Health In Europe

What’s the latest on Omicron?

• World Health Organization Regional Office for Europe • Season 3

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In this episode we speak with Dr Catherine Smallwood, WHO/Europe’s COVID-19 incident manager, to get the latest on the Omicron variant which continues to cause record cases across the Region. And WHO’s European Office for the Prevention of Non-Communicable Diseases explore how we can stay healthy in the metaverse.

Greg Bianchi (00:00):

Hello, and welcome to the WHO health in Europe podcast. I'm your host, Greg Bianchi. We've launched this podcast to bring you the latest on W H O's work in the European region. Our region is broad and diverse from the Mid-Atlantic and stretching as far as the Chinese border, we work with fascinating and driven individuals and groups. This podcast is about hearing their stories and how they might impact your day to day life.

Greg Bianchi (00:43):

Late in 2021 reports emerged of a new coronavirus variant now known as Omicron. This variant has seen cases rise dramatically in recent weeks. As the world watched and waited to see what this new variant might mean for the pandemic coverage, both online and the media grew. Some of this coverage folks on a Macron being milder than other variants with fewer people needing emergency medical care. But this has been accompanied by warnings of increased transmissibility, which places a burden on health systems that are already stretched. Today I speak with Dr. Catherine Smallwood, w O Europe's COVID 19 instant manager about Omicron and how it's impacting the WHO European region. Hi, Katie. Welcome. Thank

Dr Catherine Smallwood (01:24):

You. And welcome to you too.

Greg Bianchi (01:25):

Thank you. So I'll just dive in with the first question which has got quite a lot of coverage lately is and that's quite a lot of discussion is focused on Omicron being milder than other variants. Is this actually the case?

Dr Catherine Smallwood (01:38):

So it's a really good question. There's been a lot of attention to it. It's also really quite complex and there's several things that we really kind of have to take into account. First of all, the virus itself and Omicron as it compares to Delta, but also to a lot of the other variants of COVID 19 that are circulating or have been previously circulating, including the wild type, which was the original variant that came from China and spread across the world. So in terms of the specific viral characteristics, what we're seeing right now, and, and the evidence is accruing around this is that compared to the Delta variant, which we must all remember was more severe than the previously circulating variants Omicron has a lower infection severity, and that corresponds to approximately, and this is still sort of the, the evidence there is still accruing, but is approximately 50% of a decrease in terms of the risk of hospitalization.

Dr Catherine Smallwood (02:46):

So yes, we can say that the virus itself is somewhat a degree, less severe than the Delta variant, but it can still very much lead to hospitalization. It can still very much lead to deaths. And we do have numbers of in both those categories, unfortunately, but then there's other considerations. So then it, we also need to ask ourselves why is Omicron spreading so widely and, and in what are the kind of immuno immunologic profiles of the people that are spreading the virus. And we know that Omicron has a substantial ability to evade immune systems. So that means that a lot of people who have had COVID 19 before are getting it again. And a lot of people who have had the first and second and sometimes a third dose of vaccine are also getting it again. But those people are seeing much milder disease because despite the fact that the virus is able to evade their immunity in terms of infection, our immune systems, which is much more complex and can recognize and has a memory still protects those people from going on to have severe disease.

Dr Catherine Smallwood (03:59):

So a lot, we're seeing a lot more cases, but most of those cases are milder because of our immune systems being better equipped. And then finally we also need to, to take into account that we're very much in the early phases of this spread of Omicron. And initially it was really spreading in two contexts, and those were combined generally quite young adults in their age of 20 to 30. Those are not the people who tend to be hospitalized. They can be, but not in large, large numbers. And they're not the ones that end up in critical condition and, and dying from COVID in general. But also we are seeing the early spread in countries that have this very high vaccination uptake or in South Africa where there's been very significant waves of transmission, previous transmission through the population quite recently. And that means those populations are generally better immunized and have more protection. So we still have yet to see Omicron spread in other parts of the world where the population might be more naive to the infection in terms of the immune immune response. And so we might still see really severe outcomes in certain population groups.

Greg Bianchi (05:18):

And I think actually from the briefing today, I think the regional director touched upon on that with the, the pandemic moving into, into countries where there is, is lower vaccine coverage, as you say, but you've kind of already answered it slightly before, but but what do we know how well the vaccines are doing? What do we know about? Sorry, how well the vaccines are doing in protecting against severe disease and death from Overn.

