In Ireland and across Europe, as the last of Covid restrictions such as mask-wearing are easing, case numbers are rising sharply, with a subsequent rise in hospital admissions.
Health experts are pointing to the one crucial difference between this wave of infections and previous waves - lower death rates in countries with good vaccine uptake. Vaccines are not slowing transmission but they are successfully preventing severe illness and death for most people.
The contrast, for example with Hong Kong is stark, where 68% of over 80s were not vaccinated or only partially vaccinated by March 9, according to a Hong Kong Free Press analysis.
Since the start of February, more than 5,000 people have died there from Omicron, most of them elderly. On Friday they reported 20,079 infections in just one day. There are media reports of coffins running out and mortuaries full; grim echoes of Italy in early 2020.
The World Health Organisation (WHO) has warned since January that describing Omicron as "mild" is not giving the full picture, and now the vaccine gap is highlighting this further.
Vaccination held Omicron at bay in Ireland until recently. However as we have heard many times, the greater the number of cases the greater the chances of the virus reaching vulnerable people who become severely ill.
On Saturday, there were 52 patients in ICUs with the virus, the second time this month the figure has gone over 50, having dipped slightly at one point. On St Patrick’s Day 18% of occupied ICU beds held Covid-patients.
Hospital numbers here are also continuing to climb — hitting 1,127 on Saturday, the highest since March last year. Almost half of these people were admitted to hospitals for other illnesses and were identified as also having Covid-19 on admission.
The good news for those patients is that they are not severely ill with the virus, but it is putting additional pressure on an already stretched hospital system. Staff still need to isolate these patients and treat them as regular Covid patients. It can also mean their planned operations must be delayed until they are infection-free, meaning acute hospital beds are occupied for longer.
Around Europe, the picture is very similar.
The European Centre for Disease Prevention and Control (ECDC) on Friday warned of “a break in the sustained decreasing trend in case rates”.
Nine countries had their risk rating increased, with Ireland, Iceland and the Netherlands being put on the highest rating. Only three countries saw risks decrease and 18 were unchanged.
Six countries reported increased hospitalisations with two reporting their highest ever levels, the ECDC said. Overall the death rate has been decreasing but five countries reported an increase.
Vaccination rates vary wildly across the region with a cumulative uptake of 83.1% — masking the fact that the figure goes from 35.1% to 94.6%.
In France covid cases are also increasing with the Reuters tracker reporting 82,356 new infections on average each day now, having started rising at the end of February.
Last week, France also lifted most Covid-restrictions including mask-wearing indoors despite the Santé Publique France (French health authorities) noting a 20% week-on-week increase in cases.
Head of the doctor’s union UFML, Jérôme Marty, told France 24: “It wouldn’t have bothered me if infections were falling, but clearly it’s not the case. Moreover, we’re dropping face masks without implementing any parallel measures to ventilate closed spaces and prevent viral concentrations.”
These comments echo warnings from patient groups and some doctors in Ireland when mask-wearing was lifted here.
The Reuters tracker shows Germany reporting 215,996 new infections on average every day with the highest daily average for the whole pandemic reported on St Patrick’s Day.
Despite this, Germany also lifted restrictions with mandatory mask-wearing ending on Sunday. The German health minister told the Associated Press: “We can’t continue to put the entire country under a shield in order to protect a small group of people who are unwilling to get vaccinated.”
In the Netherlands, they are seeing 54,186 new cases on average daily, but will end most restrictions on Wednesday including lifting work-from-home advice. Masks will no longer be required on public transport except for aeroplanes.
a government spokesperson said last week.
They continue to advise in favour of improving ventilation and vaccination rates.
Meanwhile, the WHO’s regional director for Europe Dr Hans Kluge has expressed growing concern for some countries in Eastern Europe where the vaccination rates are extremely low.
Just days ago the WHO launched a €40m fund to increase vaccinations in Armenia, Azerbaijan, Belarus, Georgia, Ukraine and the Republic of Moldova. In Romania, only 41% of adults are fully vaccinated according to the ECDC vaccine tracker for example.
Some countries already struggling with Omicron infections are now also opening their doors to an unprecedented influx of refugees, adding to the uncertainties ahead.
Dr Kluge said up to St Patrick’s Day, Moldova with a population of 2.6m had taken in 350,000 refugees from the war in Ukraine. The Our World in Data tracker shows just 40% of Moldovans are vaccinated.
The head of the WHO’s office in Ukraine has said vaccination rates in Kyiv are about 65% but as low as 20% in some rural areas. Testing and vaccination have obviously been completely disrupted since the Russian invasion.
Dr Kluge also warned last week about potentially “millions with “post-Covid” Long-covid condition”.
Evidence already shows even a mild infection can lead to months of lingering symptoms, yet another reason to avoid an Omicron infection.
In Ireland, the HSE’s advice is for anyone eligible for a booster to come forward and for anyone who had Covid-19 recently to get boosted as soon as the three-month waiting period is up.
The uptake for the booster vaccines among adults appears slower than for the initial vaccines, but it is hard to accurately measure enthusiasm for the shot with hundreds of thousands stuck in this waiting period.
While the official advice remains that mask-wearing is not mandatory, the messaging from HSE and Government officials in recent days has emphasised this does not mean you cannot wear one.
Indeed on the streets, many people have already acted on this advice with more masks seen in recent days than earlier in the month. Covid-19 it seems is not done with Europe, but hopefully, we are ready for it this time.