Friday, January 28

Now we know the omikron rules of the game

NEW RULES: – It is right to ease the national measures on Friday, as has now been announced, even if it means that the infection will increase, write Raymond Johansen and Robert Steen.

The omikron variant changed the rules of the game, but now we have lived with it for at least five weeks. The figures and experiences from Oslo, although they may look scary, actually give good reason for hope for the time ahead.


This is a chronicle. The chronicle expresses the writer’s attitude. You can submit articles and debate posts to VG here.

RAYMOND JOHANSEN, Oslo City Councilor (Labor Party)
ROBERT STEEN, City Council for Health, the Elderly and Citizen Services in Oslo (Labor)

The first confirmed cases of omicron were discovered in Norway on December 1, 2021. Then followed an explosion of infection we have never seen before: In Oslo we went from approx. 12,700 infected in November to approx. 28,400 in December. Previous infection records were shattered, even in a population with a very high vaccination rate.

It looked like a worst case scenario struck: a new virus variant that could not be stopped by the vaccines. It was necessary and right to introduce measures to slow down the spread and gain more knowledge. Now we know much more.

First: omikron is less dangerous than delta

The numbers are almost overwhelmingly clear: 28,400 infected during December in Oslo, has led to us today having 84 inpatients at the hospitals in Oslo and at Ahus (which also has many patients from other places). Only 27 of them are in intensive care units. In comparison, 8600 infected in March 2021 led to around 160 inpatients at the same hospitals at the beginning of April.

The difference is striking, and we should be happy about that. The milder omicron variant has displaced the more dangerous delta variant, and this has a major positive effect on the disease burden. This is crucial knowledge when the infection increases in the time to come, as we know it will do when we facilitate the measures.

Secondly, the vaccines protect very well against serious illness, but poorly against infection

In Oslo, we now see that around 90 per cent of those infected have been vaccinated, and that around 10 per cent of those infected have not been vaccinated. The infection is thus relatively similar among vaccinated people. If only the unvaccinated were infected, all of us could just live as normal, but that is not the case. The pandemic is not driven by the unvaccinated population, but by all of us.

Among those admitted to hospital, the picture is quite different: there, the small group of unvaccinated are so strongly overrepresented that they account for more than half of all admissions. Those who choose not to take the vaccine take a high risk, which we must assume that they are very familiar with today.

Third: soon everyone in the risk groups has been offered a third dose

Omikron has really accelerated the vaccination with the third dose. Those who accept the third dose are very well protected against serious illness. All indications are that those who have received the refresher dose can count on mild illness, if / when they become infected. In Oslo, we are immediately in the goal of vaccinating everyone over 45 who wants a third dose. We are in the process of drop-in for those under 45. Our population is now well protected.

What does this mean for how we should live with the virus?

That we know more does not mean that we know everything. We will probably have to live with the uncertainty about how the pandemic will develop for a long time to come. But, from our point of view in Oslo, the experiences with omikron are beginning to provide some fairly clear answers and some clear challenges we must address.

Challenge 1: Are any rules adapted to a different time?

To curb the infection, we now have strict rules for isolation for the infected and quarantine for all close contacts who have not received three doses. To a large extent, it is now the rules for isolation and quarantine that lead to high absenteeism in important community services locally. When those who can become really ill have received three doses, and everyone else has received two, we must ask ourselves whether the quarantine rules are adapted to the situation we are now in.

If we have to introduce very strict measures to prevent the quarantine absence from becoming dangerously high, we must ask ourselves whether the quarantine rules do more harm than good to the disease.

Challenge 2: What should be the goal for the third dose?

This autumn, the health authorities were clear in their goals: when we reached approx. 90 percent fully vaccinated (which then meant two doses), we would be able to open up and live as normal. As is well known, this was not the case. In Oslo, we now offer the third dose to anyone over 18 years of age. But should we set the same goal, 90 percent, for the third dose?

It would be unwise, and weakly professionally founded. Everyone over 18 who wants it should get a third dose, and for society it is better the more people who take the third dose. But the chance that a healthy person in their 20s with two doses in the body will become seriously ill with corona, is vanishingly small. We can not expect as high support for the third dose in the younger age groups as for the second dose.

Challenge 3: How many people should actually be infected in the coming months?

If we are all to get corona at some point, as many suggest, we must ask ourselves whether in the long run it is as good to get the infection rates up as it is to get them down. Understand us right: of course we should not have uncontrolled spread of infection now. But if we are to avoid new waves of infection and shutdown next winter, it may be preferable to have higher infection rates during a period when immunity is high after the vaccines.

We may have to get used to a completely new way of thinking: that we would rather have a suitably high level of infection than a lowest possible level of infection?

In summary: Now we must learn to live with omikron

One thing we and many other municipalities are now concerned about is a larger room for maneuver locally. We have good experience with local initiatives for almost two years. The municipalities have precise knowledge about the infection situation locally, about the vaccine development and the challenges with the unvaccinated. We have a full overview of the capacity of our services. We know the local business and industry, and can adapt measures and rules so that they work best, and pain as little as possible.

Some measures and rules should be national. But a greater responsibility locally provides opportunities we need to live the best possible with the corona in the time to come: We can have proportionate measures exactly where needed, which can be changed quickly if needed. It will provide better support for necessary measures, and maintain confidence in corona management.

All this indicates that it is right to ease the national measures on Friday, as has now been announced, even if it means that the infection will rise. The pressure on hospitals and municipal services will increase somewhat, but not in the same way as before in the pandemic. Measured against the dramatic consequences of today’s measures in other areas, it is nevertheless correct. Because we know that omikron is different, and most of them are protected.

The rules have changed, but are no longer unknown. Now is the time to adapt to the new reality. Then we must take the time to look up and look ahead.

Which long-term strategy will serve us best?

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