Intended for healthcare professionals

Views And Reviews Primary Colour

Helen Salisbury: Omicron—panic mongering or appropriate caution?

BMJ 2021; 375 doi: (Published 29 November 2021) Cite this as: BMJ 2021;375:n2941
  1. Helen Salisbury, GP
  1. Oxford
  1. helen.salisbury{at}
    Follow Helen on Twitter: @HelenRSalisbury

Most doctors are cautious people. Even if it’s not our natural temperament, we learn it through our training. We may still go rock climbing or paragliding in our free time, but we must be wary of risk in our professional role, where other people’s lives are at stake.

Although a breast lump in a young woman is unlikely to be cancer, we refer for investigation because we can’t be sure, and the consequences of ignoring it could be very serious. We constantly have to readjust our perceptions of risk for our patients as more evidence accumulates about the benefits, safety, or side effect profile of a medicine or about the long term effects of an illness. We stay alert for red flags—signs that something serious could be going on—and we don’t relax until we’re reassured that the nasty thing isn’t there.

We spend a lot of our time trying to find a sweet spot between unnecessary anxiety and appropriate action. Explaining that the likelihood of cancer is low, but not zero, can be a delicate art: patients need to understand the importance of an investigation so that they prioritise attendance, but we don’t want them to panic too much while they wait.

Currently, we find ourselves in that place of uncertainty with the omicron variant of SARS-CoV-2. We don’t know whether it will be more transmissible than delta or whether it will result in more severe disease. And we don’t yet know how well the current vaccines will protect us from it.

This means that now is the time for the utmost caution. If it turns out to have been an over-reaction in a few weeks’ time, additional preventive measures—working from home, mask wearing, monitoring air quality, and restricting high risk, indoor gatherings—will have helped reduce the burden of the delta variant we already have. We should also upgrade the masks we use from simple surgical ones to better fitting, FFP2 versions.

As it stands, the group with the highest incidence of covid-19 is primary school children, and they’re unprotected by vaccines or the physical measures that could slow its spread. Currently, contact tracing isn’t happening through schools. If we continue the policy of insisting that children still attend school even when they’re household contacts of proven cases, we’ll inevitably fail to control the spread of this new variant.

We all wish that this pandemic was over. We want to have Christmas parties and carol concerts, to eat and drink and laugh together without fear. But no one wants to relive the nightmare of last January in our hospitals. This means limiting our socialising again until we know more about the risks we face.