The alarming information from South Africa about a substantially more contagious variant of COVID is bumping up against very human disaster fatigue. There is a bunch of wishing that the new variant is less dangerous, and it is possible it will be found to be - but the most likely is that the virulence is unchanged, or not dramatically changed. There is also a lot of wishing the vaccines remain effective. Again, itâ€™s unknown, but the substantial number of mutations make it seem very possible immunity will be weakened. Some estimates of R(t) in SA are 1.2 for Delta and >3 for Omicron. This implies that the public health controls in place produce a result similar to when COVID was first circulating, with zero controls - and the concern was for overwhelmed healthcare. If the new variant is equivalently virulent, but much more contageous, the risk of over whelming health resources is real, even in highly vaccinated populations, as even a small percentage of the population ill at the same time could easily be a disaster. Note this remains true even if the disease in the variant is less severe. A halved virulance but quadrupled infection rate is still doubled hospitalisation, and more as the case numbers grow exponentially. There are some clues that natural immunity from a prior infection is less effective against this variant. This would be very bad in areas which have already suffered from earlier waves. There are some hopes the hospitalisation rate is lower. Unfortunately, there is also an indication that many of the early cases in hospital were there for other reasons. If you go to hospital with a broken leg and flu symptoms it seems quite predictable that you will leave earlier than somebody hospitalised because the flu symptons have progressed to serious respiratory illness. I think in the weeks to come as the stats about Omicron become dominated by those hospitalised as a result of the disease, we'll be better able to judge the seriousness of the illness. In Australia, where we have, until a month ago, quarantined international arrivals, we have an opportunity to halt Omicron until the data on the variant is confirmed. Unfortunately, politicians are primed to hear the best news for themselves, so we are still accepting international travellers with a few days self isolation at home. We should note the NSW health minister admitted the self isolation was being frequently ignored. I hope the new variant isn't terrbily contagious, but all evidence to date is that it is. I hope the new variant doesn't evade immunity or vaccine immunity. There is very little evidence to date, though some clues reinfections are increased. I hope the new variant is incredibly mild, and it 'chases out' previous dominant strains. There is no reliable evidence at all that this is the case, just hopes in my opinion. I hope that a tailored booster vaccine could be developed swiftly. I have seen comments saying a couple of months is possible. I don't know if this is realistic, but with limited other options, we may depend on it. I hope that the combination of extreme contagion, immunity escape and similar virulence don't lead to much death, a return to lock downs and the disruptions the world experienced last time a deadly disease infected many people - just last year. But it looks like a real risk. Our leaders should have reacted in a precautionary way, instead of waiting for the data to be in on whether the new variant is stronger/weaker or more/less contagious. But they failed to do so, so we are at the mercy of luck. I'd say it will be clear in the days between Xmas and New Year whether we were lucky or not, so take care around vulnerable people and cross your fingers the politicians are right. And try not to make any plans for 2022 that a pandemic might ruin!