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What GP practices need to know about the Omicron variant

New rules come into force in England this week and the booster campaign is set to expand as a result of the Omicron COVID-19 variant.

Face masks will become mandatory on public transport (Picture: SOPA Images/Getty Images)

What rules have changed?

From Tuesday 30 November face coverings will be mandatory in shops, banks, post offices and hairdressers, as well as on public transport. Under current infection prevention and control guidance they have remained mandatory in healthcare settings throughout the pandemic.

In another change, all close contacts of anyone who is identified as a having the Omicron variant will be required to self isolate for 10 days, regardless of their vaccination status.

There are also changes to travel rules that require anyone arriving into the country to take a PCR test on or before day two and self isolate until they receive a negative test result.

What does this mean for practice staff?

Any NHS staff who have been overseas will need to follow the new requirement to have a PCR test and they should not return to work until they have received a negative result. They should also take daily lateral flow tests for 10 days after they return.

How will this impact on the booster programme and practice workload?

The JCVI has recommended the COVID-19 booster campaign should expand immediately to people aged 18-39 and second doses should be offered to those aged 12-15.

The updated advice says booster vaccination should continue to be rolled out 'in order of descending age groups' and prioritising those in at-risk groups, but shortens the timescale within which booster doses can be offered – they can now be given three months after the second dose, rather than the previously recommended six months before.

Patients with severe immunosuppression who have received three doses as part of their primary course can also be offered a booster jab three months after their third dose.

At a press conference on 30 November prime minister Boris Johnson announced that everyone aged over 18 would be offered a booster jab by the end of January, with roll out to happen by age group. NHS England also announced that primary care vaccination sites will now be paid £15 per booster delivered on a weekday, with an additional £5 for those provided on a Sunday. They will also receive £30 for each booster jab delivered to housebound patients.

NHS England chief executive Amanda Pritchard also revealed that routine CQC inspection in general practice will be paused and the NHS would review the need for patients to be observed for 15 minutes after receiving an mRNA vaccine.

Before the JCVI's announcement the new chair of the BMA's GP committee for England Dr Farah Jameel wrote to NHS England about measures to free up GP practices amid concerns over the impact  the new variant could have on the NHS.

Dr Jameel said that practices would need 'substantial support' to step up in response to the Omicron variant. Her predecessor Dr Richard Vautrey called for health leaders to support practices by suspending ‘QOF micromanagement’ to allow them to focus on patient care.

The BMA has also urged the government to go further with infection control measures by implementing compulsory mask wearing in all indoor public places and closed settings – warning it must use the ‘small window of opportunity’ to limit the impact of the new variant.

What else do practice staff need to know?

The following countries are now on the red travel list: South Africa, Botswana, Lesotho, Eswatini, Zimbabwe, Namibia, Malawi, Mozambique, Zambia and Angola.

An alert from the CMO on 28 November advised: 'If these countries are identified when taking the travel history of your patients take particular note. If they have returned in the past 10 days, then order a PCR test and isolate them in a side room if possible. Contact your local health protection team if COVID-19 is suspected in a patient whose symptoms started following return from these countries within the past 10 days.'

Why are health officials worried about this new variant?

The World Health Organization has said that the Omicron variant's ‘unprecedented number of spike mutations’ presented a ‘very high risk’ to countries around the world.

The CMO update said that data from South Africa suggests the variant may be more transmissible than the Delta variant, currently the dominant strain in the UK.

The update explained that Omicron has a very high number of mutations in the spike protein and the vaccines currently in use in the UK work by targeting the immune system to respond to this spike protein.

As a result, the CMO update said it was 'plausible that Omicron may have altered transmissibility, reduction in vaccine effectiveness and/or reduction in protection from natural immunity'. It also warned that medications currently used to treat those with COVID may also not be as effective in cases of the Omicron variant.

There is still much uncertainty about how severe Omicron is and as yet there is no laboratory data or real-world data on how the vaccines or treatments will perform against this variant. However, because of the uncertainty, officials are recommending that the government takes a 'precationary approach'.

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