The region saw over seven million newly reported cases of Covid-19 in the first week of 2022, more than doubling over a two-week period. The Institute for Health Metrics and Evaluation forecasts that more than 50 percent of the population in the region will be infected with Omicron in the next six to eight weeks. The currently approved vaccines do continue to provide good protection against severe disease and death, including for Omicron. But because of the unprecedented scale of transmission, we are now seeing rising Covid-19 hospitalizations. It is challenging health systems and service delivery in many countries where Omicron has spread at speed, and threatens to overwhelm in many more. I am also deeply concerned that as the variant moves east, we have yet to see its full impact in countries where levels of vaccination uptake are lower, and where we will see more severe disease in the unvaccinated. For countries not yet hit by the Omicron surge, there is a closing window of opportunity to act now and plan for contingencies.