Winter is here

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    Just as winter was coming during much of Game of Thrones, Covid-19 has been lurking for two years. We saw off the first wave with lockdowns, border controls and genetic tracing, and crushed the second, Delta, wave with immunisation. A less united nation now faces Omicron, a variant that has mutated to the extent that vaccines no longer work quite as well.

    But we shouldn’t take that a step further and say they don’t work at all – a claim I hear far too often. Early research (keeping in mind this version of the virus has only existed for a few short months) indicates two doses of the Pfizer-BioNTech vaccine used in New Zealand are still 30-40 percent effective against infection and 70 percent effective in preventing severe disease. A third, so-called booster dose, can increase protection against infection to 70-75 percent and greatly decrease the likelihood of severe disease. That’s why the booster doses are being rolled out with such urgency. Incidentally, influenza vaccines are usually only 40-60 percent effective but still prevent illness in millions of people and the hospitalisation of more than 100,000 people a year in the US alone.

    “But it’s mild,” say the sceptics. (Mostly young, brave and mask-free in my experience.) Yes, that seems to be true, but also far more infectious. Influenza is relatively mild, too, (compared with cancer or bubonic plague) but until the last few years of lockdowns and social distancing, many Kiwis died from the ’flu each winter – 871 in 2017, down from a peak of 1551 in 1985. These mid-year influenza outbreaks put our hospital system under severe strain. Imagine what the combined burdens of an influenza outbreak along with a surge of the far-more-infectious Omicron might do to our emergency departments and infectious diseases wards.

    Influenza has been more or less non-existent for the past two years, due to lockdowns, mask-wearing and social distancing both here and overseas. But there’s no guarantee there will be no ’flu outbreak this winter, especially since the UK and other nations are ditching all precautions. They might be right that Omicron has peaked and that it’s the final, defanged version of Covid-19, marking the much-anticipated move from pandemic to endemic. But since it didn’t mutate in a direct line from Delta, there is also the possibility new variants, mutating from a strain other than Omicron, might be both more infectious and more deadly.

    In the meantime, we will have to deal with Omicron, which is already infecting Auckland in a manner mimicking the exponential curves seen in the US, UK, Europe and Australia. As for it’s mildness, you don’t have to go far to see how relative that term is. Because of its ability to infect far more people, far faster, than earlier variants, the sheer case numbers will mean a proportion are likely to become extremely unwell. Some will die.

    My daughter and a grand-daughter live in Australia and caught Covid-19. They both recorded positive rapid antigen tests but never followed through with a PCR – which would have indicated which variant they’d contracted – due to having to either queue all day in a car or stand for hours in pouring rain while sick. However, their symptoms, which included a severe sore throat, pointed to the dominant Omicron strain. They were both double vaccinated, so they escaped the worst outcomes, but my daughter described the aches and fevers as more like a bad dose of ’flu than “a little cold”. One of her unvaxed friends, who she described as a “beautiful man”, died. Yes, we have no choice but to live with this virus. But living with it means some of us will die. And there is no such thing as mildly dead.

    It would be nice if Waiheke could pull up the drawbridge and isolate from the rest of New Zealand as we did earlier. But that would drive businesses to their knees (if they’re not there already) and maybe bankrupt. Plus it doesn’t make sense medically. This variant is so much more infectious it would have been impossible to keep it out. In fact, it is already on the island. The best thing we can do is get a third Covid vaccine if we haven’t already. With luck you won’t catch it.

    Here are some extra precautions. Get a supply of common painkillers – ibuprofen or paracetomol. They’ll ease the aches that are common symptoms. You may need tissues. Stock up on anaesthetic strepsils. They’re good for numbing sore throats. Buy a pulse oximeter. Ditto N95, KN95 or P2 masks. Once again, not to catch it is the best outcome. Store 14 days’ worth of easy-to-make and ready-made meals. You might not feel like cooking. If you’re elderly like me, appoint a stroppy family member as your advocate, so you can’t be fobbed off by someone from the health department if your blood oxygen level falls dangerously low during home isolation. (This happened with deadly effect in at least one case during the Delta surge.) Contact your GP or nearest medical centre to ensure lines of communication are open. If you’re on prescription medications, make sure you’re well stocked. And don’t forget the toilet paper. • Jim Mahoney

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