Each of the three variables is an important driver of the outcomes. We are as excited as others about the stunning developments in vaccines. The booster campaigns of the six countries shown in Exhibit 3 have primarily utilized mRNA vaccines. Today, the burden of disease caused by COVID-19 in vaccinated people in the United States is similar to or lower than the average burden of influenza over the last decade, while the risks from COVID-19 to unvaccinated people are significantly higher (Exhibit 2). "It's hard because it doesn't have an enormously robust diagnosis," Dr Lydeamore said. It is also possible that COVID-19 will be seasonal, with predictable annual peaks in parts of the world where it is endemic.147Apoorva Mandavilli, The future of the coronavirus? Mark Terry, Vir Bios COVID-19 antibody therapy could be great, but will it be too late?, BioSpace.com, November 11, 2020, biospace.com. As Australia transitions its COVID-19 strategy, it has rapidly gained immunity over the past year through a combination of vaccination and infections. At a cash rate of 3.6 per cent, most Australians will be just fine. Whether because Omicron is more infectious or has greater ability to evade the immune system, or both, it quickly became the dominant variant in South Africa.52Genomic epidemiology of novel coronavirus - Africa-focused subsampling, Nextstrain, December 11, 2021. Treasury is estimating a historical surge in net migration, but several factors including changes to COVID policy settings make the prediction seem far-fetched. AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time), abc.net.au/news/covid-omicron-cognitive-leap-into-2022/100734564. The changes to the close contact rules should limit the number of healthcare workers taken off the roster and strengthen the system, along with a new directive from NSW to allow asymptomatic staff deemed as close contacts to leave self-isolation. While it now appears unlikely that large countries will reach overall herd immunity (though some areas might), developments in the United Kingdom during the past few months may help illustrate the prospects for Western countries to transition back toward normalcy.94 Watch the U.K. to understand Delta, August 2021; Grady McGregor, Sophie Mellor, and Biman Mukherji, Delta waves in India and the U.K. have already receded. Dr Abul Rizvi reports. A transition toward normalcy is mostly likely in Europe during the late second or third quarter of 2021. The analysis is quite sensitive to public-health interventions and behaviors. Pfizer and BioNTech provide update, December 8, 2021. Factbox: Countries weigh need for booster COVID-19 shots, Reuters, December 8, 2021. Pfizer and BioNTech announce Phase 3 trial data showing high efficacy of a booster dose of their COVID-19 vaccine, Pfizer, October 21, 2021. COVID-19 virtual press conference: 8 December 2021, WHO, December 8, 2021. Evidence of past infection was also the highest among young blood donors (27 per cent), matching higher reported case numbers in this age group. Melbourne School of Population and Global Health Many, however, will not, he added. It's unclear at what price these changes come, in terms of increased risk to essential workers and their families. All industries and all levels of government must improve their digital offerings. Dr Lydeamore said he was concerned that, as we entered a new year, vaccine coverage across the nation was "dropping rapidly". WebThis was followed by two schemes in Australia, which in 2022 were merged to form the Pacific Australia Labour Mobility (palm ) scheme. We will see case numbers go up, which are effectively production numbers going up. "Australia, as a neighbour there, really has a responsibility to help with the infrastructure and with the messaging and to try [to]get those populations vaccinated," he said. Since the winter of 2021, this is Omicron for most countries, and we consider immunity against BA.1 and BA.2 rather than the more recent subvariants. Vaccine rollout and adoption are faster than expected, Natural immunity is significantly higher than realized, More-transmissible variants lead to higher rates of natural immunity, US Biologics License Applications (BLA) with full approval by March/April 2021 or earlier, Approximately 39 months for manufacturing, distribution, and sufficient adoption to reach herd immunity, Manufacturing/supply-chain issues slow rollout, More-infectious variants raise the threshold for achieving herd immunity, Vaccine prevents disease progression but does not meaningfully reduce transmission, 56 million for phase 1c: ages 6574 (through 3/31/21), 202 million for phase 1c: other (4/1/217/31/21), the arrival, efficacy, and adoption of COVID-19 vaccinesthe biggest drivers in the timeline to herd immunity, the level of natural immunity in a population from exposure to COVID-19; in our estimate, between 90 million and 300 million people globally may have natural immunity, potential cross-immunity from exposure to other coronaviruses, potential partial immunity conferred by other immunizations, such as the bacille CalmetteGurin (BCG) vaccine for tuberculosis, regional differences in the ways that people mix, which will produce different thresholds for herd immunity, continued improvement by governments in the application of public-health interventions (such as test and trace) that dont significantly limit economic and social activities, compliance with public-health measures until we achieve herd immunity, accurate, widely available, rapid testing that effectively enables specific activities, continued advancements in therapeutics (including pre- and postexposure prophylactics) for and clinical