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Some governments, mainly in East Asia and the Pacific 7, are continuing with a suppression strategy to eliminate SARS-CoV-2 infections, but this is challenged by the transmissibility of Omicron.
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Contact tracing continues in 136 countries, 77 of which perform comprehensive tracing of all cases 6. As of 12 February 2022, the use of face coverings in all public spaces was required in 152 countries, whereas mass asymptomatic testing was operational in 114 countries. Most governments have retained non-pharmaceutical interventions to mitigate infections. However, it should be noted that many groups in the world will remain vulnerable to severe infection, such as the elderly, the immunocompromised, and patients with medical conditions that include chronic kidney disease, chronic lung disease and cardiovascular disease 5.
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It is possible that many other countries will adopt similar relaxation approaches as they emerge from Omicron waves. The rationale for this is the substantial cost burden of maintaining COVID-19 policies, such as testing, and the adverse effect that these interventions have on other essential public services, such as education and mental health support 4.
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The UK government will see all public health and social measures abolished in England by Spring 2022, including the need to isolate and the availability of free testing 4. Delta previously had a devastating effect on the United Kingdom, and so hospitalizations and deaths 3 were much lower for the Omicron BA.1 variant wave than for the Delta wave. In the United Kingdom, the proportion of adults who tested positive for antibodies across all nations is estimated to be around 98% (ref. For example, the overall seroprevalence was 73% in Gauteng, South Africa, before the Omicron wave 1.
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This should also enable the effective reproduction number to stabilize below 1, with the potential to increase again if SARS-CoV-2 becomes a seasonal virus. In these populations, the relative epidemiological risk of COVID-19 to vulnerable groups to severe infection is likely to reduce, due to high levels of vaccine-induced and/or naturally acquired population immunity. Where the transmission of Omicron rose sharply, but then decreased, governments relaxed mandates and limited population-wide intervention of some public health and social measures. There are broadly three types of approach: removing all restrictions (exemplified by the United Kingdom) continuing to implement mitigation measures to protect the vulnerable (for example, South Korea) and pursuing a suppression, or ‘zero COVID-19’, approach (for example, Hong Kong and mainland China). Many governments recalibrated their COVID-19 strategies in response to the global surge of infections with the SARS-CoV-2 Omicron variant, but considerable international variations in public health approaches remain.