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23 December 2021

Omicron might be milder but it could still overwhelm the NHS

If the Tories want to rule out future lockdowns, they need to significantly expand healthcare capacity.

By Stephen Bush

Another study – this one by Imperial College London – indicates that the Omicron variant is less severe in individual patients than the Delta variant: if you get it, your chances of becoming severely ill, needing to go into hospital and needing a critical care bed are less than with previous Covid-19 variants. 

But, of course, the dirty little secret of the British government’s coronavirus policy is that it has never really been about saving individual lives: it has always been about keeping society and the economy as open as possible without the NHS keeling over. Most of the time, this has been the policy by accident rather than design, but, nonetheless, that has actually been our coronavirus policy.

Keeping the NHS going is a crude numbers game: there are around 6,000 critical care beds in the NHS, and if every single one of them becomes occupied or otherwise unusable, then: congratulations! You don’t have modern healthcare anymore. 

So Omicron’s lack of severity may be beside the point: if it spreads more effectively, then we each individually have less to fear from it, but we collectively may have as much to worry about, because we may still end up with a knackered NHS anyway. 

Of course, there is also more than one way that Omicron can take up a hospital bed: the first is for it to have an Omicron patient in it. The second is for medical staff to be off ill or self-isolating, because, without qualified staff, a critical care bed is really just a bench with some fancy hardware beside it. 

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So there are two risks that we know about, but can’t yet quantify: the first is the direct pressure on the NHS caused by Omicron patients. The second is the indirect pressure caused by isolation. (And isolation and minor illnesses may also lead to school closures and pressure on other services.)

One option is to impose pre-emptive limits on our freedoms as a precautionary measure. That’s the option that both the Scottish and Welsh governments have chosen, with restrictions due to take effect after Christmas. But since inoculation against Covid-19 wanes, we are not going to eliminate the novel coronavirus: it is going to become another endemic disease, like the flu. 

Personally, I don’t think you can countenance lockdowns and other severe limits on our freedoms as a solution to an endemic disease. As an option in the policy toolkit in the face of a new disease, yes. But as something you reach for in order to relieve pressure on healthcare capacity as a matter of course: no. That should be out of bounds. The social costs, whether the increased risk of domestic violence, the dangers to vulnerable children, the mental health toll, or the alarming number of people who have turned to conspiracies and extremist ideologies, are too great.

But you can only definitively rule out lockdowns if you expand healthcare capacity and if you rethink other policy choices: it may be, for instance, that the cost-benefit of making flu jabs free at the point of use only for certain groups needs to be revisited, and that we should maintain a permanent infrastructure to provide regular, free inoculations against the flu, against Covid-19, and expand the number of free vaccinations – so that diseases such as pneumonia and chickenpox are also fought via inoculation as a rule, rather than as an exception. (And, of course, new treatments also make it easier to manage Covid-19.)

One barrier to getting there, though, is that the Conservative government isn’t being honest (even with itself) about what has really driven its decision-making since March 2020: and that lack of clarity may have catastrophic consequences.

[See also: Why Boris Johnson cannot blame the NHS crisis on Omicron]

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