management of COVID-19, leading to lower infection-fatality ratiossubstantial progress has already been made through a combination of effective drugs, such as dexamethasone and remdesivir, and changes in clinical management, public confidence that there arent significant long-term health consequences for those who recover from COVID-19. Can healthcare systems diagnose COVID-19 and distribute therapeutics fast enough for them to be effective? but we dont yet know their efficacy, duration of protection, or the policies that will be set around fourth doses. Globally, we should aim for an always on response systemthat can scale quickly. Endemicity remains the endpoint. While even greater infectiousness (such as the sub-variant BA.2 has exhibited) is possible, to become dominant a new variant would likely need to also partially or fully evade prior immunity, including that provided by Omicron infection. An earlier timeline to reach herd immunityfor example, Q1/Q2 of 2021is now less likely, as is a later timeline (2022). It isnt yet clear whether public interest in boosters will continue to decline or demand will in time match the historical uptake of flu vaccines (around 50 percent of adults). However, even that share has been too small for them to achieve herd immunity, because of the emergence of the more transmissible and more lethal Delta variant80 Sarah Zhang, What if we never reach herd immunity?, Atlantic, February 9, 2021, theatlantic.com. Its an important distinction because what will drive herd immunity is reduction in transmission. Government has no interest whatsoever in pushing house prices down. They have already begun in some locations and could be well advanced in most countries by the first or second quarter of 2021. The strain is likely to continue spreading in the coming months, propelled by its reproductive advantage over the original. As a result, we may be significantly underestimating its spread.142Miriam Berger, U.K. Our estimate is based on the widest possible reading of the current scientific literature and our discussions with public-health experts in the United States and around the world. As growth in the regions continues, local councils must make enough land available to accommodate the increased demand for housing. These and other complexities create risk of delay. Eames, Fine, and Heymann, Herd immunity: A rough guide, pp. A transition to the next normal, in whatever form that takes, will come gradually when people have confidence that they can do what they used to do without endangering themselves or others. This is mediated by individual risk factors (age, underlying conditions, and so on), and their risk appetite. Today, much of the world is intensely focused on it, but we can reasonably expect the imminent threat to abate. A leading epidemiologist has warned Australia is heading towards 50 COVID-19 deaths a day as more transmissible Omicron sub-variants become the nations dominant strains. Despite his grim outlook on COVID-19 deaths, Professor Esterman said its not all doom and gloom. Even before the emergence of Omicron, the past four months have seen the continued evolution of the public response to COVID-19. Georgina Walker More detail is shown in Exhibit 1 below. Professor Esterman said there were a number of reasons why such big numbers could be flying under the radar. 9116. Given the likely timing of herd immunity in various geographies and the uncertain duration of protection from vaccines (both duration of immune response and efficacy versus new variants), it is likely that some measures such as booster vaccines are likely to be required indefinitely. Anthony Ives and Claudio Bozzuto, State-by-state estimates of R0 at the start of COVID-19 outbreaks in the USA, MedRxiv, May 27, 2020, medrxiv.org. The United Kingdoms experience nevertheless suggests that once a country has weathered a wave of Delta-driven cases, it may be able to resume the transition toward normalcy. "So, I expect a lot of the decisions to be slightly further behind, rather than really proactive like they were over the past 18 months.". The start, peak, and tail of this curve are almost the same as the previous one. "Those simple things, if we get that right, then the impact of this virus that isn't going to go awaywill be significantly reduced," he said. 11. Raising vaccination rates will be essential to achieving a transition toward normalcy. Older people are generally more willing to be vaccinated than the general population. F. Javier Ibarrondo et al., Rapid decay of anti-SARS-CoV-2 antibodies in persons with mild COVID-19,, Rebecca Cox and Karl Brokstad, Not just antibodies: B cells and T cells mediate immunity to COVID-19,, Katie Thomas, New Pfizer results: Coronavirus vaccine is safe and 95% effective,. There is no evidence of higher case fatality with either new strain, but there are fears that new strains may affect how antibodies bind to the virus and may reduce the efficacy of vaccines or antibody treatments developed over the past few months. Three levers are likely to be especially important, starting with the extent to which countries can effectively scale and make available new oral therapeutics with the potential to reduce the chance of progression to severe disease, and which are unlikely to be blunted by Omicron. A number of Australian states, territories, and cities have implemented lockdowns in response to the pandemic. Countries might then experience a smaller version of the recent Omicron wave, which might be managed similar to the way societies manage flu on an ongoing basis. We will Thats a problem for bricks-and-mortar stores. If vaccines are efficacious, safe, and distributed