the variant of the virus is infecting millions worldwide. countries are imposing emergency restrictions. some are even returning to lockdowns. is it enough? this is "inside story." ♪ >> hello and welcome to the program. the global surge in covid cases

linked to the omicron variant is forcing some nations to reimpose strict lockdown measures days before the holiday season begins. the netherlands was the first european country to impose a nationwide lockdown on sunday. others are following suit to try to slow the spread of omicron. france, austria, cyprus and germany have tightened travel restrictions, some even canceling christmas celebrations. ireland is among countries imposing curfews and limiting the number of people allowed in bars and restaurants. >> i am a bit surprised by the new lockdown. how quickly it has come again. we had some idea that we had it under control. that we had done everything we could. we are fully vaccinated. you do everything you can to support society and in the end it goes in the wrong direction.

>> we often say the government -- the government intervenes too late. now i think that with the emergence of the new variant, they -- and i hope we will be able to tackle it and within a months time we will be out of it. especially with the booster campaign going. -- sometimes misses the long-term vision and that is frustrating. [indiscernible] [no audio] >> there could be stricter lockdowns, but not so soon. i know -- has had no rest either, so i understand. >> realizing what is happening in the hague. trying to eliminate the situation. we stayed at home.

it is nice weather. we just follow the rules. >> while some countries are toughening up action, others have just begun loosening up after months of restrictions. united kingdom has new measures and officials are warning the full effects of the latest wave are yet to be seen. australia has seen some of the toughest preemptive action and reopened its border in november and is easing restrictions while new covid infections hit new highs. in the u.s., top scientists are urging people to rethink their christmas trouble -- christmas travel plans, warning of omicron's extraordinary capability to spread. >> let's bring in our guests from london. oksana --, leader of the global

citizenship program on outbreaks of infections -- infectious diseases. in hong kong, john nichols is a clinical professor of pathology at the university of hong kong. oksana, from the data available so far, is it fair to say the world may be bracing for a surge of infections similar to what happened in april of 2020? >> certainly be will see that vaccinations are going to mute some symptoms. boosters are very clearly needed. in the u.k., there is a target of trying to achieve one million boosters a day. which is ambitious, but it won't be enough to quell the omicron wave that is rising faster than any other variant we have seen

to date. it is likely in many countries with a similar demographic to the u.k. will experience a similar rate of spread amongst its most vulnerable populations. >> the countries that have started going back into lockdowns, or re-imposing tougher restrictions, are these measures justified? there is a great deal of anxiety here. >> there is some discussion because actually our recent wave is still going down. within that wave, there is omicron coming up. hospitals are still kind of over flooded. a lot of people actually even are getting oxygen at home because we do not have space in the hospitals. we do not have time to wait and we do not have time to figure out what happens with omicron, whether it is more or less severe as the other variants. it is necessary now.

it was necessary to take this step. >> many scientists are saying it is just a matter of time before omicron becomes the most dominant variant of covid. taking over delta. is it a right time to start thinking about measures when we do not know yet whether this is less or more severe than delta? >> this is a very challenging question because people -- data from south africa says it is very transmissible, but a milder disease. more recent data, i think oksana will have more information from the u.k. saying hang on a bit. we need to wait for about two to three weeks to see if there will be this massive increase in hospitalizations. even though some people think it will may be less dangerous, the

sheer number of patients -- what happened in the netherlands. you do not want to have overwhelming of the health care system. any measures you can do to dampen people being admitted, be it through social distancing were restriction measures or through the vaccination is what is needed to stop the overwhelming of the health care system in hospitals and increasing mortality. >> why is it the u.k., which is the hardest hit in the region with almost 93,000 daily cases, not taking on the same tough approach that the euro -- other european countries are taking. >> definitely a difficult political choice. [no audio]

>> and are suggesting more restrictions like circuit breakers. tory mps have rebelled against even mild measures that have been recently reintroduced. it comes down to political questions. the imperial study that has been published has also verified that at this stage we cannot say that in the u.k., omicron is going to be milder. in south africa, there is a younger population and a huge amount of exposure to previous variance. the picture looks different there, but it is not -- just to make that assumption now. if we go based on what hospitalizations are today, knowing that there is a significant lag, we are going to be in big trouble. the british medical association has said that by christmas we could have one in 10 nhs workers sick as a result.

