Update on Omicron

> The World Health Organization is urging caution after two South African health experts, including the doctor who first sounded the alarm about the omicron variant, indicated that symptoms linked to the coronavirus strain have been mild so far.

> The initial reported infections were among university students, WHO said, adding that younger patients tend to have milder symptoms.

> “Understanding the level of severity of the omicron variant will take days to several weeks,” WHO said in a statement, adding that “there is currently no information to suggest that symptoms associated with omicron are different from those from other variants.”

It's likely too early to tell yet.

It's frankly irresponsible to report this factoid without that caveat.

    It is not yet clear whether infection with Omicron causes more severe disease compared to infections with other variants, including Delta.

A long time ago, long before the pandemic politicized messaging so much, a researcher posted a comment here on HN where they said that virus deadliness and contagiousness were in tension.

We forget how good Western medicine is, but none of that is going to matter if the system is overwhelmed and god forbid we run out of O2.

Also I imagine most patients right now being hospitalized in South Africa have Omicron.

I'm really hoping this holds true as the situation evolves.

In the mean time, my concern with this statement is that Africa was already "doing well" against covid .. bc of a combination of low testing, but also they have a smaller at risk population compared to the west.

In the west we're a lot better at keeping vulnerable people alive a lot longer, which consequently winds up as the demographic covid likes to target.

Optimistically, I do think if omicron was an order of magnitude worse than what we've been dealing with, we would already see "hints" of such traits .. fortunately that doesn't seem to be the case, for now.

Moving forward, I hope everyone continues to treat this seriously .. but it's becoming more clear that covid is here to stay no matter what measures we take.

https://mobile.twitter.com/DrEricDing/status/146503795478362...

> Several scientists said they suspected that the variant had been spreading undetected in countries with lackluster sequencing efforts before it surfaced in Botswana and South Africa, giving it more time to scatter globally. Nevertheless, European nations did not find the variant until after South Africa alerted them to it, demonstrating the gaps in their own surveillance efforts. [0]

More on this can also be found here [1].

[0] https://www.nytimes.com/2021/11/27/world/africa/coronavirus-...

[1] https://www.linkedin.com/posts/graemecodrington_interesting-...

I'm for your proposal in the general aspect of it, but how do we take it forward as an actual plan?

I still don't think we'll eradicate it, but perhaps with lower levels of community transmission we'll reduce the flare ups of problematic variants?

While many African countries need more vaccines, South Africa was in the process of throttling shipments because less and less people were getting vaccinated.

So the other big challenge is raising acceptance of the vaccines and fighting denialism.

This is better said as "they are not produced fast enough". That will lead you directly to the solution, instead of losing time discussing the price.

It's a very similar thing, the price poor countries pay is not enough to justify investing in extra productive capacity. There is a confounding factor that new capacity takes a long time to arrive, but even when that is taken into account, there are just not enough vaccines and there won't be on the near future.

Besides, you are not even going to vaccinate 100% of any western country, let alone all of them or the entire world.

Milder mutation are what is actually going to make the virus endemic, like it happened to the Spanish flu. Reports from the South African government seem to suggest that this variant is mild, although it's early to say.

https://www.bloomberg.com/news/articles/2021-11-24/s-africa-...

Not to mention that climate in central Europe effectively stops virus from May to October so it will be way more efficient to vaccinate people in August and September.

Apropos of nothing, I was just listening to NPR and they had someone on to talk about how we don’t donate vaccines to third world countries because they are predominantly non-white and how this is “vaccine apartheid” rather than the more likely “rich countries provide for their own citizens before providing for others” sort of thing. Is there any legitimacy to this, or is it just racemongering?

Even if it were possible and achievable to vaccinate all humans, we'd still have a problem because COVID has spread to other mammal species. There's no reasonable plan that I know of to vaccinate animals in the wild.

https://www.npr.org/sections/goatsandsoda/2021/11/10/1054224...

> We’re all in this together. When COVID spreads in Africa and makes a new strain, it may as well be on your own doorstep. The world needs to step up and distribute vaccines to every corner of the globe, for FREE, or we’ll never get out of this.

But you're 100% right about this. I don't want what I said about your last sentence to diminish the importance of wealthy nations sharing the vaccine with other countries. We're all in this together. The idea that a country can vaccinate only their own citizens and then consider this problem solved is completely false.

