INTERNATIONAL AIRLINE MEDICAL ASSOCIATION

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The IATA Medical Evidence Document was updated again (10th edition) over the holiday period, incorporating information on Omicron: https://www.iata.org/globalassets/iata/programs/covid/restart/covid-public-health-meausures-evidence-doc.pdf and another update of the document should follow soon, followed by a move to a different format. 

The WHO Emergency Committee met and confirmed that COVID-19 still constitutes a Public Health Emergency of International Concern (PHEIC) as defined in the International Health Regulations. The committee provided advice in its statement here: https://www.who.int/news/item/19-01-2022-statement-on-the-tenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic

There were 15 million reported COVID cases in the second week of 2022, up from 7 million in the first week of 2022 which saw over 1% of the population catching Covid-19 each week in 26 countries.  These numbers are of course underestimates of the real case numbers. However, numbers of new deaths reported globally remained stable. Omicron is now in more than 160 countries, rapidly outperforming and replacing Delta; Omicron is now the predominant variant in at least 60 countries.

Many media reports point to locations where health systems are being stretched by very high numbers of Omicron cases, in some cases partly because of health staff being either infected or isolated as contacts. However, there are a number of countries where despite case numbers surging, hospitalisation rates are lower during the Omicron wave.

It has been a quiet period for new scientific information despite much happening with Omicron - which has now been detected in over 130 countries and is the dominant variant in several (including South Africa, Denmark, UK, Japan, India, Australia, France, USA).  It is reported that case numbers have declined in South Africa sufficiently for them to consider the Omicron wave over, and there are possible signs of a plateau beginning in UK.  Despite very high case numbers in the worst affected countries, the pattern with hospitalisations is less consistent.  In the USA there have been calls for consideration of hospitalisation numbers as the prime statistic rather than case numbers (which reached 1 million in one day).  Those regions with very high case numbers also are experiencing enormous levels of work absence due to isolation of close contacts, which strains health systems as well as the airline industry.  In some locations, systems and equipment for COVID testing are struggling to meet demand. 

We continue to await more confirmation of the degree of reduced severity of illness (reduced risk of hospitalisation/death) with Omicron.  Any such reduction must be measured against the extremely rapid growth from increased transmissibility of the variant.  But at least in some populations there is evidence of the reduced hospitalisations compared with case numbers.  Some background is available on the UK Health Security Agency site here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1043807/technical-briefing-33.pdf

Transmissibility

The increased transmissibility is not in question. Omicron has been detected in over half of countries, and is in circulation in over 50 of them; it has become dominant in South Africa, US, UK, Denmark and Portugal. It can double in 48 hours, and it can be expected that widespread circulation will become established in most locations. A few States with such circulation have now relaxed border restrictions, recognising that these will confer no benefit in limiting spread.

Omicron

Numbers of confirmed Omicron cases continue to rise dramatically but it is clear that because of low sequencing rates in many countries, actual numbers will greatly exceed those reported.  We still await clarity on the apparently (but not yet established) milder spectrum of disease with Omicron, and whether that will be outweighed, in terms of health system impacts, by the greater transmissibility.  At this early stage UK reports only 16 hospitalisations and one death from Omicron (with some thousands of cases). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1041210/20211215_OS_Daily_Omicron_Overview.pdf

Here’s an updated technical communication from WHO on Omicron summarising the current state of knowledge:
https://www.who.int/publications/m/item/enhancing-readiness-for-omicron-(b.1.1.529)-technical-brief-and-priority-actions-for-member-states

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