THE HEALTH INFORMATION and Quality Authority (Hiqa) has said that even if the Omicron variant of Covid-19 causes less severe disease, any significant wave of infection will “likely result in increased hospitalisations and deaths”.
The health service watchdog’s warning was included in a number of reviews of emerging evidence regarding the variant, which it published today.
It said that evidence is emerging regarding many questions relating to the Omicron variant, including its transmissibility, the severity of disease it causes, and its capacity for immune escape where there is the risk of reinfection, and the risk of breakthrough infections in those who have been vaccinated.
Hiqa undertook rolling summaries of this evidence, and also performed a rolling review of public health guidance from 23 countries and international agencies to summarise their response to the Omicron variant.
These reviews were then provided to the Department of Health and to the National Public Health Emergency Team (NPHET) to help inform the public health response.
The reviews found that there is evidence that the Omicron variant is associated with increased transmission and greater ability to escape immunity compared with the Delta variant.
One laboratory study examining infectivity found that Omicron had four times the infectivity of wild type SARS-CoV-2 and twice the infectivity of Delta, though the findings require confirmation.
Hiqa said: “The proportion of Omicron cases currently observed to be mild should be considered in light of the extent to which Omicron demonstrates greater infectivity and greater capacity for immune escape, and the extent to which the population possesses immunity (from either prior infection or vaccination).”
It said the virulence of the variant may not be fully understood by observing patterns of severity in the overall population, as this includes those with natural or vaccine-derived immunity, who will have less severe infections if they occur.
It is important to consider that if transmission were to increase substantially, any significant wave of infection, irrespective of changes in virulence or immune escape, would very likely result in increased hospitalisations and mortality.
It added that international agencies have warned that Omicron is likely to cause high incidences of Covid-19 which could “overwhelm healthcare systems within Europe unless action is taken”.
The health watchdog also summarised a number of studies which suggested reduced effectiveness of existing vaccine schedules (pre booster) against Omicron.
The review of international guidance highlighted that some countries are accelerating roll-out of boosters for anyone who is eligible. It also found that most countries are reintroducing and strengthening their public health measures to mitigate the threat posed by the Omicron variant.
Hiqa also published the advice it provided to NPHET on the use of respirator masks, such as FFP2 or N95 masks, for groups at higher risk from Covid-19.
It said that the policy of reinforcing current public health and mask guidance was “the most efficient and appropriate means of managing the current situation”.
“The advice against a population-level recommendation for the use of respirators by those who are at higher risk from Covid-19 does not preclude their use at an individual level, for example, where there is an opportunity for individuals to discuss with their healthcare provider to what degree they are likely to benefit from the use of a respirator mask, and to obtain advice on appropriate usage,” it said.
Hiqa’s deputy chief executive and director of health technology assessment Dr Máirín Ryan said there is an urgent need to reduce the impact of the Omicron variant in the coming weeks.
We advise that the public continues to follow public health guidance, to minimise their contacts in the run-up to Christmas, to maintain physical distance when out and about and to keep up their hand hygiene and mask wearing.
She added that given the current high rates of infection, and the increasing threat associated with Omicron, it is important that “masks are worn correctly and in all circumstances where they are recommended”.
“Those at higher risk from Covid-19 (that is, everyone aged 60 years and older, and those with specified health conditions) are advised to wear disposable medical masks rather than cloth face coverings for their own protection. And, importantly, we encourage anyone who has the opportunity to avail of the Covid-19 booster to do so, particularly in light of the developments with the Omicron variant.”
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