Omicron could send BC to record-high COVID cases by January: modelling

COVID cases could rise past 500 a day by early January in a possible best-case scenario, as Omicron establishes community transmission in BC.

One worst-case scenario of Omicron—assuming that the variant carries both an increased risk of transmission and immune evasion (possibly impacting the effectiveness of vaccines)—could cause BC to reach upwards of 2,000 cases by Boxing Day.

Provincial health officer Dr Bonnie Henry presented the modelling scenarios in a presentation yesterday as global concerns grow over the newly discovered variant—estimated by Ontario’s top doctor, Dr Kieran Moore, to be four to eight times more transmissible than Delta.

And while the province declined to put in any new restrictions ahead of the holiday season on Tuesday, one leading independent modelling expert predicts those will come down in the next week or so.

Spike in hospitalizations likely

Sarah Otto, who’s an evolutionary biologist with UBC and a member of the independent BC COVID-19 Modelling Group, told the Beacon that the province’s projections of 2,000 cases a day are very realistic.

“We haven’t seen a variant that spreads this rapidly. It’s very highly transmissible and also can infect and be transmitted by individuals who’ve been vaccinated. Signs from other countries, both the UK and South Africa, indicate that people who are vaccinated still are somewhat protected from infection and fairly well protected from hospitalization and severe cases,” Otto said.

“So that’s good news. But the fact that the virus can spread through them and get to others means that there’s this real rapid spread and real burden on hospitals, especially.”

Otto said the variant, which has been reported in 77 countries so far, has a doubling time of 3 days. She said that means that a lower rate of hospitalization doesn’t make up for the absolute number of people who will end up in hospital if thousands more are infected.

She predicts that now that community spread has been established, the province will see the highest case rate of the whole pandemic by the beginning of January. That will follow a couple weeks later with a big spike in hospitalizations.

“So around mid-January, we’re going to see more people in hospital than we’ve ever seen before. And that’s even accounting for the [possibility of] lower severity and the protection that vaccines provide.”

The only way to avoid a massive hit to hospitals, Otto said, would be if Omicron had a hospitalization rate approximately 10% that of Delta.

Omicron’s “dreadful” timing

Otto called the timing of the new variant’s arrival “dreadful”—weeks before Christmas, with people planning holiday parties and travel.

The province didn’t announce any restrictions or rules around gatherings Tuesday, but Henry recommended that people keep holiday parties small. Otto said she wouldn’t be surprised, however, if that changes in the days to come—possibly with restrictions being added right before Christmas.

“It is a real challenge, though, because the rate of spread is so rapid. Just ramping up a little bit of restrictions isn’t going to do it. So I don’t know how the province is going to react when the cases really start to skyrocket,” Otto said.

Otto’s advice to people who may be wondering about their Christmas parties in the meantime: if you can afford it, buy a set of rapid tests as an extra safety measure; avoid large gatherings where there will be a crowded number of people in a smaller setting; and upgrade to a tighter-fitting mask.

Otto expects that the Omicron wave of COVID will hit harder and faster than previous waves. She says it will be over quicker than previous waves like Delta—but that’s because it will travel faster through the population, exposing most people in a short amount of time.

“We haven’t seen these kinds of sharp peaks before. So they go up fast, they come down fast, because Omicron will run out of susceptible individuals. It’s also just harder to bend down a steep curve,” she said.

Otto said her modelling shows one way to avoid a “big crisis” in January—massively speed up the rollout of booster vaccinations.

“The only way to get a really big reduction is to ramp up everybody’s antibody levels. And we’re seeing that in the UK. And I hope that we’ll see a kind of shift because right now they keep talking about everybody being eligible for boosters in January—well, January’s too late,” she said.

44 Omicron cases so far

Public health officials indicated Tuesday that there wouldn’t be a big shift to BC’s booster rollout schedule. The province expects the bulk of the rollout to occur between January and February, when British Columbians begin to reach a six-month interval after having had their second dose.

As of Dec 12, BC had confirmed 44 cases of Omicron—24 of which are in the Fraser Health region and 11 in the Vancouver Coastal Health region. Henry said that number will increase, with more tentative cases already waiting to be confirmed.

Some of those are connected to a large outbreak at UVic, stemming from a number of events— some house parties, and transmission on the rugby team that had recently played Queen’s University. The outbreak, which abruptly cancelled in-person exams this week, has seen about 124 cases so far and Henry said the cases are a mix of Delta and Omicron.

Until this point, case rates and hospitalization rates had actually been stabilizing in many parts of the province. But BC’s reproductive value (the number of people on average that each infected individual in turn transmits COVID to) has in recent days ticked up above 1 again—possibly representing transmission to groups of people.