to all ages, vaccine coverage rates of about 45 to 65 percentin combination with projected levels of natural immunitycould achieve herd immunity (Exhibit 2). Under the broad "long COVID" umbrella, clusters of symptoms have emerged. Heres what you need to know, Fixing shortage of aged-care workers through migration has risks, Not so fast: Tony Abbott calls for the Voice referendum to be cancelled, Australians have been scared off loans and thats exactly what the RBA wants, Why was Bruce Lehrmann given the all-clear to sue? During the anticipated period, the Australia infection control market in is anticipated to expand significantly. There was an error submitting the form. NSW and Victoria on track to scrap Covid isolation rules for household contacts within days. For example, the Delta variant, which remains dominant in most of the world, was significantly more transmissible than previously circulating variants were, showed limited incremental evasion of immunity, and caused moderately more severe disease relative to other variants.56Delta variant: What we know about the science, US Centers for Disease Control and Prevention, August 26, 2021. It first caused major waves of disease in India and the United Kingdom and more recently triggered serious outbreaks in many other countries. The market size was estimated to be worth USD XX The safety records of the Pfizer and Moderna vaccines appear promising so far (no serious side effects reported), but the coming months will provide a fuller picture as the sample size grows. "Obviously we recognised that some people are probably taking a [rapid antigen] test themselves and making their own decision you should behave as if you've had a confirmed PCR if you're choosing not to [have one] but our recommendation is that you should," she said. Estimates of increased vaccine coverage needed are based on R0 = 3.36-4.32, which is 4080% greater than R0 of 2.4. An alarming spike in COVID-19 and flu cases in Australia could put the U.S. on track for what health experts call a twindemic a dangerous viral one-two punch in Alpha, Delta, and Omicron have met this standard, and have changed the trajectory of the pandemic. Most of them gained it from contracting other coronaviruses, which primed their immune systems to react to COVID-19.5Nina Le Bert et al., SARS-CoV-2-specific T cell immunity in cases of COVID-19 and SARS, and uninfected controls, Nature, August 20, 2020, Volume 584, pp. (Exhibit 1). In the context of Omicrons arrival and impending spread, three factors come to the forefront: the potential impact of new therapeutics in reducing hospitalizations and death, the criticality of boosters in the context of waning immunity, and clarity and consensus in public-health measures. And some data inconsistencies have emergedfor example, it is unclear why molnupiravirs efficacy in an interim analysis dropped in the final readout.69Merck and Ridgeback Biotherapeutics provide update, November 26, 2021. While the winter of 2020/2021 in the Northern Hemisphere will be challenging, we are likely to see mortality rates fall in Q2 (or possibly late Q1) of 2021. Every exposure, every sniffle. The transition to the next normal will mark an important social and economic milestone, and herd immunity will be a more definitive end to the pandemic. Strong public-health measures will remain critical to saving lives during this period. The United States, Canada, and much of the European Union are now in the throes of a Delta-driven wave of cases.95 COVID data tracker weekly review, accessed August 15, 2021; COVID-19 daily epidemiology update, August 18, 2021; SARS-COV-2 Delta variant now dominant in much of the European Region and efforts must be reinforced to prevent transmission, warn WHO/Europe and ECDC, European Centre for Disease Control and Prevention, July 23, 2021, ecdc.europa.eu; Ceylan Yeginsu, The new reality of a European trip: Things are going to change, New York Times, July 30, 2021, nytimes.com. There are two issues. Some of those measures (such as full lockdowns and restrictions on certain industries) have significant social and economic consequences, and others (such as testing and tracing), while expensive, dont. While we dont yet know the full extent of waning immunity for Omicron, new evidence indicates that those who have received three doses of vaccine may benefit from medium-term protection.32Frauke Muecksch, Zijun Wang, Alice Cho, et al., Increased potency and breadth of SARS-CoV-2 neutralizing antibodies after a third mRNA dose, BioRxiv, February 15, 2022, biorxiv.org. ;full approval of a vaccine in March or April; and then widespread rollout. Paul Griffin an infectious diseases physician and associate professor at the University of Queensland said communicating risk so that Australians could make informed choices remained a challenge. One is that people cant be bothered [getting tested]. "If you don't fulfil this definition of a close contact then there is no need for you to be in that line," Mr Morrison said. Sarah Zhang, Watch the U.K. to understand Delta,. Australias Covid death toll in 2022 more than double that of previous two years Federal health data shows 4,547 people have died of Covid-19 this year to date, Second, the link between cases and behavioral adjustments is largely broken. What's new this quarter For an example of a low-end estimate, see Max Fisher, R0, the messy metric that may soon shape our lives, explained,, Frank Ball, Tom Britton, and Pieter Trapman, A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2,. Our analysis accounts for waning immunity and suggests that even if Omicron were to have no impact, the next six months of