COVID-19 Megathread 6: Return of the Omicron

[Fmr. Gov. NickG]

If the Omicron variant is truly much less lethal than other variant, we should be encouraging it’s spread, not discouraging it. 

Ultimately, everyone is going to be infected with some form of covid, so the best case scenario is to be vaccinated, have effective treatments available, and be infected with a mild strain.   

Now that we have the Pfizer pill and potentially a relatively harmless strain, it seems like we are approaching that best case.

[Fmr. Gov. NickG]

If Omicron is really as mild as it sounds like from early evidence, this should all end as soon as it outcompetes Delta.

[Fmr. Gov. NickG]

What does the data look like on Omicron hospitalizations? 

[Fmr. Gov. NickG]

Doesn't it seem strange that these new variants always seem to come just when we are managing the one before it? They don't come all at once, and why is that? Are these things being engineered? And now we are being told by pharmaceutical companies to get boosters. What? We are allowing pharmaceutical companies to run the dialogue?

I believe there is something fishy going on. I'm tired of being a human pin cushion. I think we are being hoodwinked.

We're not being hoodwinked. It's omicron because we're on O.

Well they skipped nu and xi. Nu because it sounds like new, and xi because that's the name of the leader of China.

So this is totally tangential...but can anyone explain why the Chinese President's name is transliterated as "Xi" and not "Shi"?  I.e. why is an "sh" sound in Chinese written as "x" in English, when "x" is almost never pronounced as "sh" in English words?

[Fmr. Gov. NickG]

This is fantastic news out of Suid Afrika

https://mobile.twitter.com/Alicia_Smith19/status/1466820411287552016


Also, I read somewhere that the hospitalization increase is an artifact of the fact that South Africa is finally allowing Afrikaners to get hospital treatment for covid.

How is this not the top story on every new network across the world right now?

If this is holds up, it is the end of the pandemic full stop.

[Fmr. Gov. NickG]

How is this not the top story on every new network across the world right now?

If this is holds up, it is the end of the pandemic full stop.

Because that's a big if, the tweet says it's too early to tell if it's a milder variant, and even if it is true, no that doesn't mean the end of serious variants. That's a possibility, but not assured at all.

I realize it's too earlier to know for sure.  But there have been headlines about how Omicron -might- be more infections, and -might- evade the vaccines for the entire past week, and we have no more certainty about these than we do about the variant's severity.

[Fmr. Gov. NickG]

https://www.nbcbayarea.com/news/local/south-africa-reports-rise-in-number-of-kids-hospitalized-with-covid-19-omicron-variant/2747608/

This story on the same topic is more recent.

https://www.reuters.com/world/africa/safrican-official-says-number-children-sick-with-covid-19-is-not-cause-panic-2021-12-04/

Higher hospital admissions among children during a fourth wave of COVID-19 infections in South Africa that has been driven by the Omicron coronavirus variant should not prompt panic as infections have been mild, a health official said on Saturday.

[Fmr. Gov. NickG]

The WHO said the other day that there hasn't been a single recorded death from the Omicron variant.  If it turns out that this is just a cold, we need to stop treating it any differently from other colds (and that includes stopping testing and no longer encouraging those who have it to quarantine).

I would agree with not requiring quarantine for Omicron as long as the data on the mildness of the variant holds up.  And we should certainly lift any Omicron-related travel restrictions.

But I'm not sure what you mean by "stopping testing" given that you can't know exactly which variant you have before you test, and much deadlier variants are still much more prevalent than Omicron.

[Fmr. Gov. NickG]

It's seeming more and more certain that the worst thing we could do right now it implement restrictions that would impede Omicron from out-competing more deadly variants.

[Fmr. Gov. NickG]

We don't actually know that Omicron is mild enough or that it's potential mildness outweighs the increased spread especially if that is also driven by reduced vaccine efficacy. We can't rely on a few known cases from southern Africa.

South Africa has over 10,000 cases a day right now.  And still zero reported deaths?  This seems like a pretty substantial sample size to me.

