The second reason is very disappointing:Omicron infectiondoes not boost your immunity as had been hoped.Reinfections are increasingly common,not necessarily milder than the initial infection and appear to be associated with cumulative damage. The more infections you get the worse it appears to be.
Which leads us to another major concern – the neglected issue of long-COVID. Recent data show thatlong-COVID still occurs with Omicron. Although less than the rate with earlier variants,the gargantuan Omicron case burden means long-COVID will have a large,ongoing effect on health,wellbeing and business.
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Like all aspects of the disease,long-COVID is worse in disadvantaged communities:the very people we are meant to look after the most. Importantly,the mechanisms oflong-COVID-driven organ damage (it’s much more than fatigue) are becoming better understood with the worrying potential of persistent virus,or components of the virus in the body.
This new understanding of what is driving frequent reinfections and new waves,and the increasing concern and understanding of long-COVID,argues that any strategy presuming widespread infection might form part of a COVID exit pathway needs to be jettisoned in favour of one that reduces transmission.
Stopping infection completely would be great,of course. But delaying infection and reducing the frequency of getting infected are also very powerful for individuals and the community. Apart from reducing clinical damage and slowing viral evolution,delay buys time for even better tools and strategies to be developed and delivered.
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What should be done now? The most important thing we can do is for our leaders to clearly signal a strategic about-face to be fiercely anti-transmission,and to do this without disruptive restrictions. Underneath that strategic pivot,we suggest a few priorities:
First,we need far greater efforts to increase the languishing coverage of third and fourth doses in adults,to vaccinate children aged five to 11,which remains at a meagre 40 per cent,and hopefully soon to vaccinate younger children. Encouragingly,the new health minister took the first step towards this yesterday by announcing an $11 million campaign to encourage vaccination uptake.
Second,we need to reduce airborne transmission by promoting,providing,and reintroducing high-quality (N95/P2) masks in high-risk indoor settings and investing seriously in improving indoor air quality. The latter needs no social licence,it should be done immediately.
Third,we need a national database that provides more timely information on various aspects of the pandemic,such as more details on those who are hospitalised and dying,who can access life-saving antiviral drugs like Paxlovid. It should also track how common long-COVID is.
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Our Omicron experience,and the underlying science,both scream that the current high transmission situation is unsustainable. Many Australians are on track for two,three or even more bouts of COVID-19 this calendar year. We can do much better.
We can shift to a low transmission,vaccines-plus strategy,where we apply proven measures that cause minimal disruption to our lives and,through vastly less COVID-19,promote a healthier,less disrupted,and economically stronger community.