Will the Omicron variant cancel plans for a 'normal' Christmas?

When Prime Minister Boris Johnson announced a tightening of Covid restrictions in December last year – effectively cancelling Christmas for millions of families – it felt like a fitting end to an unforgettable year.

Despite the arrival of life-saving vaccines, the first of which began going into arms earlier that month, a planned relaxation of the rules around festive gatherings had to be abandoned. In Scotland, it meant travelling to see loved ones was only allowed on Christmas Day. Amid warnings over social distancing and keeping windows open to aid ventilation, many decided it simply wasn’t worth the risk.

With less than a month to go until Christmas 2021, it’s hard to overstate the progress made since last winter. For many of us life has largely returned to normal thanks to the scientific success story of the vaccines. Where 2020 was marked by fear and anxiety about the virus, this year has seen a gradual reclaiming of our old lives and a slow relaxation amongst even the most inveterate worriers.

All that was before the discovery of a worrying new variant, however. Omicron, which was first noticed by doctors in South Africa, is understood to be more transmissible and has a significant number of mutations, meaning the effectiveness of the vaccines could be affected. 

As of yesterday, there were five confirmed cases of the new variant in England and six in Scotland, at least some of which are in those with no recent travel history, suggesting community transmission has already taken place.

No doubt stung by criticism earlier in the pandemic that is has been slow to act, the UK Government has announced measures to limit the number of cases being brought into the country, while the Joint Committee on Vaccination and Immunisation (JCVI) has halved from six months to three the amount of time an adult must wait between their second dose and the booster. 

It's all a far cry from just last week when despite the continuing transmission of the virus, the situation appeared to have stabilised. 

As First Minister Nicola Sturgeon took to her feet at Holyrood last week to give an update on the pandemic, there were 743 people in hospital in Scotland with Covid, compared with 1,208 on the same day the previous year. Nearly 12,000 deaths where Covid-19 was mentioned on the death certificate have been registered in Scotland since the start of the pandemic. But while the vaccine rollout had yet to begin this time last year, now nearly four million people in Scotland are double-dosed.

“We are in a much stronger position now than I would have dared hope for just a few weeks ago,” Sturgeon told MSPs. Asked whether families can expect to enjoy a “more normal” Christmas this year, she added: “I certainly hope so and at this stage, I’m very optimistic about that and that would be my expectation. I’m very hopeful that all of us will have a more normal Christmas but to make that possible we have to comply with all the protections in place now…”

Despite the cautious optimism, the World Health Organisation has been issuing warnings for some time about the state of the pandemic in Europe. Even before the emergence of Omicron, it said there could be 700,000 Covid-related deaths in Europe this winter. The WHO said the number of reported daily deaths had doubled in a week across the region, driven by the dominance of the highly transmissible Delta variant, the relaxation of measures to limit the spread, and the large numbers of those still unvaccinated.

In Austria, where around two-thirds of the population are double-vaccinated, one of the lowest rates in western Europe, a new national lockdown has been introduced due to rapidly rising case numbers.

The Netherlands is another country which has seen an alarming spike in cases in recent weeks. Amid anger over the introduction of a vaccine passport scheme which prevents the unvaccinated from entering bars, restaurants, and some entertainment venues, as well as the re-introduction of a partial lockdown, protesters have repeatedly clashed with police as Covid demonstrations turn into riots.

While the situation in mainland Europe is stark, there are also considerable variations within the UK. Scotland currently has a case rate of 349 per 100,000 population, while the figure for England is 440 per 100,000. In contrast, Northern Ireland has recently recorded over 600 cases per 100,000, prompting renewed advice to work from home.

Speaking to BBC Radio 4’s World at One last week, Mark Woolhouse, a professor of infectious disease epidemiology at the University of Edinburgh, said: “We’re seeing variation between parts of the UK and parts of Europe. I think the implication of that is that every country, every region has to manage its own epidemic in the way that is best suited to its own particular circumstances.”

Woolhouse said it was unlikely the UK would see the “explosive” rise in cases currently being experienced in some parts of Europe due to being further ahead in the current Delta wave. 

That was until Omicron come along.

While there is still relatively little known about the impact of the new variant - anecdotal reports from South Africa suggest it does not lead to more severe disease - its transmissibility and potential to evade the vaccines has spooked decision-makers in London and Edinburgh.

Holding a briefing yesterday morning, Sturgeon said the new variant was “potentially the most challenging development in the course of the pandemic for quite some time”. Professor Jonathan Van-Tam, England's deputy chief medical officer, said the new variant had moved us into “uncharted territory”.

If we’ve learned anything from the pandemic, it’s that pre-emptive measures can often remove the need for more drastic interventions later on. This was at least part of the thinking behind the Scottish Government’s controversial vaccine passport scheme, which it was hoped would also drive up vaccination rates, particularly among young adults.

However, the government’s own assessment of the certification scheme, published earlier this month, suggested an extension of the measures could be damaging to hospitality businesses in the run-up to Christmas. The evidence suggests that it has also not significantly increased vaccine take-up.

Sturgeon confirmed to MSPs last week that the scheme would not be extended to theatres, cinemas and other indoor venues, and said that from December 6, entry to venues such as nightclubs would be possible with proof of a recent negative lateral flow test as an alternative to vaccination.

While many of us have incorporated the use of lateral flow tests into our routines this year, the first minister said anyone visiting family, socialising with friends, or even shopping in the run-up to Christmas, should take a test to know they are unlikely to be spreading the virus to others.

There is particular concern over waning protection from the vaccine among even some of its youngest recipients, who had their second jab in late summer. According to the UK Health Security Agency, two doses of the AstraZeneca vaccine cuts hospitalisations by 94 per cent in the first week after getting the second jab. However, this figure falls to 77 per cent after 20 weeks.

The UK Government agency says booster doses, which are currently being rolled out to older adults, provide over 90 per cent protection against symptomatic infection in adults over 50.

Until the weekend, health secretary Sajid Javid’s reluctance to re-introduce measures such as social distancing and mask wearing in England, the so-called Plan B, were what separated Scotland’s approach from that of its nearest neighbour. The extra mitigation measures may be reflected in the slightly lower infection rate north of the border, but we’ve seen previously how quickly the situation can change.

One area where all parts of the UK appear to be struggling is in protecting the NHS ahead of the winter surge. The slew of headlines about the challenges being faced by Scotland’s hospitals and the ambulance service have dominated recent exchanges at First Minister’s Questions, with the pandemic brutally exposing long-standing issues in the health service.

Both Labour and the Conservatives recently raised the case of Richard Brown, 55, who died in a stairwell after waiting five hours for an ambulance, prompting an apology from Deputy First Minister John Swinney. While this tragic case may still be an exception, it nevertheless provides as vivid a picture of the stresses and strains under which the NHS is operating as reams of data about the state of the pandemic.

Many scientists have expressed hope that 2022 will be the year the threat of Covid begins to gradually diminish in the UK, posing less of a danger to a largely vaccinated population without disappearing completely. It remains to be seen what impact Omicron will have, but even in the best case scenario, Humza Yousaf, Scotland’s health secretary, has said it will take “a number of years” for the NHS in Scotland to fully recover.

As Christmas approaches, many of us will be thankful just to spend the day with family or friends. But we should not lose sight of the toll this virus has taken and the distance yet to travel.