[Fmr. Gov. NickG]

ing NUT!!!

https://mobile.twitter.com/kylamb8/status/1469014009907138561

https://twitter.com/nataliexdean/status/1468988174693289994

It’s a valid point in general.  But reinfections alone can’t explain why there are basically ZERO cases of severe illness from Omicron. 

I don’t understand why people seem so invested in continuing to rationalize unfounded fears of this variant despite overwhelming evidence to the contrary.

[Fmr. Gov. NickG]

ing NUT!!!

https://mobile.twitter.com/kylamb8/status/1469014009907138561

https://twitter.com/nataliexdean/status/1468988174693289994

It’s a valid point in general.  But reinfections alone can’t explain why there are basically ZERO cases of severe illness from Omicron. 

I don’t understand why people seem so invested in continuing to rationalize unfounded fears of this variant despite overwhelming evidence to the contrary.

There is no overwhelming evidence. I mean, we already know that covid is less dangerous then flu for the vaccinated (or infected probably). Given that ~80% has already been infected.

There is no "zero" severe cases, either. What did you get if from? From the twitter thread I linked to.

https://twitter.com/nataliexdean/status/1468988200882524166

I don't know the definition of "severe" is, but no one, I personally know, who got Covid needed to be hospitalized. Doesn't being hospitalized counts as severe?

Given that ~80% of people has been infected = immunity, very young population and the fact that a lot of vulnerable population has died (0.3% of total population has died in SA due to corona). The thing is, that the "data" would perhaps be the same, if it was delta.

+ lagging. Obviously, if no one dies in 1-2 week in SA, it'd really great news.And soon we'll start to get good data from UK. They have vaccinations (and previous infected?) status for each patient. Then we can actually make apple to apple comparison vs delta etc.

I posted a link 2-3 days ago explaining why South Africa has seen an increase in hospitalization but no evidence of an increase in severe illness.  The gist of it was that South Africa has been admitting every child diagnosed with covid into the hospital for observation whether or not they had any serious symptoms.

[Fmr. Gov. NickG]

You can be pretty damn certain that Omicron is much less severe than other variants just from the 0-deaths-in-1780 cases data point.

You can plug this data in to a binomial calculator to find the threshold at which the you reach a 95% confidence level for a given death rate.  With these numbers, 95% confidence is reached at a death rate of 0.17%.  In other words, if the null hypothesis was that the death rate for Omicron was 0.17% (about 1 in 600) or greater, you could reject this null hypothesis at 95% confidence.  

(Of course, given that we have no deaths, it is more likely than not the the actual death rate is even less than 0.17%, we just don’t have a big enough denominator to say this at 95% confidence.  For example, we only have 83% confidence to reject a null hypothesis death rate of 0.1%.)

[Fmr. Gov. NickG]

I'm confused as to why you all are so strung up over wearing masks. You have the freedom to do literally whatever you did pre-pandemic, yet you're all acting as if we're still living under March 2020-era lockdowns because some places want you to wear a face covering.

Do you still have a hard time breathing with it on, or something?

It’s obviously not on the scale of March 2020, but it is definitely not true that everything that was open pre-pandemic is now available.  Concerts, festivals, and conventions are still being postponed.  International travel is still really difficult.  And many of the restaurants around me still have not reopened for in-person dining.

[Fmr. Gov. NickG]

I'm confused as to why you all are so strung up over wearing masks. You have the freedom to do literally whatever you did pre-pandemic, yet you're all acting as if we're still living under March 2020-era lockdowns because some places want you to wear a face covering.

Do you still have a hard time breathing with it on, or something?

It’s obviously not on the scale of March 2020, but it is definitely not true that everything that was open pre-pandemic is now available.  Concerts, festivals, and conventions are still being postponed.  International travel is still really difficult.  And many of the restaurants around me still have not reopened for in-person dining.

