26 Jan 2022

Health experts warn of risks in phased approach to tackle Omicron outbreak

7:45 pm on 26 January 2022

Omicron is not "mild" and can still overwhelm the health system, nor will it be the last Covid-19 variant so the government must prepare, public health experts say.

A bus passenger wears a mask during level 2 in Wellington, 15 February 20201.

The government is planning a more hands off approach once cases of Omicron hit the tens of thousands. Photo: RNZ / Samuel Rillstone

The government has announced how isolation periods and testing requirements will change once the number of Omicron cases begins to rise in the community.

The response to Omicron will be split into three phases, the county is currently in phase one, but may move to phase two before the country hits a thousand cases.

Once in phase two, Associate Health Minister Dr Ayesha Verrall said there would be a shift from identifying all cases to targeting those most at risk and those needed to keep the country going.

She said at phase three the definition of contacts would change to household and household like contacts only.

Covid-19 modeller and Canterbury University professor Michael Plank said the changes aimed to isolate cases during their most infectious period.

"Reducing isolation periods is necessary to ensure critical services such as healthcare and supply chains can be maintained. Other countries have reduced isolation periods to less than seven days. However, there is a risk involved with this because if people return to work while still infectious, they could spread the virus to co-workers exacerbating the problem."

With case numbers in Aotearoa still very low, Plank said it was possible that contact tracing efforts would delay the start of the exponential growth phase.

"It is currently difficult to predict exactly when these phases will be reached. In places like South Australia and Queensland, daily cases grew from single digits to over a thousand in about two weeks.

"For most people, if you're up to date with your vaccines, the risk of getting severely ill with Omicron is very low. However, the small percentage of serious cases still has the potential overwhelm healthcare systems. This is why, especially once we move into phases two and three, measures such as mask use, gathering limits, and minimising time in crowded indoor places will be crucial to flatten the curve," Plank said.

Omicron in the community: what this means for you

Photo: Ministry of Health

University of Otago associate dean (Pacific) and immunologist Dr Dianne Sika-Paotonu said the Omicron outbreak was occurring against the backdrop of high Covid-19 vaccination rates.

"However, evidence indicates that a booster shot is still needed to protect against Omicron - it is important to remember there remain areas where vaccination levels are lower than others.

"Although about 60 percent of the eligible population in Aotearoa have received boosters already, many will not be eligible for their boosters until February 2022 as result of the original planning for the Covid-19 vaccination rollout in 2021 which meant less time was given for Māori and Pacific peoples to get vaccinated before Delta arrived in the community. Our Covid-19 boosters must continue to be rolled out as quickly as possible with the appropriate prioritisation and delivery taking into account our most vulnerable now that Omicron is here."

Omicron won't be last variant

GeoHealth Laboratory co-director and University of Canterbury public health senior lecturer Dr Matthew Hobbs said Omicron being less severe than Delta "does not mean it should be thought of as mild".

"Omicron is hospitalising people, it is killing people, and we should take it seriously."

He said unless the red setting was updated, the health system could expect a steep and rapid growth in cases like Australia.

"Just because Omicron was less severe than Delta does not mean we are not going to experience another new, more severe variant, especially given the global inequities in vaccination coverage.

"NZ needs to and can step up at the global level. The root of this problem, which encourages more variants to emerge, is that the world isn't doing enough to stop the spread of Covid-19. Booster after booster in a small number of countries will not end a pandemic while billions remain completely unprotected. More needs to be done here."

Testing remains cornerstone of pandemic response

Rapid antigen tests (RATs) will become the go-to testing tool as the number of new daily Omicron infections grows.

Victoria University health senior lecturer Dr Clive Aspin said it was good to see RAT kits were at the centre of this strategy.

"I am writing this from Sydney, NSW, on Invasion Day (aka Australia Day) where Omicron is out of control and RATs are like hen's teeth because the government refuses to make them widely available, and especially to vulnerable populations. I have heard cases of them being sold for $100 a kit.

"Also, people's levels of anxiety and concern are through the roof.

"Access to RATs and PCR testing is highly problematic and now there seems to be an overreliance on reaching peak levels of Omicron as a way of dispelling people's anxieties."

Verrall said New Zealand had good stocks of RATs but opposition parties have accused the government of taking RATs from the private sector and treating the public like children.

RATs have not been commandeered, Director-General of Health Ashley Bloomfield said, but suppliers had been asked to prioritise the government's order.

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