Dr Catherine Smallwood (05:39):

Yeah, so I mean, that's exactly rights. So in terms of vaccination the, the entire purpose of the vaccination campaigns, and we've said this from the very beginning, is that it protects people from ending up in hospital and dying from COVID 19. And so the wave of mild infections that we're seeing now is really Testament to the success of these vaccination campaigns, where they're happening. So if you look at the numbers and here again, it's early data coming out from several countries that have the number of cases in hospital to be able to measure the actual effectiveness of the vaccine in people who are hospitalized, we're seeing, depending on the vaccine product, of course, there's a range and the vaccines do have slightly different efficacy rates, but depending on the vaccine product based on two doses. So the PRI full primary series of vaccination between 65 and 80% vaccine is effectiveness against hospitalization.

Dr Catherine Smallwood (06:39):

So that's still really good. And it shows that even without a booster dose, people remain really quite largely protected against hospitalization. With Omicron. Now, of course there has been some waning in that immunity and that's across all variants, and that might happen slightly faster with <inaudible> than with other variants. And we're still learning about that. But we do know that with a booster dose as well, that protection goes up from already really good levels to over 90% protection against hospitalization. We don't know how long that will last, that will likely weigh into, but the overall message is that the vaccines that we have are really good at protecting against severe disease. And that's really what's accounting for this really relatively mild resurgence of COVID. And unfortunately, no vaccine is 100% effective. And when you have a very, very large number of cases, there will be amongst those cases, people who are hospitalized, people who go on to have severe critical disease and require intubation and ventilation support. And some of those people will go on to die.

Greg Bianchi (07:54):

Okay. And I mean, we've, we've spoken mostly about Omicron here as well, but obviously towards the end of last year, the big focus was still very much on Delta. So now thatn seems to be increasing so dramatically. Does that mean the Delta's gone away or is it, is it here to stay?

Dr Catherine Smallwood (08:09):

Not yet, it's, it's going away at least in some parts of the region and and that will happen. ASN spreads I would say for the moment, a large proportion of the countries across Eastern Europe, central Asia are still predominantly seeing Delta circulate. They haven't yet had the high increase and the spread of <inaudible>, although that's very likely to happen. And that's also what the regional director highlighted today, that as it spreads, we're likely to see it characterized in a different way, depending on, on the context that, where it's spreading, what we're seeing in Western Europe and in those countries that saw the early spread of O micron is that it has very rapidly become dominant and very rapidly is accounting for the majority of COVID 19 cases in a given population initially. And that's likely to be driven in fact by the dynamics of the population at that time.

Dr Catherine Smallwood (09:14):

So in Western Europe that actually tended to coincide with the end of the school period and the beginning of the Christmas holidays and the new year holidays, which meant that initially it was spreading in 20 and 30 year olds schools closed. So it wasn't spreading so much in children and children were seeing much more debt, but then over the Christmas holidays, families, mingled generations, mingled, and now we are seeing those cases go up very sharply across all age groups, and that's what we would expect to see. And so we would tend to see that over time Omicron will likely come to replace Delta. There may be pockets of circulation of Delta, but it it'll likely come to replace it in, in a good proportion of the cases.

Greg Bianchi (10:06):

Okay. And kind of, we were speaking a little bit earlier about, you know, how phenomenally effective the vaccines have been since they've been rolled out and how, how good they are at yeah. Preventing severe illness and death in, in particular. But given that vaccination seems to be having such an impact on severe illness. But transmission, as you mentioned before, still occurs how important is it that people continue to isolate if they test positive, or if they're a close contact of someone who tests

Dr Catherine Smallwood (10:33):

Positive, it's really important. <Affirmative>, and, and it's also really important that people do that quickly because we know from the data about COVID 19 con disease that we are most infectious around about the time where we develop symptoms. In fact, we're infectious up to 48 hours prior to set of symptoms so we can spread. And we've seen this, you know, in the past, and there's no significant change to what we think is happening in Omicron. We can spread the disease before we know it, we have it know we have it ourselves, but also in those couple of days after onset of symptoms and then our infectiousness tends to tail off and it takes some time, but it does tail off quite quickly. And and so people isolating quickly, even if they're waiting for their test result, if they have symptoms is really important and equally identifying cases contacts of cases, sorry, is really an important to be done quickly because that's where you can prevent those infections from happening prior to onset of symptoms.

