Now that 2G isn’t going to work, the call to ‘let go’ the virus is getting louder

The QR code for vaccinated and recently cured people (2G) is not enough to stop the omikron variant, new research shows. What options are there for the near future with corona? “The time to pull the band-aid off in one go is approaching.”

Option 1: let it blow

With barely three hundred corona patients in IC and less than a thousand in the regular hospital ward, the call to let go of all corona measures is getting louder. At some point it will be time to resume normal life and brave the wave of disease from the much less harmful omikron variant. let it rip, as the approach has come to be called internationally, after some Australian states decided to stop their strict fight against corona.

‘Ultimately, the only way out is if we have built up enough protection against serious illness, so that the hospitals can no longer become overloaded’, says professor of epidemiology and OMT member Marc Bonten (UMC Utrecht). ‘And the group of people who have not yet seen the virus at all, through vaccination or infection, is getting smaller. This brings the moment to remove the plaster in one go closer.’

For ICs, overload may already be ‘no longer an issue’, thinks Bonten. According to calculations made public by the RIVM last weekend, the ICs could in theory still expect more than 2,500 corona patients at the end of next month. But nobody actually believes that such a thing is realistic: RIVM assumed, in the absence of more precise figures, that omikron puts just as many people in IC as previous variants.

‘I think that the data is more likely to go to: it is more than half the number’, says Bonten. ‘And the length of stay in the IC is shorter, which gives even more relief.’ In that case, if everything goes wrong, not 2,500, but around a thousand IC patients would be at risk. A number that the ICs can handle.

But those are the ICs. A care sunami is still not out of the question for ordinary hospital wards. Risky, because that too can lead to delayed operations and major problems. ‘I certainly wouldn’t dare to throw everything completely loose at the moment’, says epidemiologist Matthijs Berends (UMC Groningen and Certe). ‘Not because I necessarily expect major problems, but because I have no idea what to expect.’

The first real wave of omikron patients will appear in hospitals in the coming weeks. ‘Then you really have a good idea of ​​what awaits us.’ So let’s wait and see, epidemiologist Alma Tostmann (Radboud UMC) also thinks in Nijmegen. ‘From ‘2G not working’ to let it rip is a very big step,’ she thinks. ‘First I want to see the updated models of the RIVM, with the new assumptions for, among other things, the length of stay in the hospital incorporated.’

Option 2: more testing

In the meantime, omikron has infected so many vaccinated and previously infected people that shielding workplaces and public places with QR codes will be of little use, according to research in Delft and Utrecht. ‘Very bad news’, says Bonten. “This means we’re not going to get any help from 2G or 3G.”

One possibility would help, according to the same study: constantly asking everyone for a negative test certificate. Such a system has been set up in parts of Germany, among others, where rapid test barracks have arisen everywhere: without a recent negative test, no access to catering or museum.

So a test society, in which we test daily until our noses and throats look raw? ‘That seems to me to be a completely hopeless exercise’, says Bonten. After all, other recent research shows that rapid tests, in people who have no complaints yet, miss up to three quarters of all infections. In the case of omikron, this would mean that all people have to be tested every day – everywhere, always – according to the Delft figures. ‘And I don’t believe that a measure has ever been taken that one hundred percent of the people adhered to,’ says Bonten.

Option 3: slow down and wait

Throwing everything open is therefore risky and it is impossible to exorcise the virus with cotton buds. A dilemma, Berends also thinks. ‘You want intervention that is early enough to prevent escalation. But not too early, because then there will be no support for it again.’

So we muddle through, with one foot on the brake and one on the accelerator, that’s the most likely outcome. Until the threateningly bulging RIVM expectations are punctured by more precise figures from abroad and have collapsed like a soufflé, and it is clear that the coast is safe. ‘That moment is approaching’, Berends also says, ‘fortunately, a lot of care is being caught up in the meantime.’

Do not exclude the QR codes, says professor of clinical virology Louis Kroes (LUMC). Because Delft research or not: ‘If you don’t do anything, you can’t do anything. The motto of 2G is: keep the unvaccinated at a safe distance. That seems to me to be an acceptable interim solution in this situation’, says Kroes. ‘In the Netherlands we don’t have any form of distinction between vaccinated and unvaccinated. I find that somehow quite amazing.’

Or maybe it can also be done without extras, and the current course is enough: with one leg still in lockdown and in the meantime testing for complaints and staying home with corona. ‘We now also do additional braking’, says Bonten. Until care is out of the question, now and in the near future. ‘We don’t take all these extra measures for a rhinovirus, a cold virus, either.’