How much of a threat does the emergence of Omicron pose to the NHS? Among hospital bosses there is a curious combination of apprehension that the new variant could lead to a surge in infections but also a battle-weary belief, born of negotiating the previous waves of Covid-19, that they can handle a potentially major rise in people seriously ill with the disease.
“Trusts are already making contingency plans for what would happen if there were to be a significant spread of this variant and it turned out that the symptoms and disease produced as a result is as serious as with the Delta variant,” said Chris Hopson, the chief executive of NHS Providers, which represents health service trusts in England.
He added: “If it turns out that this variant does evade vaccines then clearly the NHS will see a significantly higher caseload than it has at the moment.” Hopson pointed out that when the second wave was at its worst in January, hospitals in England were treating 34,000 people with Covid. On Monday, it was far, far fewer – just 6,094.
He said: “The chief executive of a district general hospital told me today that they were going through plans for how they would expand critical care capacity, and their general respiratory support capacity, because that’s exactly what they needed to do last January when we had over 34,000 cases.
“The chief executive said that an advantage of having had that sudden massive increase last January was that we know what’s needed now if numbers go up significantly again.”
A return to that number of hospital beds taken up with Covid patients would again force hospitals to cancel planned operations, he said. “If we get anywhere near the 34,000 cases we saw in January, then something would have to give. Elective surgery could be cancelled. As we saw last January, we would need to prioritise [care] on the basis of clinical need.”
For now, though, Hopson is confident that hospitals can cope if Omicron does wreak havoc. “[In January] the NHS showed just how resilient and effective it is at times of extreme pressure. This is what the NHS is really good at: dealing with short-term crises and problems that get thrown at us.”
But others are more concerned. One intensive care consultant said: “The system is very fragile just now so Omicron could have absolutely no impact – or tip things over the edge and lead to complete collapse. Nobody really knows.
“People have the same air of uncertainty and apprehension now as they did in March 2020. What I do know is that nobody is up for another run around the track.”
A spokesperson for the Faculty of Intensive Care Medicine, which represents doctors in that speciality across the UK, echoed that nervousness.
They said: “The faculty is very concerned to hear reports of the new Omicron variant.
“The NHS is already facing one of the worst winters in its history. We urge members of the public to follow all social distancing measures and safety protocols to reduce transmission and alleviate pressure on critical care services.”
Dr Sue Crossland, the immediate past president of the Society for Acute Medicine, said that the uncertainty around Omicron’s transmissibility, symptoms and also whether existing vaccines will limit its impact meant it was too early to know how much it might add to the many pressures the NHS was already under.
She said: “If it is more transmissible, even if it is milder in general, we will see more hospitalisations – the unknown is how many? Given the capacity issues at present, even a small increase could cause problems. But we just don’t know. As ever, I remain worried.”
The new variant could affect the NHS in another way, by increasing the already high number of staff off sick, warned NHS Employers, which is part of the NHS Confederation.
“Health leaders will have some concerns about the impact that new self-isolation requirements could have on their staffing levels,” said Danny Mortimer, the organisation’s chief executive.