The still hoped Christmas 2021 would feel lighter and happier than a year ago. Not clear of the pandemic, but coping with it much better, with the vast majority of the population benefiting from the immunity conferred by vaccination. But the extraordinarily rapid spread of the Omicron variant imbued this year’s holiday season with a grim sense of déjà vu.

The situation we face now is materially different. A year ago, only a fraction of the population had received their first vaccine and social restrictions were the only way to fend off an impending second wave of Covid. Today we have a much stronger wall of immunity as a result of the vaccination and a previous infection.

But the arrival of Omicron is very worrying. The first UK case was documented on November 27; just three weeks later, and it is estimated to be the dominant variant in the UK, accounting for four out of five positive results in London. The number of daily cases is the highest it was during the pandemic, and increasing. This is due to the additional transmissibility of Omicron: the number of Omicron cases is doubling in less than two days.

Omicron’s impact on the NHS will depend on the degree to which his capture is associated with serious illness and hospitalization. But for now, there is a lack of real data on the strength of that link in the UK. We know that Omicron is more resistant to the vaccine than Delta, the double vaccination offering much less protection against symptomatic infection, but a booster restoring it to very good levels. Estimates based on early data suggest that a booster vaccine is 80-86% effective against hospitalization, compared to over 95% against Delta. But better data on the link between the Omicron capture and hospitalization is not expected for at least a week.

The other route through which Omicron will affect not only the NHS, but all emergency services and critical infrastructure, is staff shortages, as record numbers of cases force more people to self-isolate than to other times of the pandemic. Guy’s and St Thomas’ Trust in London was forced to cancel non-essential services and redeploy staff to emergency medicine last week as hundreds of employees self-isolate, and nearly a thirds of fire engines in London were out of service last week, also due to understaffing.

Lack of data means ministers have to make decisions with a high degree of uncertainty. Should the government bear the cost of imposing new social restrictions in England before Christmas – as Wales and Scotland have already done – in an attempt to slow the spread as a precautionary measure, in the event the entirely plausible scenario that the link between obtaining Omicron and hospitalization is strong enough to pose a very serious threat to the ability of the NHS to respond to this wave? Or should it wait until there is more data and hope for the best, but impose restrictions if necessary later? To make matters worse, the reality is that with a virus growing exponentially – especially with spreading as fast as Omicron – taking action later means imposing stricter measures for longer to flatten the infection curve. and hospitalizations, and what to wait might be to leave it too late.

In the face of these critical choices, it is vital that the public can trust Boris Johnson to make decisions in the national interest, based on the best scientific evidence and advice. Yet he inspires little confidence; in part because of its history of consistently being too slow to act in the pandemic, which has resulted in thousands of preventable deaths in previous waves. But also because weeks of self-taught scandals have stripped him of all authority within his own party. These include the allegations of Downing Street Christmas parties which violated last year’s Covid restrictions, which it seems implausible that Johnson himself was not aware of.

This left him with an irrevocably weakened and damaged prime minister. Last week 99 Tory MPs rebelled against the introduction of vaccine passports for large sites even as Omicron swept the capital. The wing of his party that opposes necessary Covid restrictions is out of step with the nation, but will be even more emboldened by the Tories’ shocking by-election defeat in North Shropshire.

Johnson’s political crises will therefore not only take him away from the current crisis, but will discourage him from taking the timely steps necessary to protect the NHS for fear of further upsetting his resentful party. And the entire cabinet will likely be distracted by the possibility of a Tory leadership election, with candidates positioning themselves rather than focusing on the ongoing national crisis. This is already interfering with government communications on public health matters: Johnson made a much more ambiguous note than Chief Medical Officer Chris Whitty in terms of advice to people on reducing socialization before Christmas. Whitty’s suggestion that people prioritize the social commitments that really matter to them has led some Tory MPs to launch shameful political attacks against him.

There is still a chance that the link between Omicron’s capture and hospitalization is weak enough to minimize the impact of the next wave on the NHS. Thanks to a remarkable effort by the NHS, the roll-out of the booster vaccine continues at a steady pace, after a slow start that has left the UK more exposed than it needed to be. But there is a very real risk that January 2021 will not be any less difficult than January 2020. Here we are approaching a Prime Minister no more competent than he was a year ago, but whose power and authority. practically fainted. It’s a dark way to end the year.