Health officials in New South Wales warned vaccines “may be less effective” against the Omicron variant and could lead to an increase in hospitalisations, just days before premier Dominic Perrottet announced Covid-19 restrictions would be scrapped.
On 10 December, NSW Health’s Covid-19 critical intelligence unit published a briefing note on what was then the emerging Omicron variant, which had been discovered in South Africa in late November.
Based on emerging data at the time, the unit warned of early evidence suggesting that vaccines could be less effective against the strain, and of “enhanced transmissibility” which suggested Omicron had a “substantial growth advantage over Delta”.
It also flagged preliminary evidence suggesting “an increased risk of reinfection” from the variant, and pointed to increased hospitalisation rates in the Gauteng province of South Africa.
The note was published as Covid-19 case numbers began to surge following the arrival of the first case of the Omicron variant in late November.
When the critical intelligence unit published the note on 10 December, NSW recorded more than 500 daily cases for the first time in two months. A week later the figure had more than tripled.
Despite that, the NSW government pushed ahead with its decision to ease restrictions introduced during the long Delta-wave of infections. On 15 December the government announced masks would no longer be mandatory at most locations indoors, scrapped the use of QR code check-ins for low-risk venues and dropped density limits.
The NSW opposition leader, Chris Minns, said the fact the document had been published just days before restrictions were loosened was an “extraordinary revelation”.
“This is clear evidence that the department of health was briefing the NSW government about the emerging risks of Omicron at least five days before the premier dropped the mask mandate, density limits, proof of vaccination and QR check-ins,” he said.
“It was early days of Omicron but clearly the experts warned that caution was needed. Instead Mr Perrottet decided to ignore the emerging threat and all related advice.
“Ignoring this health advice has had major real-world consequences, for the health system, our frontline workers, and to businesses and families.”
In a statement, a spokesperson for Perrottet did not respond directly to questions about whether the briefing note was included in NSW Health advice given to the premier prior to easing restrictions on 15 December.
“The NSW government’s top priority is and always has been the health and safety of our people,” a spokesman for Perrottet said.
“The government carefully considers the health advice and also weighs up a range of other important factors before making its decisions including operational demands on the health system.
“Throughout the Omicron wave, and over the past two years, our government has tailored the settings as the situation evolved to keep the community safe and ensure those who need care can access it.”
The premier has repeatedly defended the decision to push ahead with the re-opening in the face of Omicron’s arrival as necessary for the state to begin living with Covid-19. He has continually pointed to hospitalisations and ICU presentations remaining well within the capacity limits outlined by NSW Health, and pointed to the fact that NSW has adopted restrictions similar to neighbouring Victoria and Queensland.
“We’re not going our own way in NSW, we are following the national plan with every other state along the eastern seaboard,” he said last week.
But Minns pointed to the fact Perrottet subsequently re-introduced the restrictions on 23 December as the number of health workers furloughed either by illness or isolation requirements rose into the thousands as evidence it was a “mistake”.
“It was a case of closing the gate after the horse had bolted,” he said.
“And it was one thing to completely ignore the health advice, it was another to fail to plan for the inevitable consequences.”
While the Guardian has previously reported the decision to scrap QR check-ins at low risk venues was recommended by NSW Health, Perrottet has previously refused to say whether the state’s chief health officer, Dr Kerry Chant, supported removing the mask mandate.
When the decision was made on 15 December Chant said only that it was a “matter for government” and that she was “strongly recommending we keep masks”.
But the briefing document, which was published online but went unreported before being overwritten by an updated brief in January, suggests NSW Health was aware the Omicron variant was likely to present a significant challenge to the state’s hospital system.
The 10 December briefing note was provided as an overview of emerging information on the new variant and collated data from the experiences of a number of countries as well as advice from the World Health Organization.
The note advised that while studies were still under way to understand how effective vaccines would be at suppressing Omicron, it said there were “early indications that fully vaccinated people are protected against the Omicron variant”.
“However, the protection may be less effective,” the note warned.
“There are early reports of breakthrough infections in South Africa among people who have received any of the three kinds of vaccines in use in that country (Johnson & Johnson, Comirnaty and Vaxzervia).
“Preliminary data presented at a briefing hosted by South Africa’s Department of Health suggests some mutations may be associated with increased antibody resistance [and] Moderna’s CEO says current Covid-19 vaccines are likely to be less effective against Omicron.”
While significant data has now emerged linking Omicron with milder symptoms than other previous strains of the virus, on 10 December the briefing warned that it wasn’t yet clear “whether Omicron causes more severe disease” and warned that it had led to increasing hospitalisation rates overseas.
“Early reports suggest increasing rates of hospitalisation in South Africa; however, this may be due to overall increasing rates of infection, and not a signal of more severe disease,” it stated.
It also noted the European Centre for Disease Prevention and Control had rated the risk of the emergence and spread of Omicron as “high to very high” and warned the mutations observed in Omicron were “associated with enhanced transmissibility”.
While briefings are not an endorsed position of NSW Health, the critical intelligence unit was established to provide “rapid, evidence-based insights” on emerging Covid-19 trends. It sits within the Agency of Clinical Information, and provides high level summaries of studies and evidence, which it regularly updates and publishes.
In an updated note on 27 January the critical intelligence unit pointed to data from a number of countries suggesting people infected with the Omicron variant are less likely to require hospitalisation compared with Delta, and that the overall stay for those who did require hospital treatment was shorter.
