Omicron Update, Dec 2
yourlocalepidemiologist.substack.com
yourlocalepidemiologist.substack.com
In my region people is pretty sensible about mask use etc. We relaxed a bit, but people still take care. I've been to Madrid and Barcelona for work and people behaves like this never happened.
I hope I get a chance to a boost shot, because I know a couple of dudes that got covid and the side effects are pretty ugly. I'd rather be in my bed with fever for a couple of days.
Given that widespread vaccination does not stop infection from spreading, lockdowns seem arbitrary and pointless. Especially when you consider economic consequences, which also inflicts very real pain and suffering on the populace.
Anecdotally, it doesn't seem to have made any difference at all in the US, state by state.
Edit: if Omicron becomes a second 2020, I'd pay close attention to how Sweden reacts, given their recent experiences.
[1]: https://www.businessinsider.com/sweden-covid-no-lockdown-str...
It’s not clear yet if it is putting any evolutionary pressure towards vaccine evasion (some people expect it to).
But SA is no more a breeding ground than anywhere else.
The well-documented breeding grounds are the immune suppressed, and it is incredibly unlikely that omicron developed in one of them.
No one ever claimed it would, except for the anti-vax crowd. Infection, transmission, and immunity aren't binary, and over 99% of domain specialists are in agreement on that. So why would you open your post with that claim?
And that’s why I started with this claim. Now, if you have an explanation as to why SA would be a better breeding ground for variants, I would love to hear it.
If you read my post in context, you would likely have noticed that, so I’ll wait till you do and if you have more questions I’ll consider answering them.
The Covid vaccine is very leaky, and Marek’s disease and it’s vaccine in chicken is an interesting comparison.
And I did not claim it was news - all I said was that there is no reason to believe SA is a variant breeding ground (any more than any other place) and explained why.
There are of course density, age, and other differences to consider.
https://www.statista.com/statistics/1104709/coronavirus-deat...
It’s also significantly better (x2-x4) than Israel by every excess death measure, where Israel locked down super seriously and vaccinated super quickly.
So you can’t conclude “it didn’t end well”
Sweden's numbers are really good all things considered [1]
This defies intuition, we would expect a "no restrictions" policy to result in significantly worse outcomes. Maybe the take away is that a healthier population and a better healthcare system is a more significant factor than restrictions and mandates?
Imagine seeing what's going on in eg Australia and still thinking this is about a virus!
One of the things I see "going on in Australia". Australia has had around 8 covid deaths per 100K population. Compared to, say, the United States with 237 covid deaths per 100K population. I see that and still think it's about a virus, yup.
In general over the past two years as a whole, people in Australia have lived with fewer restrictions or changes to everyday life than here in the US, with an order of magnitude fewer deaths. I still think it's about a virus, yup.
(I do not necessarily endorse international travel restrictions, including the ones the USA is enforcing, which seem to be pretty fruitless, and in some cases stricter than Australia's. I think they are mistaken. But it's about a virus, yup. Among other things, certainly US general xenophobia and anti-immigrant sentiment are involved in ours too. I too worry that we are imposing controls we will never see the end of, including related to border-crossing, which suits the agenda of some just fine. I'm sure it's about more than one thing in Australia too. Human things usually are. But it's about a virus, yup.).
It's just a question of timing. Late for Madrid, nicely timed for my city.
Another new problem I see is that healthcare personnel is burnt-out. Not only because of the insane work-hours and all the jazz, they feel mistreated by politicians and society in general, and I have doubts that if they get called for a new emergency they'll go contribute in the same numbers.
and by true, that means something you can actually validate isn't fake, while checking for ID at the same time. And also not allowing in un-vaccinated children because of fairness. Deadly viruses do not care about fairness
At least here in NY, USA - I have my vaccine passport checked very often, but verified with my ID about 10% of the time. So that wouldn't have the same effect
It is not the vaccine passports that stopped lockdown - in fact, there is no evidence they had any effect on transmission.
Also in NY (upstate). I can recall my passport being checked only once or twice since the beginning of the pandemic. I assume you're referring to NYC?
You are just pushing the work to be done by low-level employees at this point. Yes, it can work for a while but go talk to anyone who works in public event spaces (theaters, bars, cinemas, etc.) in, for example, Germany and you will see how much fatigue this causes.
And what happens when people get fatigued due to the extra workload created by forcing these measures to be taken by small businesses? People get sloppy, they get tired of a procedure that usually would take 2 minutes taking 15, chipping time away from other duties they are responsible for (and supervised). Over time they stop doing the checks properly and just like with other COVID measures, becomes increasingly ineffective.