At this point the only point where there is still government intervention is international travel, and issues are most likely due to the actions of foreign governments as the US travel policies are rather mild, just get vaccinated and tested. All the other points are the free market reacting to the new normal. So what's your problem? You want to force the free market to cater towards the old normal that no longer exists? Force conventions and concerts to be held despite lack of demand and at risk of legal liability for hosting superspreader events?

lacK Of DeMAnd: https://blockclubchicago.org/2021/08/02/lollapalooza-had-more-than-385000-people-officials-announce-after-lightfoot-defended-holding-fest-during-pandemic/

lacK Of DeMAnd: https://www.cnbc.com/2021/11/29/spider-man-no-way-home-ticket-demand-crashed-box-office-sites.html

lacK Of DeMAnd: https://wolverineswire.usatoday.com/2021/12/01/michigan-football-vs-ohio-state-ratings-most-watched-college-football-game/

I'm seeing the new Spider-Man movie next Thursday night and the theater is almost completely booked. This is in Washington DC, not Trump Country Oklahoma. You may not be ready and probably never will be for the rest of your life, but most people are.

Last year, gas was cheap because people weren't getting out that much. But guess what? Gas prices have gone up this year because people are traveling again.

You missed my point entirely. The post I quoted bemoaned that various concerts and festivals had cut back or cancelled their events, and that some restaurants had closed their dining rooms, clearly intending to blame the government, Joe Biden, and other Democrats. My point is that this blame is entirely misplaced as any "blame" for that is entirely on the free market. If event organizers felt they could hold the events profitably, then they would hold the events. Otherwise they will cancel. Clearly these events are being cancelled because of lack of demand or the risk of being sued is too high. This is the free market. Movie theaters are open because there is ample demand and there is just about no way to prove that you caught COVID while watching the movie, basically shielding them from lawsuits. Whether there should be demand or not is another story and entirely subjective but I'm making an objective statement that it's not the government shutting anybody down.

And by the way, I have watched movies in a theater during the pandemic. It's easy to stay safe. Just put on an N95 mask and don't eat or drink anything. See what happens when you get past "feelings" and come to recognize masks as the zero cost, low effort mitigation measure they are?

I don’t really blame Biden at all for the pandemic response.  He’s done his best to implement vaccine mandates to the extent feasible given his powers.  And he’s hasn’t demanded any shut downs or national mask mandates, etc.  Executive branch failures lie much more with agencies like the CDC, FDA, and TSA, which should be independent from Biden.  Congress should really have just passed a national vaccine mandate a year ago and we’d have been out of this whole thing by last Spring.  

But the real failure lies with the media.  They are really leveraging the public’s innumeracy to stoke irrational fears.  Just look at the coverage of Omicron…the early data suggested that this variant was at least as likely to be good news toward ending the pandemic as it was bad news.  And yet when presented with uncertainty, the media only wants to present the most pessimistic possibilities, discussing Omicron’s possible increased transmissibiliy or ability to evade vaccines.

Most of the failures to return to normal -are- due to free market decisions.  But they are decisions by the public that are based on false narratives that the media have presented them, and which things like mask mandates have exacerbated.  Like, of course people are going to be less likely to go to restaurant where everyone is wearing masks, and this is going to prevent a lot of restaurants from reopening.  Just because they government didn’t force this restaurants to close doesn’t mean the public response to the pandemic wasn’t at fault.

[Fmr. Gov. NickG]

https://twitter.com/CNN/status/1470242128974565379?s=20

This is an odd measure...it's compared to cases from 14-days ago...which of course was the end of Thanksgiving weekend when a lot of states weren't even reporting.  Note that Florida's cases are listed as Rising (+Infinity%).

[Fmr. Gov. NickG]

Notice that a quarter of the ICU cases are breakthrough cases, and that the queues for surgeries are long due to a lack of ICU beds. I am extremely concerned about Omicron variant.

https://www.politico.eu/article/belgium-intensive-care-unit-coronavirus-trial-survival/

This article doesn't mention anything about ICU cases or breakthrough cases being tied to Omicron.