it's not just about the number of hospitalizations, we have to care for people with essential medicine and urgent care. >> since the start of the covid-19 heartbreak, countries took different approaches. drastic lockdowns, tough measures, others went for contact tracing to contain the surge. the netherlands, when they opted for the option of returning to lockdown, is this because they wanted to give some leeway for the medics to be able to start with a booster before they decide how to move forward. >> there was an issue with the booster campaign. it started too late. we are one of the last in europe that have started. only 6% of the population has received their booster. in most other countries in europe, it is 25%. even 35%.

we need time to catch up. contact tracing has never been performing well in the netherlands. we lost track in march. we tried to ramp it up in the summer but -- it has never helped us much. our health service does do contact tracing, but not in a way to push down the curve, just to inform people, to get them to isolate. >> people seem to be a little baffled by the fact that politicians need to get their act together when it comes to how to move forward. we were told at the beginning you just need two shots, and this is it. a booster is just for those with underlying health conditions. now we are being told everybody needs the booster. otherwise omicron might be a

nasty variant. >> i think the thing that all of these words are coming back to bite us. all of these predictions. it is because we are dealing so much with uncharted territory. when we thought we had delta under control, the vaccines were working, and along came omicron. some people were predicting it because in parts of southern africa, there was a low vaccination rate. also the reality is that this is an rna virus and the more virus gets a chance to replicate, the more mutations you get. people were saying there have been -- in the equality between rich places and other countries. i think it is not surprising that omicron broke out. but, this variant is basically the sweet spot of being able to replicate effectively and cause

great transmission. i think we've got ourselves to blame when we are treating vaccine programs around the world. >> is it because omicron spreads as fast as measles, which means that it is likely to further continue spreading all over the world, which is creating concern here, but is it because we do not know whether this is something that could send many people to the icu? >> we are looking at the question of transmissibility versus severity. what we have tried to explain is that any benefit in the virus being milder, whether that is due to vaccination, prior exposure or the strain itself, because we are now looking at so many more people being infected at the same time, that makes

whatever reduction in hospitalization is in some way thwarted. you still are going to see a big pressure, particularly in those who we already know, certain populations, vaccines are just not as effective. the booster, however, there has been good news it provides 18% reduction in hospitalization. that is great news but it is going to take time for many countries to get there. there are many countries in the world that still have not even had their first dose. it will look very different in different places but the key message here is that the negative impact on health is going to be exponentially worse the longer we allow exponential growth of the virus to occur. >> sometimes the political advice outweighs the medical considerations. in europe they have 89 million

cases and more than 1.5 million covid related deaths. does attic slain the reason why people are going into those more drastic actions, because they do not want to end up having hospitals bombed in the coming weeks? >> this is the main goal. in particular that another event -- the netherlands, but we call it code black where people will not get a place in hospital to get treated. either for severe covid or an accident or anything else that is severe. that is what they want to prevent. they have never actually tried to keep the virus down and transmission low. they flirted with herd immunity for a long time and tried to maximize the number of cases within health care capacity and that has proven to be a very shortsighted strategy particularly now, that previous infections -- well, no longer

create enough immunity to not get reinfected still thinking it is too late to chase that strategy. and that we should have done it earlier, or we should still do it. it is very difficult political situation. >> explain this, don't you think there needs to be a re-think of the strategies themselves? we started with covid-19 and there was an alpha and beta and delta variant, omicron, most likely we are going to see many more mutations. what -- whatever you do, whatever research you would have to do you would have to wait until the next winter and reimpose the same sanctions. >> we can't predict with the next variant is going to be like.

some people are saying hopefully this variant will -- crowd out to the other ones and may just disappear. i think that is a big challenge. that is i think where the frustration people feel is. they say we have done the right thing, i have done this and now we are told to go back to restrictions. just to get back to what was said earlier, one of the reasons last week was that omicron actually replicates 70 times more effectively in the upper inner respiratory tract of humans. this is a virus in which each person when they get infected it is a very effective at replication. i think from -- it is going to lead to far more transmission. it is a different beast from the other variants. >> we know that the unvaccinated face 20 times greater risk of

dying from covid compared to those vaccinated. does it bring to the table the issue that people have to be fully vaccinated now, plus the booster, to be able to say by the springtime, we could see light at the end of the tunnel? >> we know that the unvaccinated are also going to be putting on some of the greatest pressure on the health care system. as mentioned, even if they were infected previously, reinfection with omicron is three to four times more likely than any other variant we have seen today. -- to date. there has to be a better effort at engaging with these groups that have up to this point refused. we need to ensure we are rolling out to younger populations so the u.k. has been late to that but they are starting now vaccinating younger groups. we also have other tools.