I feel like that would help greatly to this end.

All for greater support of less developed countries in terms of vaccine supplies, but not sure this is the argument for it.

I understand the negative reaction to any authority figure forcing something, and I react negatively, to the point of using technical workarounds, to Australia's metadata retention rules and other privacy-related political BS.

Living in a functioning society requires the sacrifice of some freedoms for the benefits that a society provides. People that can get the vaccine have a certain responsibility to get vaccinated on behalf of those members of that society that cannot get vaccinated for valid health reasons, or even for the sake of children currently below the vaccination age range. The vaccinated are forming a shield around the more vulnerable members of their society.

Freedom of personal choice versus 'doing your bit' to protect the weak, elderly, and vulnerable. And most of us have family and friends and co-workers and acquaintances that will fall into this vulnerable category that we'd probably rather they stay alive for a little longer.

I just don't hear it presented this way very much. There's a lot of publicity around the actions of the freedom flag-wavers without too much of the other side of that particular coin being explained.

Like the economics of uber-capitalism being an unhealthy extension of capitalism, this is an unhealthy uber-individualism outgrowth of individualism. It's far more prevalent than I thought it would be, probably because we've had it so good for so long - nearly 80 years since WWII ended.

Edited to add two explanatory things:

1. If COVID sticks around, or if there's a new "thing" in one, two, three, decades' time, we'll be getting into that 'vulnerable' category. When that happens, how will you feel about large groups of 'kids' (25 - 45 year olds) protesting getting vaccinated against a disease that may be very mild for them but fatal for you?

2. I personally know someone, of my age, with COVID-long. The symptoms are something like chronic fatigue syndrome. As a result they're essentially a non-productive member of society who used to be a productive member of society.

The current thinking is that new variants are most likely to evolve in immunocompromised patients who experience persistent infections. Vaccines aren't very effective for such patients.

https://www.scientificamerican.com/article/covid-variants-ma...

I completely agree that we should donate vaccines to low income countries. The US federal government has donated 264M doses so far with more on the way.

https://www.state.gov/covid-19-recovery/vaccine-deliveries/

When I hear words like everything, everyone, everywhere to describe any system I get disheartened failure is almost assured. I wouldn't design software like that for example. Whether they are engineering systems, social systems, or in this case viruses. Relying on every part to comply is the opposite of redundancy. The probability of getting everyone to comply in a group as large as this planet all at once, at the same time without lags (e.g. vaccine rollouts), etc is sadly IMO extremely small.

We probably need new approaches, some which may challenge the current status quo. I remember watching a video early in COVID where isolating populations into smaller groups allows quick treatment of each group and the ability to contain the spread (i.e. limiting the R factor). As long as highly available world air travel is around, reducing redundancy and increasing the interconnectness of our populations into a single system the virus will have an advantage IMO.

So vaccinated populations are creating the pressure on the virus to mutate. And un-vaccinated population may get effected (irrespective of which version of virus they encounter at the time)..

my 2 cents.

This isn't quite true. All epidemics come to an end eventually, vaccines or no vaccines. There were no vaccines to end the 1918 flu epidemic, but that one too died out just like all the ones before it in a few years' time. At a far greater cost to human life, of course, but we "got out" of it.

I guess, we don't have good enough brain washing media compared to a civilized world. And when people are using their own heads, without trusting government, it sometimes results in a wrong common knowledge.

The problem in South Africa is vaccine hesitancy, not vaccine availability

https://www.usnews.com/news/world/articles/2021-11-24/exclus...

Not really. There is a very low evolutionary pressure to become less deadly.* You start infecting people in day 3, have symptoms on day 8 and die on day 20. You can walk around for a week infecting people before you die. Compare it to previous SARS epidemic, where people started infecting others much later. It just died out, because people were isolated at homes and hospitals.

*SARS-COV-2 is an upper respiratory track disease and SARS-COV-1 is a lower respiratory track disease.

The whole snippet here:

> WHO is working with technical partners to understand the potential impact of this variant on our existing countermeasures, including vaccines. Vaccines remain critical to reducing severe disease and death, including against the dominant circulating virus, Delta. Current vaccines remain effective against severe disease and death.