Dr Catherine Smallwood (11:44):

And all of this is about slowing the spread preventing onwards, transmission, and breaking that cycle that's continuously happening. And of course there's so many cases in the community right now that it's causing huge pressures on workforces. So of course it's still important to slow it down. The faster the transmission happens, the more cases will be generated in a very short period of time. And that's what happened. That's what puts pressure on our critical services. When you have too many people off sick at any one time, it's not necessarily the severity, it's just the acuteness of, of that workforce shortage, which which is what we're seeing in some European countries now where we can almost for, from a public health perspective, tolerate or cope with a much higher infection rate in our population, but in terms of the broader societal impact that that's having and the disruption, that's something that's unprecedented at the moment. And we wouldn't have got to that because the public health impact previously in non-vaccinated population, would've been so severe that we wouldn't have been able to, to manage to, to, to keep things open. And we would've had to have entered a lockdown. We don't need to do that anymore, but now there's a different problem. And, and that's really what we're seeing.

Greg Bianchi (13:11):

And just as a follow up to that, I mean we've seen a lot in, in the media, particularly in governments, making decisions around particularly workforce to see fake and shorten lengths of of isolation what's w O Europe's position on that, or what's our views on that rather.

Dr Catherine Smallwood (13:28):

Yeah. And that's, that's, that's a really acute present issue that countries are grappling with. And, and they're having to make dis decisions based on balancing the risks and the benefits of shortening periods of both quarantine and isolation. So from our perspective as w H O and we are very much a science driven organization and, and look looking at the evidence, there's no change in the science, it's the situation that is really demanding that certain adjustments are made and, and there's good reason for those adjustments to be made. And we would support that, but only in that context where there are these critical pressures on services, in any other situation where those critical pressures are not causing disruption, we would still recommend that the quarantine period for a contact of a case is 14 days, which is the incubation period of COVID 19, that has not been adjusted by w H at this stage.

Dr Catherine Smallwood (14:37):

And that for people who test positive as cases, that the isolation period is 10 days, including three, and potentially in addition to that three days without any symptoms or without acute symptoms, there is room in w H O guidance for these adjustments to be made. So already in w H O's recommendations for contact tracing, we do say that in terms of increasing adherence and compliance with contact tracing and quarantine requirements that are shortened period of quarantine can be taken into account. And that's really balancing those risks and benefits, knowing exactly what the potential risk of onward spread might be. And the same goes for isolating patients who have tested positive. We do recommend that after the 10 day plus three, without symptoms patients can be released from isolation or cases who don't have any symptoms without the need for any test whatsoever.

Dr Catherine Smallwood (15:40):

That's because sometimes with a PCR test, people can continue testing positive for quite some time. However, those periods can also be shortened, and we would also support that, but we would want to see the inclusion of a, of a test, potentially a rapid diagnostic test or a PCR test, just to ensure that even with a shortened period of isolation, patients are not still testing positive and going out into the community and infecting others. And that's especially important for anyone who is potentially coming into contact with vulnerable populations in their, in their day to day work or in their dayto day life. For example, healthcare workers. The worst thing that we could do is to release a healthcare worker from isolation and have them infectious providing care to vulner individuals who might not be vaccinated, and who might go on to die from COVID-19

Greg Bianchi (16:52):

Now staying for and eating a balanced diet are just two ways that we can stay healthy in our day's day lives.

Greg Bianchi (17:01):

But with technological advances, seeing people spend more of their days online, there's a concern about the potential health impacts on our digital lives. What's more, there's a growing discussion around the blending of the internet and virtual reality sometimes term the me averse, but do we necessarily have to associate digital technologies with unhealthy habits last month w chose European office for the prevention and control of NTDs, along with the ministry of health of the Russian Federation hosts the conference on tackling non-communicable diseases with digital solutions during the conference, w O's Alexandra Olson and Eagle OV sat down with experts to find out some of the risks, digital technologies post to our health, but also how they may be used to promote healthy behaviors over to Alexandra and Eagle. Hi, there,

Aleksandra Olsen (17:45):

You're listening to a mini podcast series from the w H O N C D office in Moscow. And this time we're going to talk about how to stay healthy at a time when the internet and virtual reality are increasingly replacing face to face communication. Our hosts in the studio are Alexandra Olson and eco