Delta-driven disease in the United States could be about as severe as the past six months were. Generations mixing together after months of distancing. Even countries, such as the United States, with high McKinsey COVID-19 Immunity Index scores continue to experience many new COVID-19 cases as a result of the extremely high transmissibility of current SARS-CoV-2 variants. At the same time, booster uptake has been significantly lower than first- and second-dose coverage in many countries. The drugs are more likely to be effective if taken within five days of symptom onset,68Merck and Ridgeback Biotherapeutics provide update, November 26, 2021; Pfizers novel COVID-19 oral antiviral treatment candidate, November 5, 2021. requiring an efficient pathway from diagnosis to prescription and distribution. As ever, different parts of the world will experience the coming phase differently. The most likely scenario we discussed in the December 2021 edition of this article has proved to be largely accurateOmicron is more infectious than any previous variant and evades the immunity provided by both prior infection and incomplete vaccination18Omicron Variant: What You Need to Know, Centers for Disease Control and Prevention, February 2, 2022, cdc.gov. Case controllers. We think Q3 or Q4 of 2021 are even more likely to see herd immunity in the United States. Thats not the same as reducing transmission. WebA barrier on the state border of Queensland and New South Wales preventing interstate travel in April 2020 during the COVID-19 pandemic in Australia. Sarun Charumilind and Jessica Lamb are both partners in McKinseys Philadelphia office, Matt Craven is a partner in the Silicon Valley office, Adam Sabow is a senior partner in the Chicago office, and Matt Wilson is a senior partner in the New York office. predictions for 2022 And government policy still mattersin particular, the few remaining countries with zero-COVID-19 strategies may also experience the coming months differently as they choose whether to continue or relax their border policies. He said improving antivirals which are most effective at reducing severe illness when taken shortly after an infection beginswould also help. This comparison should be qualified, insofar as the burden of COVID-19 is dynamic, currently increasing, and uneven geographically. Our analysis suggests that countries fall into three general groups (within which national conditions can vary to some extent): 1. One of the key changes in 2022 was a shift from government-imposed restrictions to personal responsibility. Of course, the low rate of severe COVID-19 in this age group means that the impact on pediatric mortality will be small. In the United States and most other developed economies, the epidemiological end point is most likely to be achieved in the third or fourth quarter of 2021, with the potential to transition to normalcy sooner, possibly in the first or second quarter of 2021. In less than three months, Omicron has spread around the world, caused record peaks in cases in many places,16WHO Coronavirus (COVID-19) Dashboard, World Health Organization, February 2022, covid19.who.int. Super discrimination worsens for women as the gender gap widens in key age groups, King Charles coronation is almost upon us. While data indicate that the most likely scenario is to reach this state on the timelines described above, five risks could delay progress. The principal challenge we have in Australia at the moment, as is seen in the United States and the United Kingdom, in France, in Germany, in Italy, right across The ongoing Delta-driven wave of cases in Europe has led a number of countries to accelerate their booster-dose rollout, with some discussing the timing of potential additional doses.75Alisa Odenheimer, Israel is preparing for possible fourth Covid vaccine dose, Bloomberg, September 12, 2021. Other governments, however, are maintaining or strengthening public-health policies, including vaccine mandates.29Anna Engberg, COVID-19: Vaccine mandate enforced in Austria, Healthcare IT News, February 1, 2022, healthcareitnews.com. Whats more difficult to estimate is when a new variant of SARS-CoV-2 will emerge. Both Pfizers and Modernas would be two-dose vaccines, necessitating rigorous follow-up for series completion. Emerging data on these antibodies suggest that they can reduce the need for hospitalization of high-risk patients, and hold potential for post-exposure prophylaxis.154Laura DeFranceso, COVID-19 antibodies on trial, Nature, October 2020, nature.com; Coronavirus (COVID-19) update, FDA, November 2020. In the United States, while the transition to normal might be accomplished sooner, the epidemiological end point looks most likely to be reached in the second half of 2021. variant continues to spread around the world as coronavirus pandemic enters 2021, Washington Post, January 2, 2021, washingtonpost.com. A communitys level of immunity is a precarious balance, constantly shifting as individuals gain and lose immunity. As immunity wanes, however, the next stage remains highly uncertain. "We perhaps overdid it early on, so the risk perception was too high. Each of these observed trends may change as sample sizes increase, confounding factors are considered, and the clinical course of disease plays out over time. Weve always knownofficial COVID case data didn't capture the full scope of transmission, but 2022 was the year that Australia lost grip of just how big an underestimate it is. The highest proportion of adults with the coronavirus antibodies was in Queensland (26 per cent), followed by Victoria (23 per cent), New South Wales (21 per cent) and Western Australia (0.5 per cent).