[Fmr. Gov. NickG]

Notice that a quarter of the ICU cases are breakthrough cases, and that the queues for surgeries are long due to a lack of ICU beds. I am extremely concerned about Omicron variant.

https://www.politico.eu/article/belgium-intensive-care-unit-coronavirus-trial-survival/

This article doesn't mention anything about ICU cases or breakthrough cases being tied to Omicron.

"While 76 percent of people in Belgium are fully vaccinated, approximately 75 percent of those in the COVID ICU are not."

What does this have to do with Omicron?  It says nothing about whether these ICU cases are the Omicron variant.

[Fmr. Gov. NickG]

First preliminary non-peer-reviewed study from South Africa re:Omicon.


https://twitter.com/ReutersAfrica/status/1470723224942034944
In South Africa Omicron wave, Pfizer vaccine less effective against hospitalisation - study

• 2 doses of Pfizer shot provide 70% protection against hospitalisation - study
• Findings are some of the earliest outside of lab studies
• Data preliminary, but encouraging - scientist

JOHANNESBURG, Dec 14 (Reuters) - Two doses of Pfizer-BioNTech's COVID-19 vaccine appear to have given 70% protection against hospitalisation in South Africa in recent weeks, according to a major real-world study which suggests weaker efficacy against the new Omicron variant.

The study released on Tuesday by South Africa's largest private health insurance administrator, Discovery Health, was based on more than 211,000 positive COVID-19 test results. Around 78,000 of those results from Nov. 15 to Dec. 7 were attributed to Omicron.

Based on analysis by Discovery's (DSYJ.J) clinical research and actuarial teams, and in collaboration with the South African Medical Research Council (SAMRC), the study calculated that two doses of Pfizer-BioNTech offered 70% protection against hospitalisation compared with the unvaccinated during the recent surge in cases and 33% protection against infection.

It said this represents a drop from 80% protection against infection and compares with 93% efficacy against hospital admission during South Africa's outbreak of the Delta variant, which is the globally dominant variant and considered to be the most infectious to emerge during the pandemic.

Discovery cautioned that the study's findings should be considered preliminary.

So 2 doses Pfizer gave 70% efficacy against hospitalization (Omicron), but only 33% against being infected. But:

With 70% or more of the South African population estimated to have been exposed to COVID-19 over the past 18 months, high estimated levels of antibodies in the population might be skewing the data.

"This could be a confounding factor for these hospital admission and severity indicators during this Omicron wave," Ryan Noach, chief executive of Discovery Health, said in a briefing on the study.

So you have to wait the data from UK anyway

This same study also finds (as many of us suspected for a while) that Omicron is less severe than other variants.

Omicron variant more resistant to vaccine but causes less severe covid, major South African study concludes

[Fmr. Gov. NickG]

It is kind of ridiculous for a government to put the onus on private individuals to check vaccine cards every time someone wants to use their business.

Congress should have passed a nationwide vaccine mandate, enforced by federal law enforcement, and sent everyone who refused to get vaxxed to the ANWR.

[Fmr. Gov. NickG]

The study above doesn't actually study Omicron cases, but total cases--and they're estimating how many cases are in there via extrapolation.

More than likely, the drop in hospital protection is a combination of waning immunity and the large number of people that are hospitalized for other things, and test positive on screening.

The 78,000 cases were attributed to Omicron based on the relative prevalence of the variant within the country over the study period, but because they have not been confirmed as being the new variant the study cannot offer conclusive findings.]The 78,000 cases were attributed to Omicron based on the relative prevalence of the variant within the country over the study period, but because they have not been confirmed as being the new variant the study cannot offer conclusive findings.

Why would you conclude, without any sort of actual evidence, that your explanation is “more than likely”?

Just statistically speaking, even if we had no evidence whatsoever, or prior estimate should be that Omicron is less severe that previous variants, just because variants tend to become less severe over time for most viruses.  But now we actually have tons of evidence to back this up, and I don’t understand why people keep scratching around for explanations other than the obvious one.