Vaccines work, boosters work, masks work, lockdowns work, and testing works. And the combination of these measures works. They operate in tandem. I am not advocating keeping all of these measures forever—merely noting that they are not, in fact, really that comparable to airport security.

When the genie was out of the bottle(as in containing the virus in China was not possible), they switched gears and went with the opposite narrative, even though not much was known about the severity of the virus besides it spreading very quickly and easily.This is not the scientific method, because if it was you wouldn't firstly claim it was nothing and then suddenly say it was so bad you need to half-ass shut down civilization.A scientific-method approach would have been: "we don't know" until "we do" , not to mention denying the claim it was a lab-leak (which is now the most probable thing).

As they say in politics & propaganda: "never let a good crisis go to waste".WHO and national institutions that were responsible for measures and actions governments should take are fully responsible, but nothing will happen.The fact people still debate about the origin of the virus should be indicative that facts don't matter, but twitter blue checkmarks and fact-checking labels on mainstream platforms do.

where is this person even from? She/he says senior scientist? Of what?

https://youtu.be/k_BaSdDNnVw

This appears to be an individual in the thought camp of "we don't know if it's a big deal so let's not treat it like one". I disagree, personally - we did that the first time and it made things worse. Why risk it?

>“‘Nu’ is too easily confounded with ‘new,’ and ‘Xi’ was not used because it is a common last name,” the WHO said, adding that the agency’s “best practices for naming disease suggest avoiding ‘causing offence to any cultural, social, national, regional, professional or ethnic groups.’”

>Those best practices were outlined in a May 2015 document issued by the agency. The organization said at the time that it wanted to “minimize unnecessary negative effects on nations, economies and people” when naming infectious diseases.

https://apnews.com/article/coronavirus-pandemic-science-heal...

If your reply is China's data can not be trusted, then Australia or NZ. But same conclusion, we can and should mitigate the virus.

Also, the economy is doing fine. Some places better than other, but we're much better off now than in 2009, the last global recession. If this is a crisis, it's milder than the last, from an economic standpoint.

Fact is:

- It is quite clear how to protect oneself. Wear masks, get vaccinated, try to reduce contact, keep distance.

- Governments need to balance safety concerns with concerns for the economy and the health system. Not an easy tasks and it's different everywhere.

- The only context in which it is important where the virus came from is science, and perhaps the development of better vaccines and preventing future pandemics. For the individual it is irrelevant.

- The question whose "fault" it is is totally useless. The virus is here and we will all get it. The only question is how we get through this.

I agree. Regardless of your beliefs about the pandemic and how it’s been handled, everyone is sick of this shit.

> governments and organizations like the WHO are not telling us exactly what's going on, they change the narrative everyday, apparently its a lab leak

This is because they don’t know. Maybe the Chinese government knows the truth. And maybe they’re telling the truth. But no one else actually knows and so it’s all educated (at best) guesswork and the media prints anything sensational for clicks.

> Apparently the people concerned about governments using this opportunity to grab more power to keep us all in order are crazy antivaxers, the moment you step out of line you become a "non believer" in science

I remain unclear what exact power governments are getting from this. They’re spending hundreds of billions on vaccines and tests. What are they actually gaining?

My impression is that governments are for the most part doing the best they can against a disease we don’t have good tools to fight. The best bet was social distancing until everyone could get vaccinated. Then it turned out that 1) tons of people are refusing the vaccines, and 2) no one ever really addressed the fact that the entire world needs the vaccine, not just wealthy nations.

This is why we are stuck in this shitty state of bouncing between open and locked down to the constant drumbeat of “please get vaccinated”. No one knows what else to do because the alternative of “fuck it” is also not a solution, at least not if you care about minimizing the death toll from this thing.

the only scrap of solace i've personally found in all this is that at least in historical terms, this isn't too bad as far as generational trials go.

if once upon a time we made it through great wars, then we can make it through this.

For all we know about transmission, you should stay outdoors, if possible. If this isn't possible, maximize ventilation. Limit contacts in general. Masks have a very modest impact on transmission.

This is not on me to solve. The government had enough time to convince everyone to vaccinate or prepare the healthcare sector for influx of cases of unvaccinated.

https://www.bitchute.com/video/UvuXzdVwj3ed/

Get lots of Vitamin D from sunlight and be sure to take your Vitamin C. Breathe lots of fresh, unfiltered air. Keep the curve low.

