COVID-19 Megathread 6: Return of the Omicron

[politicallefty]

https://twitter.com/yascha_mounk/status/1297226437905260545?s=21

I fear that if students can't socialize, the resulting anxiety and depression will be far more dangerous than the functionally 0% death rate 21 year olds have from COVID. 

I'm also wary of the financial impact which the reversion to online learning will have for many students. Tuition costs remain the same regardless of format, and I don't think online education provides the same utility as in-person instruction. What kind of lasting effects will the pandemic have on college enrollment? And might it encourage prospective students to consider alternatives?

Considering the cost, college as it's been known for a long time should really have started to have been rethought some years ago. Maybe the track for many should be a 3-year program instead. Obviously, some majors would have a longer program and some would go on to post-grad. For many people, the 4-year Bachelor's is nothing more than a piece of paper saying they went to college. They're just overqualified for flipping burgers and under a mountain of debt. I realize that's getting a little side-tracked from the issue at hand.

In terms of the actual education provided, many general education classes can easily be done online. I'm thinking classes like your basic English and whatever starting math you get placed in. But you raise a good point about the cost. Why would you want to pay a premium for an online general education class when you can pay much less for the same basic thing at a community college (which tend to be directly transferable, at least to state colleges)? That's something you could ask already though, which would lead back to my first question and the one you got me to ask. That doesn't mean they're questions that shouldn't be asked, however.

[politicallefty]

Governors around the country are about to face the worst of this pandemic (save Governor Cuomo). They need to start planning and acting quickly to forestall mass death. Despite nasty numbers for most of the year, most of the country hasn't seen what NYC has. The infection rate is rising far too rapidly and the healthcare system isn't going to be able to keep up. It's going to inevitably start collapsing. That's what really scared me when this started early this year. So far, we've mostly been able to prevent that. I'm not sure we're going to be able to prevent that going forward. It's when the healthcare system starts collapsing that the death rate will start to jump considerably. Even if we couldn't stop the spread of infection at this point in time as we enter the colder months, the failure to prepare for this moment is so absolutely inexcusable.

[politicallefty]

Do you think it's likely that we hit the death figures from the Spanish Flu at this rate?

In the US (assuming the estimated death toll of 675k)? When all is said and done, I do expect that number to be surpassed. A major difference between influenza viruses and coronaviruses is that the former tend to mutate far more often. In that pandemic, it had mutated into a more virulent strain in the second wave. It's hard to see waves with COVID-19/SARS-CoV-2 because we've never gone below a certain point. That doesn't say anything as to what might have changed in terms of virulence if the virus had subsided for the summer.

I will reiterate my point from before to say that what really scares me is a high infection rate all at once that overwhelms the healthcare system. We are not ready for anything like that. It's what scared me at the start of the pandemic in terms of lack of ventilators. That's what can and will drive up the death toll. When managed, we do seem to have some tools in our arsenal against the virus in the medical setting. There are no cures and there isn't a vaccine, but there are treatments/drugs that have improved outcomes and increased the survival rate. Those will become mostly ineffective if they become mostly inaccessible to those infected. This all goes back to the goal of flattening the curve. The lower/broader the curve, the better the healthcare system can respond in time and treat those infected. Higher peaks invariably mean a higher death rate.

[politicallefty]

These numbers are very disturbing and they're almost certainly going to be very disturbing for at least the next few months. Vaccines may be on the way, but production and distribution to the masses will take considerable time. The average person will probably be waiting until mid-to-late Spring. At this rate, I'm very concerned that the death toll could exceed the 1918 pandemic.

Unfortunately, the response and measures by government have been very lacking. This is really the moment for a shutdown of sit-down restaurants, bars, etc. The urgency is far greater than it was earlier this year, but at least there appears to be light at the end of the tunnel (and not an oncoming train). This is almost the ideal time for a large stimulus package, yet Congress is negotiating around a total garbage bill. If we're trying to keep the economy working, another round of stimulus checks would be a perfect idea in time for Christmas. Maybe reduce the income level from last time, but I think most households that make under six-figures total income would greatly appreciate the money. But overall, the pandemic is at its worst ever and getting worse and the responses by government are going the other way.

[politicallefty]

Anyone have projects when we will stop seeing 200,000 cases per day?

On a regular basis and apart from the way data is reported (i.e. expect low reported numbers on holidays like Christmas and New Year's), late January would be optimistic. I would expect February or March, depending on how quickly we can dispense vaccines. Thanksgiving was a terrible super-spreader event across the country. I expect Christmas to be even worse, and in contrast with Thanksgiving, that's something celebrated across many countries. As the medical professionals have been saying, we are in for a rough winter.

