Data insight

Wake us up before you go, O!

The world remains wholly underprepared against the downside contingency of a more infectious and lethal variant

Note:  Charts current as of date above; text updated on January 6, 2021.

Are we in for a rough ride? The global picture so far doesn’t suggest so, but let that not deceive you as Omicron has progressed unequally so far. But even if Omicron turns out less severe, let this episode of heightened worry serve as a wake-up call: the world remains wholly underprepared against a downside scenario of a more transmissible and a more lethal variant. 

In for a rough ride?
The chart above shows daily developments for new cases and new fatalities per million people. The global picture is clear: cases are skyrocketing and have surpassed their previous peak, but mortality has been flat and has even dropped over the last few days. But underneath this aggregate global picture there is a diversity of experiences. Let’s illustrate this using the World Bank’s income classification and showing cases and fatalities across countries grouped by their level of income. 

The above chart shows the steep rise in confirmed cases in high-income countries (HICs) but exactly the opposite pattern in the upper- and lower-middle income countries (UMICs and LMICs) – as of when this post was last updated. Given Omicron, it’s only a matter of time before cases will start rising everywhere. 

Conversely, as the chart below shows, fatalities have risen considerably in high-income countries, and this is being offset by lower mortality in upper- and lower-middle-income countries. Again this is unlikely to persist.

Omicron and beyond
The near-term outlook will depend critically on the pathogenicity of Omicron. Early reports are positive about severity but suggest increased transmissibility, which creates a scale of infection unseen before. Clearly, we don’t have the full picture yet, but Omicron’s properties may be particularly worrisome for countries with less-resourced health systems. If we’re unlucky, we may see a repeat of India May 2021 or worse.
But even if it transpires to be less lethal, Omicron should serve as a wake-up call for us all. What is most worrisome is how under-prepared, under-coordinated and short-sighted we remain as a global community.
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’s both more transmissible and more lethal? (Note that Delta was already an aberation in this respect.)
We therefore need to look beyond Omicron and ask: “If a more 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 simple: we should have ramped up GLOBAL capabilities for development, production & distribution of updated vaccines & therapeutics.
Let our actions today be guided by that strategic foresight.