So it's become quite clear to me that we are not, in fact, "all in this together". The situation is that the ruling class are in it for themselves, and they are demanding everybody else lose their jobs and businesses and we comply and mask up and shut ourselves in, so that they all may carry on as usual and refuse to invest our own money in our healthcare systems.

Given what we know about this situation now, I think perhaps a better approach might be to instead not comply with these demands. Ridicule and hound and vote out anybody who insists that after two years of complying we have to continue to shut ourselves away because the healthcare systems they have not adequately invested in are still on the brink of collapse.

0. https://www.nbcnews.com/health/health-news/covid-antiviral-d...

Of course such a thing hasn't been invented yet (AFAIK).

I'm sure people under the threat of smallpox felt just like you.

I'd like to think so but I fear there's no selective pressure with regards to decreased lethality for COVID-19. An infected person has already spread it far and wide by before they even develop symptoms – if they die after spreading, where's the pressure?

> Why less deadly? Because a virus that is too deadly will likely die. It's why the Spanish flu is now just H1N1.

The Spanish flu mutated into a deadlier strain first.

Given how slowly SARS-CoV-2 kills you (if it does), there isn't any selection pressure to do it less often.

Indeed, my understanding is that no human virus has evolved to become less virulent. It is unclear why H1N1 disappeared a few years after it emerged as the Spanish flu, most likely it simply ran out of susceptible hosts. In particular, we have no evidence of a successor virus, evolved from H1N1, that was both less virulent and drove out H1N1 at that time.

I agree that annual shots are a very real possibility. I also share your pessimism about our response to global warming.

Without going into the medical and scientific reasons why this perception may exist among people, I'd just like to point out that trust in the media and other institutions has been sabotaged over the last 5-6 years among a non-trivial percentage of the population, perhaps permanently, just for the sake of political victory.

The lesson that these institutions should learn is a self-reflective critical one that they'll forever refuse to acknowledge. Don't cry wolf repeatedly for years and then complain that the ignorant villagers won't believe literally anything you have to say on any topic ever again.

Yes, provided that immunity gained by infection with Omicron also provided immunity for the other variants.

Kicking the can down the road is a good thing. It buys us more time to look for a more impactful solution.

we already know it's far more contagious but not if it's more deadly than delta with an r0 of 2:

> The estimated reproduction number, the average number of people that an individual is likely to infect, is almost 2 in Gauteng compared with nearly 1.5 nationally. https://www.newscientist.com/article/2299194-omicron-how-dan...

PCR tests cost something around 100€ a piece, so assuming Germany has ~90 million population, that's 9 billion Euros for a single cross-sectional population test.

Now let's add some speculative factors: Some 10 million (+/- 10 million) are strongly opposed to state-mandated measures. Some will evade the tests, some will fake them, some may become violent. These people are also among those who are most likely to be Cov-positive.

Also, testing the entire population would only help if you simultaneously lock down the borders to prevent re-import.

So while broad testing has its merits, I feel like the gains here would be mostly modest.

Probably because there aren’t enough qualified people to do the work. It takes a lot of people to manage a mass vaccination. Even just crowd control at a mass vaccination site requires quite a few people.

It’s not clear that capacity to vaccinate is a significant factor in industrialized nations at this point, anyway. Vaccine uptake had halted due to “hesitancy”, not capacity.

1. Tells anyone that's paying attention that any speculation is just that, speculation, and 2. Tells people that while we don't have answers yet, those answers are being looked for.

We don't know for sure yet one way or another.

Furthermore, airports are good places to track and study infections. Assume that this variant will spread worldwide. We've already been through this with the wild type, with Beta and with Delta/Gamma.

https://www.npr.org/sections/coronavirus-live-updates/2021/1...

One is the evolution of myxomatosis in Australia, it is a disease affecting rabbits. The disease split into 4 strains. Eventually the dominant one become, IIRC, one that had the slowest progression, but also was the deadliest overall.

Buns infected with that strain had larger chances of passing it on (since they were alive longer), and yet they would be more likely to die.

I guess evolution doesn’t care, and if a strain is more deadly, yet more persistent, it will win.