Igor Kryuchkov (18:06):

The COVID pandemic has taught us that digital technology can help us to human improve our mental health and share how we feel during lockdowns. Their ability to communicate with family and friends online has helped hundreds of thousands of people maintain mental wellbeing and peace of mind for many children and young people communication on social platforms or online games occupies place in their lives

Aleksandra Olsen (18:30):

Today. Supporters of innovation are talking more and more about the digital universe, or metaverse an advanced form of online communication, which with the help of a virtual reality headset or other devices can allow a person to almost completely immerse themselves in a virtual reality. So

Igor Kryuchkov (18:50):

How can we maintain and improve our health with these new digital tools after all life online is usually associated with a sedentary lifestyle and a less healthy diet. And these are serious risk factors for the development of non-communicable diseases, or S such as diabetes, cardiovascular diseases, and even S account for more than 80% of premature deaths across the w O European region, including Russia and the CAS countries,

Aleksandra Olsen (19:19):

But does living online necessarily have to be associated with risk factors for non-communicable diseases? Could we not create a safe environment in social networks and video games that prevents rather than provokes disease and promotes a healthy lifestyle? For example, according to recent studies, some popular modern video games can be used as a tool to overcome mental disorders. Digital entertainment can also serve as a distraction for painful conditions. Wells support people in coping with chronic diseases,

Igor Kryuchkov (19:55):

Dr. Kremlin Wickramasinghe acting head of the w H O European N office in Moscow summarizes how digital technologies can help us tackle entities and build back better after COVID 19.

Dr. Kremlin Wickramasinghe (20:08):

We all know that our health systems are stretched during the COVID 19. A lot of colleagues working on prevention NCDs are now spending more time on pandemic related work, and patients don't have the same capacity and opportunities to come in contact with the health systems and NCDs require more frequent regular interactions with health systems. So what digital are solutions could do is provide that extra space and strength to use our existing resources and give the maximum care and services to people living with CD, but also through data and better connections to provide better information, to make quick decisions and informal policies. So we hope digital solution will be helpful for both prevention and management of non-chemical diseases.

Igor Kryuchkov (21:02):

Although we're open to the opportunities that digital world provides, WHO is still concerned with the promotion of unhealthy products within the digital environment. Manufacturers of tobacco, alcohol, and fast food, actively use social networks and games to advertise their products. At the same time, advertising campaigns are often disguised as entertaining internet content or organically integrated into the gaming space. According to data, most junk food ads, target children and teens. Tovan Ireland, special industry advisor to the world health organization explains how to get the most impact out of digital spaces

Speaker 6 (21:41):

In order to have more impact governments and policy makers and the w H need to consolidate their voice a bit around the, the requirements or the requests for the platforms to behave differently across all of the different health health programs, but also in the, in the larger construct of online harms where health is just one important area where the platforms have a massive impact on the quality of life of, of

Aleksandra Olsen (22:10):

Children online to create a healthy environment online and in the field of digital entertainment, w H O recommends that countries pay special attention to policy gray areas. For example, where clear rules for advertisers have not yet been developed in addition specialists from the w H O European office for the prevention and control of non-communicable diseases have developed a special digital tool called click that can track advertising of unhealthy products, including hidden ones, a

Igor Kryuchkov (22:43):

Healthy digital environment and social networks games, and the metaverses of course, an ambitious go, however, as practice shows, internet users and with them, the authorities of many countries in the w O European region are increasingly paying attention to the need to regulate this area of our lives. This theme was also in focus at the Moscow digital for NCD conference, which was organized by the WHO European office for NCDs in collaboration with a ministry of health of Russian Federation on 14th, 15th of December. Other

Aleksandra Olsen (23:15):

Episodes can be found in the WHO playlist on all major podcast platforms. Stay tuned.

Greg Bianchi (23:26):

That's all we have time for. Special thanks to all our guests. If you want to find out more about any of the topics in this episode, you can do so on the WHO Europe website, that's www.euro.who.int. , Or check out the links in the show notes, the music during the second segment on the metaverse is courtesy of riot games. Give us a rating. And if you like what you've heard, make sure to recommend us to a friend or a colleague, thanks for listening. And until next time, stay safe and stay healthy.