‘People are moving on with their lives’: is the end of Omicron in sight?
England joined Denmark with plans to lift its remaining coronavirus restrictions, Joe Biden’s top medical adviser said the “full-blown” phase of the crisis was nearly over and Europe’s biggest holiday group revealed that bookings were returning to levels last seen before the pandemic.
The flurry of announcements from around Europe and North America this week crystallised hopes that the worst of the Omicron variant wave has passed, allowing health experts to speculate whether a return to normal life was within grasp.
“There are no real criteria for the end of a pandemic — but it probably feels something like this,” said David Heymann, professor of infectious disease epidemiology at London School of Hygiene and Tropical Medicine.
“People are moving on with their lives,” agreed Ali Mokdad, a University of Washington global health professor. “The question is not will countries lift all restrictions, but when.”
Social distancing, self-isolation, mask-wearing, testing and contact tracing have comprised the backbone of the measures recommended by the World Health Organization since the early days of the pandemic.
But two years on, with Omicron receding, moves are afoot to scrap even basic measures, as a range of governments bank on high levels of population immunity and broad vaccine coverage to limit the pressure on hospitals.
Under the UK government plans for England, all virus legislation would end by late February, including removing the legal requirement to self-isolate following a positive Covid-19 test.
Sweden and Norway have scrapped most restrictions while Italy and Spain have moved to ditch outdoor mask mandates. Switzerland said it could stop using vaccine passports as early as next week having dropped contact tracing and homeworking rules.
In the US, Anthony Fauci, the White House’s leading Covid-19 expert, this week told the Financial Times that the country was exiting “the full-blown pandemic phase” of Covid-19, as major US states, including New York and California, rolled back laws requiring mask-wearing in indoor public places.
In another sign of returning confidence, Europe’s largest travel operator, Tui, said the loosening of travel testing requirements had pushed summer bookings back towards pre-pandemic levels. By January 30, 3.5mn customers had booked flights for summer — about three-quarters of 2019 levels.
For Heymann, the rule changes provide further evidence that countries are shifting from a “top-down, legislative approach” to an “endemic control programme”, similar to that used to combat seasonal influenza.
Mokdad said it was “really down to how bold governments want to be”, adding: “We’re at the stage of the pandemic where people are increasingly weighing their own personal risk, rather than being told what to do.”
Case numbers are falling across western Europe and North America, down 73 per cent from the Omicron peak in the US, and down 60 per cent in England, Spain and Belgium. Even in countries where the surge was especially strong or long-lasting, the tide has turned, with rates dropping in Denmark, Norway, Sweden and the Netherlands.
Crucially, though cases climbed above previous records this winter, markers of severe disease did not follow suit. In Denmark and Norway, where case rates soared to 12 and 20 times their respective pre-Omicron peaks, the number of Covid patients in intensive care units stands at just 23 per cent of last winter’s peak.
It was Denmark that made the early move towards lifting all restrictions, when at the start of the month it said it would stop treating Covid-19 as a “societally critical” disease.
This meant revoking emergency public health legislation and removing all restrictions apart from a testing requirement for foreign visitors. The decision was taken despite record infection rates in Denmark, driven by the more infectious sister strain of Omicron, BA.2.
Camilla Holten Moller, head of the expert group for mathematical modelling at Denmark’s public health body, said: “We don’t see the same extent of severe disease [as previous waves] and we don’t see our intensive care units full of Omicron patients.”
She continued: “Whenever the threat of the epidemic is really low, the government realises it’s important to let go and try to bring some normality back by easing up this legislation.” But she admitted it would “be a while” before Denmark was “back to full speed”.
Denmark’s relaxation comes against a backdrop of low levels of public anxiety about Covid, according to survey data from YouGov. Danes have consistently been the least likely people in Europe to say they always wear a mask in public spaces, and among the least likely to say they are avoiding large or crowded indoor gatherings.
The data also show the English are increasingly opting to live with Covid: rates of mask-wearing have dropped in recent weeks to tie with the Danes as equal-lowest, and the English are now more comfortable than any other nationality to socialise in large groups.
Not everyone is convinced that an end to restrictions is the answer, with countries including China continuing to pursue a zero-Covid policy.
Kevin Schulman, professor of medicine at Stanford University, said the removal of restrictions should come with a disclaimer that the “world is not out of the woods yet”.
“The idea that we’re done with [the virus] is not the right message,” he said. “We’ve sacrificed a lot . . . and now we need to work to preserve those gains. That’s how we should be thinking about it.”
And despite this week’s changes, experts agree that because of the lingering threat of new variants, governments can never be conclusive that new measures will not be required again.
“The question of whether we have to reimpose restrictions will be asked,” said Mark Woolhouse, professor of infectious disease epidemiology at Edinburgh university. “Because I’m as certain as I can be that there will be other variants.”
Tim Spector, professor of genetic epidemiology at King’s College London, added: “It could be the last time we have legal limits in place but it doesn’t mean the end of the pandemic.
“The virus has been one step ahead of us every time . . . we can’t just ignore it. That would be folly.”