I only had this realisation after chatting with some friends of friends in Berlin working in hospitality (hotels, bars, etc.) and events, almost every single one of them were exhausted from having to perform the extra checks on every customer, every shift, every play, every table they sit. They were trying really hard to not get sloppy because they actually care about the people, but it was clear how it was affecting them. It didn't look as a sustainable measure against COVID after 2 years of a pandemic.
That was also the fear I read voiced by experts during the first 6 months of the pandemic: people will get tired of the measures, when they get tired and don't follow them anymore it gets much worse. How to balance that is exactly all this political game going on, there is no simple solution when we talk about population levels of a nation.
So to answer your question, you would have to define 'objectively better'. Are you referring to economic outcomes, number of deaths or some other measurement?
https://www.nature.com/articles/d41586-021-02054-z
Vaccination rates in the US have been abysmal by developed world status, precisely because so many of you don't think vaccination works. It does work to dramatically slow spreading, but only if enough people take it up.
But the virus is endemic and vaccines will not stop it from being caught by everybody at some point.
You can't lockdown the virus away. You can't stop the spread by canceling flights either. Just seems like awful policymaking driven by virtue signaling.
Covid is here forever, and that's life.
In places where hospitals were under capacity, deaths were significantly lower. Germany is a good example of this.
Overwhelmed healthcare systems, by comparison, saw lots more deaths.
Once it escaped Wuhan the goal was no longer to contain, but to control and soften the impact.
Vaccination stopped smallpox and polio. Failure at Zero Covid is the result of poor, anti-realistic policies and attitudes - like yours, for example.
It's not because it's impossible, either economically or scientifically.
Vaccination did not stop measles or whooping cough, and has not even reduced their spread (only their symptoms) despite decades of availability.
Both of their vaccines are leaky - just like the Covid vaccine.
Measles vaccine is, indeed, likely the best vaccine ever in terms of efficiency and safety. It’s also sterilizing rather than leaky.
Plenty of people live their whole lives without catching smallpox or polio. We have/can develop effective vaccines for COVID. Why should it be different?
Not all viruses are the same, and sarscov2 is much more like cold/flu than polio.
Specifically, saracov2 has reservoirs in animals. Unless you had an effective vaccine that also works for cats, dogs, deer etc and the ability to actually deploy it (think wild deer all over the US), it’s here to stay.
I fully expect to contract the virus at some point, and that's fine. I'm well protected by vaccination and the rate of propagation in the country is moderate enough that the hospitals aren't being overwhelmed by huge surges in infections and deaths any more.
Slowing down and limiting the impact of the virus doesn't stop it, correct, but it does massively reduce the damage it causes. That is very much worth doing, as the experience here in the UK clearly shows.
Did the stricter lockdowns make a difference in the end?
We were hammered early on because we are very highly connected with the rest of the world. London is very international, and Heathrow is one of the busiest airports in the world, out of proportion to our population size. We were always going to take a heavy hit.
Nevertheless as soon as vaccines became available we have had broad adoption, and ever since we've been reaping the rewards. Delta arrived here early, but by then our vaccine take up was enough that it didn't really make as much of an impact on us as it has elsewhere.
It's just amazing to me that in 2021 here on HN the fact that vaccines protect against viruses is an actual question, or in any way political.
They likely also have some marginal impact on transmissibility.
But the data shows pretty clearly that the effect on reduction in transmissibility is quite low, or else there would be an obvious relationship in the data in infection rate vs vaccine uptake... Which clearly there isn't. If you believe otherwise, please share data proving some macro effect of reduced case counts correlated with vaccine uptake.
There's nothing political about what I'm saying. I am arguing against policies that are not backed by the data or science.
People proposing policies that are not evidence based are the political ones.
Good thing we didn't take that attitude with smallpox. Or polio. We have eradicated disease. It's not like we've never done this before.
There's something called proportionate response. Personally I think policymakers should consider the actual pros and cons and the weight of them, rather than virtue signal as if everybody can be saved from every ailment, and acting as if second order effects don't exist.
We also could have locked down every winter to save people from dying due to flu. Why do you think we didn't do that before, when it could have saved hundreds of thousands of lives? Why don't we wear masks 24/7 to protect from flu?
https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...
The first study finds that "The SAR [secondary attack rate] in household contacts exposed to the delta variant was 25% (95% CI 18–33) for fully vaccinated individuals compared with 38% (24–53) in unvaccinated individuals" and "Fully vaccinated individuals with delta variant infection had a faster (posterior probability >0·84) mean rate of viral load decline (0·95 log10 copies per mL per day) than did unvaccinated individuals with pre-alpha (0·69), alpha (0·82), or delta (0·79) variant infections." (The study did not determine a meaningful impact on peak viral load and on the SAR in households when the index case was vaccinated.)
The second link is a letter that reiterates the fact that vaccinated index cases are just as likely to infect other household members and concludes with "It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission when deciding about public health control measures", which makes sense, but does not mean spread
When you say "which is evident just by looking around what's going on everywhere", it's important to point out that we're now dealing with a variant that is significantly more transmissible than previous ones, so we can't compare the numbers like-for-like.