Congress is failing the American people. We should be paying as many people to stay home as possible, especially now. There is light at the end of the tunnel and it does not appear to be an oncoming train. However, it will take time to reach that point. This is the exact time when we should be putting very serious money into stimulus, something far bigger than the CARES Act. We need to be pumping massive support into small businesses and the American people, not to mention money to support the healthcare system (taking care of patients and expediting vaccine distribution).

[politicallefty]

No I am not spending 4 to 5 trillion dollars to waste another lock down.

There is no public support for a lockdown and the only time there was happened in spring and the lockdowns in spring were a joke. We should have locked down hard at very first.

If you can't accept that, then there will be hundreds of thousands of new cases everyday and thousands of deaths everyday. On top of that, people will continue to fall into poverty and unemployment. Small businesses will continue to fail on a mass scale. You don't need a lockdown to affect behaviour. Most people I know, including myself, haven't been to a sit-down restaurant since no later than March. Most people, including myself, still order drive-through and take-out, but that's it. Restaurants that cannot accommodate that are suffering. Trust me, I don't like it. I want to keep these businesses alive for when things eventually reach some level of normalcy.

I've stopped worrying about the national debt. It's really not much to get excited about. We can afford a few trillion dollars directed at small businesses and Americans that make less a set amount. At this point, all we have to do is bear with this for a few more months. Let's pass a generous stimulus package and get this country through the hardest and most difficult part of this pandemic. There is light now, but we still have to keep our efforts at max for the next few months. This isn't that difficult.

[politicallefty]

Anyone have projects when we will stop seeing 200,000 cases per day?

Very soon. The Plains states are already cratering, and a vaccine even for just a limited number of people should limit the spread.

California is really the main culprit in keeping the numbers high, as they keep imposing lockdowns that don't work.

The culprit? You mean 1/8 of the US population? I'm guessing you have a problem with masks too?

Honestly, what is wrong with people like you? I'm surprised you even believe a vaccine is real.

[politicallefty]

Honestly, what is wrong with people like you?

You mean the states that don't threaten to throw people in jail just for leaving the house?

How about just wearing a mask when you're around others that don't live with you and maintaining a certain distance from others? I never realized that was so hard to abide by.

[politicallefty]

I think it's far enough after Thanksgiving that we can say that we didn't get the doomsday that many folks predicted from the Thanksgiving holiday. Eyeballing the NYT trendlines, I'm seeing unmitigated spikes in a couple of places: Northern New England, and the broader Sunbelt (TN, CA, AZ, SC, GA, NC, etc.). Very happy to see the downward trend here in Erie County

I don't think we can say that at all. Things are worse than ever and I'm sure Thanksgiving made things worse. I'm very concerned about the numbers we're going to see as a result of Christmas and that's something we're likely to see across the entirety of the Western world (unlike Thanksgiving a few weeks ago, which is just here in the US). I also wouldn't be surprised if shopping and being out in stores and whatnot right now is helping to drive up numbers, especially in areas that are more lax on restrictions (particularly restaurants). I don't know about most people, but a lot of people I know traditionally eat out a lot when they're doing Christmas shopping.

[politicallefty]

Hopefully the next pandemic we just immediately go into a wuhan style lockdown at start of outbreak and pay people who cant work from home so we can end it very quickly.

If there's anything like this in the future, this country will almost assuredly do nothing of the sort. We can't even get everyone to put masks on, quite literally one of the easiest things for an individual to do. I'm surprised so many on the right are pushing for a new Cold War with China. We argue about keeping our government open while China has plans for the next 50-100 years. We stand no chance with our current political paradigm. That said, the Chinese government has powers no Western country would ever accept from their government. They literally used the full power of their government to quarantine all of Wuhan for months and forced people to stay home, not even to go out for so-called essentials. Also, it's been awhile now, but how can we forget that China built a 1000-bed hospital in 10 days.

[politicallefty]

I think Trump could've easily won the popular vote as well with a strong response to the virus. He basically ruined Dr Birx's career, who happened to be one of the leading HIV/AIDS researchers. I am somewhat sympathetic to her circumstance. He overran Dr Facui at almost every opportunity. We now know that he was barred from appearing on programs like Rachel Maddow.

