quite so lucky next time. Our politicians and policymakers need to take a cold shower, and then dump a bucket of cold water on the rest of us. Just over a year ago, we warned in these pages that our vaccine strategy needed an “urgent rethink”. What we need now is to overcome the complacency that the fruits of that eventual rethink have wrought upon us.
Steven Hamilton is assistant professor of economics at George Washington University and visiting fellow at the Tax and Transfer Policy Institute at the ANU. Richard Holden is professor of economics at UNSW Business School and president of the Academy of the Social Sciences in Australia.