there is some promise with antiviral drugs. it is key that they be administered early. for this rave, there's not enough supply for it to make a big enough dent. hopefully this is going to be the last winter of even discussing restrictions because we will have a wider toolkit available which perhaps some people who although the vaccine remains the best preventative measure, it may be that others are also more willing to take other treatments. the wider therapeutics that are available, more population immunity built, hopefully more efforts in ensuring other countries have access to doses as well so that we are tackling the vaccine equity problem. if we look at it globally, we can push things further along as long as we do try and learn those lessons about how we can't ignore the rest of the world.

it is going to have local impact. that seems to be, for whatever reason, difficult message to get through. >> if you are talking about africa, places where you only have 28% of the population vaccinated. you mentioned antiviral drugs. the biggest fear for a doctor, nurse and a politician is the same peak of hospitalizations we saw last year. between's obviously more tragedy and more death. have we invested more time and money on the antiviral drugs? do you think we could have reversed the trend? >> it is one of the tools. we talk about swiss cheese. tools, not at all at the same time. sometimes this season helps. sometimes we are more vulnerable and sensitive to treatments. we will need them, these extra

tools but also, that is what i heard from a facts and allergist this week that even for vaccinated people that have not had their booster, they get infected, they may be -- they may benefit from getting the vaccine the day after they get infected. antivirals can help the unvaccinated or other people who have not had the chance to get there extra shot. >> in the u.s., you have grim news coming from different parts of the country. dr. fauci is saying basically that the country should be bracing for a tough few weeks. and then you have places like maryland where the surge in infections has gone to something like 150%. in places like new jersey and new york. what is the problem here? what is the failure here? where does it come from?

>> it has been mentioned a few times in this debate, i think it comes down to politics and it comes down to people's attitudes. most studies have showed -- where people are reluctant to even have their mask mandates. even in hong kong, they hadn't a community case of covid for two or three months yet everybody goes around wearing masks. outside, indoors, because we had this experience with sars and we do not see it as a social stigma to wear a mask. that to me as one of the most cost-effective ways to try to decrease infection, simple masks. if people were to bite the bullet and say, we know masks are effective, they are cheap

and they decrease transmission, when there is no vaccines available. >> the grim statistics we have been shown globally, is there any glimmer of hope we should be sharing with our viewers today? >> i think all of the things we know about breaking chains of transmission still hold true. for every viewer, making sure that you are taking a test before you leave the house, that is a good move. i know here in the u.k., they have been shortages. the same measures to protect yourself and your loved ones at this time you can employ to really gauge your own level of risk even if you are somewhere where there is perhaps flexibility around that. i would say in the next couple

of weeks we are going to go through, in the winter period it is going to be difficult but going around the other side, there is going to be better weather. people are going to be outside more and we will have more tools available to us. as long as we have the spirit of cooperation and global solidarity, we can make a significant difference in saving lives and economic recovery. >>, but i think it is important to emphasize the dynamic of having boosters every couple of months. it is not so different from the things we know from influenza. except influenza only sticks to the season, at least in the northern hemisphere we have a flu season. then we get this shot right in front of that season. as long as we can keep the virus as low as possible just by

having enough people that have some immunity during the rest of the year, we can boost once a year. that would be a good perspective. >> john? >> good news, i think we are in much better position than last year. for more vaccines, far better looking ways of treatment. i think we have -- it is just going to be a matter of willpower and also making sure you protect and look after health care workers. they are the ones who will be looking after you when you are in hospital. >> always good when you hear scientists telling you there is light at the end of the tunnel. i appreciate your insight. thank you. and thank you too for watching. you can see the program any time on al jazeera.com. go to our facebook page.

you can also join in the conversation on twitter. from the entire team here, bye for now. ♪ çotataptúñ■añ&ñwñwñwñwñw

♪ ♪♪♪ ♪♪♪ ♪♪♪ huh wonjea: four twenty-five is the time