I really do think Trump could've easily won this election (and the popular vote). All he had to do was be an example and wear a mask on a regular basis, make full use of the Defense Production Act, and allow scientists like Dr Fauci and Dr Birx to explain things to the American people. He failed on all of that and that alone should disqualify anyone from holding the Presidency.

[politicallefty]

In the 3rd wave which is monstrous, it looks like it is actually winter making it much worse. COVID-19 prefers the low humidity present in the cold environments of the northern hemisphere. People with low vitamin D also appear to suffer more.

That's something I see pop up from time to time. There definitely does seem to be evidence that Vitamin D deficiency worsens one's prognosis, including higher risk of serious illness and death. I really wish healthcare professionals were pushing that line more. Vitamin D deficiency is very common across the population, especially for those with darker skin. Everyone should probably be taking a daily Vitamin D supplement, just 1000-2000 IU. (To be honest, a lot of people should probably be doing that anyway, regardless of the coronavirus.) That's generally enough for most people to build up and maintain sufficiency. And at that dose, there's basically no downside. It's not a miracle cure or a vaccine, but it definitely is a strong tool in our toolkit to combat the virus.

Has it been discussed why this virus is mutating to become worse than it was before, when most viruses generally mutate to be less severe?

Depends what you mean by worse. It appears to be either only slightly more lethal or no change in lethality. But it's more contagious which is good for the virus.

It was my understanding that there's some concern about increased lethality for younger adults with the South African variant. Also, for other reasons, that's the variant that concerns me the most. (The  Brazil variant seems to be very concerning in a similar vein too, but it's not quite as understood yet.)

I don't think masks are going away anytime this year. And if SARS-CoV-2 becomes endemic (as is expected now) like the cold and flu, it's quite likely mask-wearing will become the cultural norm, especially and particularly during flare-ups. That doesn't mean shutdowns. It just means wear your mask, wash your hands, and use common sense. The rest of the world is going to have to take a page from Asian countries on that one. That's not a bad thing though.

[politicallefty]

I don't think masks are going away anytime this year. And if SARS-CoV-2 becomes endemic (as is expected now) like the cold and flu, it's quite likely mask-wearing will become the cultural norm, especially and particularly during flare-ups. That doesn't mean shutdowns. It just means wear your mask, wash your hands, and use common sense. The rest of the world is going to have to take a page from Asian countries on that one. That's not a bad thing though.

Maybe they'll still be required in places like airports, congregate care facilities, doctor's offices, & the like, but even though mask-wearing would obviously still be beneficial in such a circumstance from a public health perspective, it's naive to believe that peer pressure & ridicule won't kill masks - at least here in the U.S. - as soon as the general public has gotten their vaccine & they feel safe once again. Remember: if the irresponsible didn't care about it during the pandemic, then they sure as hell won't be caring about it after either.

I would hope you're wrong about that. Maybe I am naïve, but I can't remember the last time I've seen someone in public without a mask. These mandates have been in place for a long time now in most places. It's really one of the easiest parts of dealing with this too. Vaccines aren't going to return us to where we were before the pandemic. As I said, if it becomes endemic as many believe, maybe mask-wearing in public will have to return during certain flare-ups like during winter. It also has the added bonus of generally protecting people from the cold and flu as well.

[politicallefty]

https://twitter.com/SenateCloakroom/status/1357449693098344450

If this means what I think it means, I'm very disappointed in some Democrats.

I admit I'm not entirely informed as to the reconciliation process, but I assume some of these amendments can be stripped out when dealing with the House, right?

[politicallefty]

https://twitter.com/SenateCloakroom/status/1357449693098344450

If this means what I think it means, I'm very disappointed in some Democrats.

I admit I'm not entirely informed as to the reconciliation process, but I assume some of these amendments can be stripped out when dealing with the House, right?

The House Rules Committee could strip it out when the budget goes back to the House this weekend, but the Senate would have to approve that change. Once an identical budget has passed both chambers however, the eventual actual relief bill does have to comply with the budget's terms.

I'm aware of how bills are passed and adopting the bills as amended by the other House. I think what I was getting at was in terms of other parts of the process. First, doesn't the Origination Clause require the House to pass the bill first? Second, is there a Conference Committee for reconciliation bills?

[politicallefty]

Anybody else who’s young fine with waiting on getting a J&J? I might be able to get one of the others starting next and if I get offered on, I’ll definitely take it but I don’t need the efficacy of the others and the one shot and done sounds much better.

There's absolutely no reason to wait for any vaccine; get the first one that's offered to you. They all prevent severe disease, hospitalization, and death.