> It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission
You're going to have to dumb it down for me as to how this doesn't refer to spread.
> we're now dealing with a variant that is significantly more transmissible
And yes, agreed. Many are still focused on data from the previous variants though, whereas the thinking will need to change.
Vaccinated index cases infecting others in the same household are only one scenario, and in that particular scenario, the study found no impact on spread. The study did find that vaccinated household members were less likely to be infected (SAR 25% vs. 38%) and that vaccinated cases had a faster rate of viral load decline - both of these findings (especially the first one) also relate to spread.
(It's arguably a bit surprising that the faster rate of viral load decline did not have an impact on the SAR for vaccinated index cases - one could make a (hopefully) reasonable hypothesis that this would matter more outside of household settings and thus still have an overall impact on spread, but that's not backed by any data from this study.)
There's also a world of difference between not "ignor[ing] the vaccinated population as a possible and relevant source of transmission" and saying that it doesn't stop spread to any significant degree. It's not binary.
> Prior to the emergence of the delta variant, it was reported that the risk of symptomatic cases in household contacts of vaccinated cases was about 50% lower than that among household contacts of unvaccinated cases(22). However, the impact of vaccination on reducing transmission in the context of the more transmissible delta variant appears to be lower(23).
https://www.who.int/news/item/24-11-2021-interim-statement-o...
[0] The first link I posted, reference 23 in the WHO statement
Scenario 1: A vaccinated household member (the index case) is COVID-positive. The study finds that other household members are just as likely to get infected regardless of the vaccination status of the index case. There is no reduction of spread.
Scenario 2: Some household member (regardless of vaccination status) is COVID-positive. The study finds that other vaccinated household members are less likely to get infected. Spread is reduced.
That's basically what the WHO is saying - we may have had the positive impact of scenario 1 prior to Delta, but that's mostly gone. Scenario 2 still shows some effect on spread. It may be lower now, but it's still significant.
The article also states that "Vaccinating school-aged children may help minimize school disruptions by reducing the number of infections at school" and "there are benefits of vaccinating children and adolescents that go beyond the direct health benefits. Vaccination that decreases COVID transmission in this age group may reduce transmission from children and adolescents to older adults".
Not downplaying anything here. Reducing the symptoms is great. But interesting also to not that we don't even knows why it does that:
> The reason for the efficacy of the new mRNA vaccines is not clear.
How do you draw that conclusion? I never said that. Vaccines work across the board. But to illustrate an extreme, they do practically nothing to kids. For 80+ year olds they're miracle drugs.
There is not widespread vaccination, though. That's where your argument falls apart.
In the US, the CDC stopped publishing the data one would need to get answers on this in May. For some reason.
Citation please, because you're challenging the entire field of immunology here.
Look at the trends in Italy, UK, US, for example.
I agree the vaccine helps, but there is no clear impact on reducing spread if you look at infection data in aggregate.
We've gone from 0% vaccinated, to 60-70% with no discernable dip in infection counts.
Taking for example the NL numbers: we have twice as many cases/day as during last winter's peak, but only half as many deaths/day. Naively, that suggests that the vaccines reduce case mortality by 75%. But that data is also hopelessly incomplete: we recently reinstated some of our lockdown measures, so the number of infections/day is stabilizing, but fatalities/day will probably keep rising for another week.
I am disputing that lockdowns have led to any discernable difference in outcomes over the long run in regards to case counts.
New Zealand may be the special case where they were able to actually completely halt inbound travel. But obviously their situation doesn't generalize.
The vaccines have been instrumental in getting back to normal.
Italy had severe shortages of medical supplies that led to many medical workers on the frontline to die of infection.
Your personal life bubble does not reflect the rest of the world. Asserting "most places" weren't under collapse is quite strange given that it's patently false.
I just took Finland as an example, since I have family there and happen to follow closely what's going on there (so I don't have to look things up).
And you brought up two examples. Need I remind you how many countries/regions/cities there are in the world?
If you disagree, use hard data to support your assertions that vaccines have noticeably reduced infection rate.
The one following the science is the one using the data, by the way. Anything else is religion.
So no, you don't get to claim "hard data" on your opinion.
This is called verifiable data.
Also the numbers in the US south are roughly equivalent to the east/west that had much more stringent lockdown, mask, and vaccine measures.
If these policies had any significant impact, you would see a large disparity in outcomes of TX, FL, vs NY, CA.
This is also verifiable data. Prove me wrong with data showing FL and TX had worse outcomes in regards to infections to blue states with strict measures.
If you can't show a significant difference in outcome, reassessing your firmly held beliefs that have been proven wrong through data is called "following the science".