[Fmr. Gov. NickG]

You are obliged to show your driver's license when stopped by the police for a possible traffic violation even if you did nothing wrong. I have been stopped by the police for suspected DUI... once because I found a traffic sign confusing and another time because I was in no condition to be on the road (it was 8 PM, I have sleep apnea, and I was driving erratically). In both cases I should have been stopped.

A vaccine card is an indication that you have been inoculated, and its absence suggests otherwise by default. I keep mine in my wallet and consider it as important as my driver's license. I can kill someone with bad driving, and if I did get COVID-19 and spread it I could kill people.

Getting inoculated is easy and it is available at the right price -- FREE.

Most restaurants and many stores have signs that say "NO SHIRT, NO SHOES, NO SERVICE". You can be removed from a public place for disorderly conduct such as profanities or heckling.
 

I don’t really think this is the right analogy for a vaccine mandate on restaurants.

The drivers licensing requirement is a mandate passed by the state, enforced by the state, and funded by the state.

The restaurant mandate is passed by the state, but then the state completely passes the buck and washes their hands of enforcement.  Instead, the enforcement burden is passed on to private individuals (business owners) who have done nothing wrong.  And then these businesses end up being harassed by anti-vaxxers, and some may lose business because of it.

This is really like if a state said that drivers had to have a license, but instead of police or the DMV checking licenses, they told restaurants that they had to check the licenses of all customers who wanted to use their parking lot.

If a state wanted to pass a vaccine mandate to drive, I would be all for it.

[Fmr. Gov. NickG]

You are obliged to show your driver's license when stopped by the police for a possible traffic violation even if you did nothing wrong. I have been stopped by the police for suspected DUI... once because I found a traffic sign confusing and another time because I was in no condition to be on the road (it was 8 PM, I have sleep apnea, and I was driving erratically). In both cases I should have been stopped.

A vaccine card is an indication that you have been inoculated, and its absence suggests otherwise by default. I keep mine in my wallet and consider it as important as my driver's license. I can kill someone with bad driving, and if I did get COVID-19 and spread it I could kill people.

Getting inoculated is easy and it is available at the right price -- FREE.

Most restaurants and many stores have signs that say "NO SHIRT, NO SHOES, NO SERVICE". You can be removed from a public place for disorderly conduct such as profanities or heckling.
 

I don’t really think this is the right analogy for a vaccine mandate on restaurants.

The drivers licensing requirement is a mandate passed by the state, enforced by the state, and funded by the state.

The restaurant mandate is passed by the state, but then the state completely passes the buck and washes their hands of enforcement.  Instead, the enforcement burden is passed on to private individuals (business owners) who have done nothing wrong. And then these businesses end up being harassed by anti-vaxxers, and some may lose business because of it.

This is really like if a state said that drivers had to have a license, but instead of police or the DMV checking licenses, they told restaurants that they had to check the licenses of all customers who wanted to use their parking lot.

If a state wanted to pass a vaccine mandate to drive, I would be all for it.

You've gone so deep into false equivalency you've leapt entirely into a different concept entirely. To enter a bar, you are not carded in the parking lot, you are carded on entry. And it's not the police or DMV checking your ID in any circumstances.

The red bold is very literally how card checking works where ID is required. Absolutely nowhere is the state or DMV involved in this process--nobody has police or DMV officials standing outside to make sure your ID is valid.

You’re talking about the law that requires you to be 21 to drink, not the law that requires a license to drive.  You are right that requiring bars to enforce the drinking age is much closer to the vaccine mandate for restaurants than the drivers license requirement.   I kind of think we don’t have state enforcement for this because in many contexts a lot of people don’t want it rigorously enforced.

[Fmr. Gov. NickG]

Sadly, we're not done with this stuff.

https://twitter.com/axios/status/1471503110052872200

Why do people keep posting data that is comparing cases now to cases over the Thanksgiving week?

[Fmr. Gov. NickG]

It’s been three weeks now since cases started surging in South Africa, and there still has been no increase in covid deaths.  If omicron were anywhere near as severe as past variants, we should have started to see some sign of this my now (spikes in deaths tend to follow spikes in cases by about two weeks).