I think there's concern with one of the vaccines when it comes to efficacy against the South African variant, which is the variant that's concerned me most. But you're probably right about taking the first vaccine offered. That doesn't mean you stop the measures that have been in place. Maintain social distance, wash your wands, and keep wearing your mask. And as I mentioned in a previous post, I'd definitely recommend taking a Vitamin D supplement. There is some evidence that deficiency can lead to higher risk of serious illness or even death. And as long as you take the appropriate supplement dose (i.e. don't take the entire bottle in one sitting!), there is no risk. We don't have a lot of tools right now, but that seems to be one people can utilize as well.

[politicallefty]

We had such large declines the last few days that it's kind of disappointing seeing a red number again. Still, one day is not a trend so I won't read too much into it. 

Unfortunately, states like Texas and Mississippi are intent on sending us on the wrong path.

[politicallefty]

Speaking of the vaccines, I have a two-shot appointment for March 27 and April 24. I'm pretty sure it's the Pfizer one.

It's likely the Moderna if your appointments are four weeks apart.

My husband just got his first Pfizer shot and the second appointment is four weeks from now.

That's weird. I wonder if it's a supply issue for that location or something. My mom got Pfizer over the weekend and her second dose is scheduled three weeks later to the date and time. My dad's getting Moderna today and his second dose is four weeks from today. They both went to Rite-Aid, although different ones (hence the different vaccine). But I assumed that the time frame for each was according to what federal guidelines and makers of each required.

[politicallefty]

Maybe it’s weird, but Canada is doing four months between shots, so I’m not really sure you have much to worry about in comparison...

The only one I've heard that's supposed to take nearly that long between shots is the AstraZeneca vaccine, which I think is 12 weeks. That hasn't been approved yet here in the US and we're sitting on a stockpile of 30 million doses of that one. I don't know if that one's been approved yet in Canada or not.

Maybe it’s weird, but Canada is doing four months between shots, so I’m not really sure you have much to worry about in comparison...

Is that just because Canada's supply is so low or is there another reason for it?

It does seem like Canada and the EU weren't making the right decisions in pre-purchasing vaccines last year, whereas the US and UK seem to have made some of the right decisions both then and now and are now rolling out vaccines at a very nice pace. A number of countries in Europe are going back into lockdown once again, so clearly some things have gone very wrong there.

[politicallefty]

Maybe it’s weird, but Canada is doing four months between shots, so I’m not really sure you have much to worry about in comparison...

The UK is doing 3 months between shots, and it seems to be working great for them. 

The UK is primarily using the AstraZeneca vaccine, which is recommended to be 12 weeks between shots. I think Pfizer recommends no more than 6 weeks between shots. I'm not sure about Moderna, but the practice in the US so far is 4 weeks.

[politicallefty]

Why are the red? What’s going on? New variants causing trouble?

No, just people making bad decisions and bad policy from certain state governments.

That does seem to be the case. As I've said before, I can understand some reopening of various businesses at reduced capacity. But the way some states are just doing away with all restrictions is declaring victory when you've just started the 4th quarter. Doing away with mask mandates is the most idiotic and annoying aspect of what some states are doing (namely a subset of Republican Governors). That's one of the easiest things to do to reduce the spread of the virus. Closing down businesses and/or enforcing capacity limitations are more debatable issues that have real consequences either way.

Wearing a mask and standing on a sticker on the floor (keeping a certain distance) are the easiest things you can do. There is no downside apart from some people feeling inconvenienced. Fortunately, it looks like virtually all Democratic Governors and most of the reasonably sane Republican Governors are aware of that fact. Even Republican Governor Jim Justice of West Virginia said those that are lifting mask mandates are basically making a political statement. He's opened up businesses more than I'd prefer at this time, but he's been adamant in maintaining his state's mask mandate.

[politicallefty]

It is the final wave of the United States but with less portion of deaths compared to the winter wave. We will be fine. There is an ending point.

Though I do wonder if there will be a mini wave of sorts next winter? Like some days with +50k cases due to holiday travel, anti vaxxers and variants.

I hope it's the last wave and a small one, but it's too early to say. My concern is partly that people in this country are celebrating too quickly. I'm also concerned about the rampant spread of the virus in countries like Brazil. Every new infection gives the virus that many more rolls at the dice to become something more deadly, more infectious, or both. It's quite possible that something could emerge out of Texas, Florida, India, or Brazil that renders our current vaccines weakened or useless.

