Sunday, November 28, 2021

Australia and Denmark Announce COVID Omicron Infections In International Arrivals


Although the number of countries detecting the COVID Omicron variant continues to rise - we still don't know how much of a threat this new SARS-CoV-2 strain really poses - only that it does seem to be spreading rapidly in spite of Delta's dominance.  

Many of these recent cases are - at least so far - reported to be either asymptomatic or mildly ill

While somewhat reassuring, most international travelers have been vaccinated, which could lessen severity. Also, Omicron's incubation period, and time from a patient's first symptoms to more severe illness, may be different from previous incarnations of COVID.

Making it far too soon to say whether this variant is more - or hopefully, less - virulent than its predecessors. 

But a significantly more transmissible virus need not be deadlier to be highly disruptive.  We are going into the winter respiratory season with hospitals in many places already at or near capacity (see NHS England: Record 999 Calls & Most A&E Visits For Month Of October).  

Influenza is already on the rise (see CDC HAN # 00458 : Increasing Seasonal Influenza A (H3N2) Activity), and the arrival of a more transmissible COVID variant could push some healthcare delivery systems to their limits (see The Realities Of Crisis Standards Of Care), even if overall severity is no worse than Delta. 

This morning we have reports from Australia, and Denmark on the detection of confirmed or probable Omicron infections in arriving travelers.  While the number of countries reporting Omicron remain small, the virus appears to have a substantial head start, and those numbers will go up rapidly as testing is increased. 

This first news release comes from Health New South Wales. 

Omicron variant in confirmed NSW cases
28 November 2021

NSW Health can confirm urgent genomic testing undertaken today shows two overseas travellers have been infected with the new Omicron B.1.1.529 COVID-19 variant of concern.

Both passengers came to Sydney from southern Africa on the evening of Saturday November 27. They underwent testing on arrival and tested positive for COVID-19 late last night.

The two positive cases, who were asymptomatic, are in isolation in the Special Health Accommodation. Both people are fully vaccinated.

The two passengers were amongst fourteen people from southern Africa who arrived on Qatar Airways QR908, Doha to Sydney, which arrived around 7pm, Saturday November 27.

The remaining 12 passengers from southern Africa are undertaking 14 days of hotel quarantine in the Special Health Accommodation.

Around 260 passengers and air crew on the flight are considered close contacts and have been directed to isolate.

It is an offence not to comply with a Public Health Order and penalties can apply. Close contacts will be contacted regularly, and compliance checks will be undertaken.

In line with Commonwealth measures, all travellers arriving in NSW who have been in South Africa, Lesotho, Botswana, Zimbabwe, Mozambique, Namibia, Eswatini, Malawi, and the Seychelles during the 14 day period before their arrival in NSW must enter hotel quarantine for 14 days, irrespective of their vaccination status.

All travellers who have been in any other overseas country during the 14 day period before their arrival in NSW must travel directly to their place of residence or accommodation and isolate for 72 hours, pending further health advice.

All flight crew who have been overseas during the 14-day period before their arrival in NSW must travel directly to their place of residence or accommodation and isolate for 14 days or until their departure on another flight that leaves Australia, consistent with the current rules for unvaccinated flight crew.

Anyone who has already arrived in NSW who has been in any of the nine African countries within the previous 14 days must immediately get tested and isolate for 14 days, and call NSW Health on 1800 943 553.
And this (translated) report comes from Denmark's SSI (Statens Serum Institut). I'll have a brief postscript after the break. 
Two suspected cases of Omicron (B.1.1.529) have been detected in Denmark by travelers from South Africa

The Omicron variant (B.1.1.529) is a new variant of coronavirus. It was first reported in Botswana on 11 November 2021 and on 14 November in South Africa. The variant has since been observed in several European countries in travelers from South Africa. Today it has probably been found in two people who have entered Denmark.
Last edited November 27, 2021

The cases have been demonstrated by variant PCR, which captured mutations that are characteristic of Omicron, and are thus most likely Omicron. It will only be finally confirmed when the result of whole genome sequencing is available within the next few days.
New variant worries

The new variant, B.1.1.529, worries virologists internationally because it has many more mutations in the spike protein than usual, and there is uncertainty about the infectivity and, if possible, less sensitivity to the vaccines. Confirmed travel-related cases have been found in i.a. England and Belgium.
Travelers from South Africa

The Danish Agency for Patient Safety carries out intensified contact tracking of the cases, ie. that both close contacts and close contacts close contacts are informed about testing and isolation. The Agency also makes contact tracking on the relevant aircraft.

“It is positive that our strong test system has found the probable cases, so soon after we became aware of the new variant Omicron. The strategy is to delay the arrival of this new variant in Denmark until we become wiser about its infectivity, severity and ability to dodge vaccine antibodies. ” says director Henrik Ullum

All travelers who have resided in South Africa and the six neighboring countries of Lesotho, Swaziland, Mozambique, Zimbabwe, Botswana and Namibia since 16 November are encouraged to test and isolate.

SSI follows the development in the spread of Omicron continuously both nationally and internationally.
         (Continue . . . )

Today Israel will close its borders (see Corona Cabinet communique) to foreign nationals, and other countries are imposing new travel restrictions - particularly from high risk regions of the world.  While such measures may help slow the spread of this variant - it is highly unlikely to stop it. 

It's been less than 96 hours since news of the B.1.1.529 variant first emerged (see South African NICD Statement On B.1.1.529 Variant) - and unlike during the first 60 days of 2020, when the world sat on their hands and waited to see what the coronavirus would do - many nations are acting aggressively. 

Admittedly, some of today's reactions may be overblown, while others may be too little, too late, or ineffective.  

Unfortunately, we don't have the luxury of waiting for all the data to come in to react.  Omicron may turn out to be less dangerous than currently feared, but we won't know that for weeks, maybe months. 

Until then, our best course of action will be to do those things we know can slow the spread of the virus, and reduce it impact on healthcare delivery systems; get vaccinated, wear face covers in public, avoid crowds, social distance, and increase indoor ventilation whenever possible. 

Not the Rx that most people what to hear, but right now these remain our best options going into an uncertain winter.