Data insight

Wake us up before you go, O!

The world remains underprepared against the downside contingency of a highly contagious and more lethal variant

It is fair to say that recent Omicron/Delta wave was more scary in its initial stage than it has eventually turned out to be. Indeed, many commentators have argued that we have been lucky. Be that as it may, let this episode of heightened worry serve as a wake-up call. For the world remains underprepared against a downside scenario of a highly transmissible and more lethal variant. 

Omicron, come and go
 
The current Omicron wave, which has combined itself with also the effects of Delta, raised the alarm bell initially given the previously unseen degree of infectivity. The scale of escalation turned out to be huge when it comes to cases. But the impact on mortality has been less severe than feared. Meanwhile, the wave is starting to dissipate with cases falling and mortality turning the corner.
 
Let’s unpack that global picture and have a look at how this peak compares to previous peaks in terms of cases and fatalities.  
 

For cases, the recent peak exceeded the all-time peak by a factor of 4.7 for high-income countries (HICs), 2.5 for upper-middle-income countries (UMICs), 1 for lower-middle-income countries (LMICs) and 2.1 for low-income countries (LICs).

For fatalities, the impact of the recent wave has been less severe across country groups compared to previous peaks. Peak mortality stood at 62% of the all-time peak for HICs and 58for UMICs. The ratio was lower for LMICs and LICs at 35% and 58% respectively. 

Meanwhile, the Omicron/Delta wave has started to dissipate as the chart below shows more clearly as it zooms into the shorter period since October.

 

Beyond Omicron
 
Even if the above results hold and the wave continues to dissipate, Omicron should serve as a wake-up call for us all. What is most worrisome is how underprepared, undercoordinated and short-sighted we remain as a global community.
 
Over a year into the global vaccination campaign, a large part of the world population is not vaccinated yet (see chart below). The present state of vaccine inequity illustrates perfectly our vulnerability with respect to a more dangerous variant  as it demonstrates our inability to quickly update, manufacture, distribute and administer vaccines at the global scale.
 
As John Nkengasong (Director of the Africa Centers for Disease Control and Prevention) noted:
“The world got lucky with Omicron. It’s unimaginable what would have happened if that highly contagious variant had caused disease as severe as Delta has. We may not be so lucky the next time. The world cannot afford to be so unprepared ever again.”
The emergence of a more transmissible AND more pathogenic variant is not the standard pattern in viral evolution (typically bugs become more infectious and less lethal). 
 
But given the sheer scale of infection, how confident can we be that we will avoid the downside scenario of a bug that is similarly transmissible as Delta or even Omicron but is more lethal? Recall that Delta has been an aberration in this respect as it was both more transmissible and slightly more lethal. 
 
We therefore need to look beyond Omicron and ask: “If a highly transmissible and more lethal variant emerges a year from now, what will we wish then we had done differently today?”. 
 
The answer to that question is that we should have made greater efforts to ramp up global capabilities for development, production & distribution of updated vaccines,  therapeutics and diagnostics.
 
Let our actions today be guided by that strategic foresight.