[politicallefty]

We've really become accustomed to the death rate. It was several months ago that we found it staggering that we were experiencing a death rate equal to 9/11 every other day. At best this year, it's a 9/11 twice a week. A lot of people seem to think this pandemic is over. It's not even close to over.

This really is a race now between vaccines and the infection rate of the virus. We don't need to give the virus any advantages right now. If you can get a vaccine, get it as soon as possible. Even after and for everyone else, keep wearing your masks. Most places aren't checking vaccine records, so everyone should still be wearing masks in public places. We're probably on track for a 4th wave no matter what. Hopefully, we can keep hospitalizations and deaths to a minimum.

As I've said before, what concerns me is the possibility of a mutation that can bypass the current vaccines. The more people get infected means more people that the virus can attempt to throw the dice and therefore more attempts at a mutation that is even more conducive to infection or serious illness.

Just don't be stupid. Wear your mask, wash your hands, and stay socially distant as much as you can. Those that are vaccinated can probably skip the last step most of the time, but there's no good reason for anyone to skip the first two.

[politicallefty]

I don't know if it's been mentioned here, but pandemics have a "social end." This is when people act as if the pandemic is over even if there's still people getting sick and dying. I think this is just something people do by instinct, when it gets to the point where worrying too much about getting sick poses as much of a threat to them personally as the virus itself. I think people are naturally evolved to just stop worrying too much, once worrying gets too stressful, which is itself unhealthy.

I'm not saying anyone should worry. I'm just saying people should use common sense.

Vaccines are winning. Let's say America adminsters 3 million a day. Even if all of them need 2 doses, and if vaccines are 95% effective, that works out to enough for 1.425 million people. Let's say we find 65,000 new cases a day. If we find only half the cases that really exist, that comes out to 130,000 actual cases. That means people are getting vaccinated 11 times as fast as they can be infected.

It's been 13 months since the first major wave of infections in the U.S., and it's already been almost 4 months since the vaccine was rolled out. With so many vaccines administered, how many people remain for the virus to infect before immunity wears off (which might take years)?

I agree. Right now, our vaccine rollout has been a massive success. That doesn't mean we need to declare early victory. We still have a lot of work left. Let's leave the mask mandates in place for now. As vaccine rates increase and cases go down, I would say that we should ease up on businesses. The mask mandates should probably be the last thing to go in terms of health orders.

I'm pretty strict about wearing a mask myself, but by the end of May I'll be fully vaccinated. After that I don't plan on wearing a mask unless the business mandates it or I'm feeling sick.

I don't think that is unreasonable.

I've already received my first dose, but I will still wear my mask in public so long it's necessary for public health. I don't mind anyway as it's seemed to eliminate the cold and flu. I don't think it's necessary year-round, but it'd be nice if we had seasonal masking (maybe something like from October to March).

[politicallefty]

I've already received my first dose, but I will still wear my mask in public so long it's necessary for public health. I don't mind anyway as it's seemed to eliminate the cold and flu. I don't think it's necessary year-round, but it'd be nice if we had seasonal masking (maybe something like from October to March).

F**k no. I'll only wear masks if I need to go out while I'm actually sick.

Masks are not fully going away, but they'll become fully voluntary. No public would stand for a post-pandemic mask order and any business that chooses to keep a mandate would likely lose a chunk of their customer base. It'll become a personal safety thing and we might wind up seeing about 20-30% of people keep using them during the cold and flu season.

I want to respond to both of these posts at the same time. As for the current mask mandates in place, they need to stay for awhile. To be honest, they should be one of the last public health measures to be rescinded. We're making very good progress with the vaccines and that is excellent news, but we still have quite some time before we hit something nearing herd immunity. Let's crush the virus before we start taking victory laps.

As for what I said about seasonal masking, I'm not arguing for a government mandate. It should be voluntary, for both businesses that want one and individuals that want to wear one. One of the problems prior to the pandemic is that masks haven't really been socially acceptable outside East Asia. It should be socially acceptable as a public health measure (once again, not arguing for a government mandate barring another serious epidemic or pandemic).

As for your response, DTC, I actually applaud your second sentence. If you and me and everybody else actually wore a mask in public when actually sick, we might have learned something from this pandemic going forward. How many would've considered wearing a mask in public when sick 15 months ago? When this pandemic is over and if people in this country (and the rest of the Western world) just started wearing masks in public when sick, we could seriously mitigate the cold and flu season (and coronavirus if it becomes a far less lethal endemic seasonal disease).