Most lockdown proponents are following religion, and what they desire to be true, than science.
There's numerous confounding factors in these numbers that you conveniently ignore, and that you keep ignoring even when they're pointed out to you. This is called doubling-down on an indefensible position.
Then, instead of defending why your use of those numbers is scientifically sound, you accuse others of having "firmly held beliefs". This is called a personal attack.
And lastly, instead of doing the hard work to show why your conclusion is scientifically sound, you expect the other party to disprove your argument for you. This is called trolling.
All you've done is is ad hominem and provide no data. I am at least referencing factual data. Looks like I'm following the science and you're not.
Explain the confounding factors for how Texas ended up very similar to NY, despite obesity and comorbidities being much higher in the south. I can tell you from living in both places through the pandemic, that the populace of Texas doesn't care at all about covid and largely takes no precautionary measures vs New York residents who are much more diligent about masking and protocols.
You won't do it because the data doesn't exist to do it. The differences between states with vastly different policies are super marginal. If there was any strong effect, you would see an obvious disparity in outcome.
Does everybody staying inside reduce transmission? Yes, in the short term. Does it do anything in the longer term? No, absolutely not. Unless the draconian lockdown is done in perpetuity, which has devastating consequences.
If you choose not to spend 1 minute to Google it, that's your prerogative. I'm not going to cite my comment like a research paper when the verification is a Google search away.
If you disagree with the stats, feel fee to provide evidence that refutes it. That would enhance the conversation.
Only because they're partial and temporary. NZ and Australia went into a full borders closed lockdown and were back in stadiums with tens of thousands while the epidemic was in full swing in the rest of the world.
I mean, I get that it's a morally difficult one because freedoms and rights and shit, but if the world went into lockdown for a month when this thing first came out, we wouldn't be in this situation.
The 'lockdowns' we get now are compromises; in my own country, their aim is to keep the economy going and kids going to school, even if workplaces and schools are probably the biggest spreaders. I say probably, because they announce new measures without providing evidence that the actions they take are the most effective at stopping the spread. Things like closing shops at 5; where are the facts that open shops after 5 are the biggest problem?
Excess mortality in the USA and the EU in 2020 were ~470k and ~580k deaths.
The population of the USA and the EU in Jan 2020 was ~329 and ~447 million.
The excess mortality in the USA and the EU in 2020 was ~143 vs ~129 excess deaths per 100.000 inhabitants. The USA had ~10% more excess deaths per capita than the EU.
People living in the EU during 2020 had statistically a significantly better chance of not dying of COVID than people living in the USA, even though COVID hit the EU first, which gave the USA longer time to prepare.
This doesn't really answer your question, because the answer is very personal. Some people were really scared and preferred to trade some freedom for more safety. And well we have many examples of vocal famous people that traded off safety for freedom, and died of COVID. These people would have probably been better off had they lived in the EU, even if they would have been breaking the law and paying fines.
With such drastic policy differences you would expect to see a larger effect.
In the US, you'd get a few thousand $, many months later. So yeah, you might have had a similar chance to catch COVID but your livelihood and financial security were much more secure in Europe.
Policy-wise w/r/t COVID, EU and US are nowhere near NZ, Tiawan or China. Now that's containment taken seriously and it shows.
You can see the aggregate personal income data here: https://fred.stlouisfed.org/series/PI
The Nordics, France and German-speaking countries have half the death rate of the US or less, in some cases even negative excess deaths.
There was no pan-Euro response nor was there a pan-American response, so these groupings are arbitrary. Unless you have an objective "score" that Euro lockdowns and policies on average went further than American lockdown policies, these numbers are meaningless.
You could easily justify the differences as deriving from Europe having an objectively healthier population and better healthcare systems than the US.
I never claimed that this data is the result of COVID policies.
This is something you made up, and then proceeded to debunk, which is essentially the definition of a strawman.
Please stop building strawmans and putting words in people's mouth. It's unpolite.
It's not clear you're making any claims at all, which begs the question why you bothered posting in the first place.
Excess mortality is the only fact that we know for sure given that every country counts "COVID deaths" differently.
Given that there is a statistical difference, the only thing we can probably know for sure is that an individual chances were slightly better in the EU.
The difference is small, like others have mentioned, so it doesn't seem like EU policies did a lot for the whole EU.
This makes sense, since for example Germany had pretty harsh policies, but due some of its neighboring countries having pretty lax policies (e.g. Austria), some parts of Germany were extremely affected (e.g. Bavaria).
This hints that it doesn't really matter if single states have harsher policies as long as neighboring states do not, at least for states of the size of Germany.
If we look at China, which had a very cohesive policy in all its provinces, the story differs.
This hints that if cohesive policies would have been taken at EU and USA scale, the outcome might have been different.
That didn't happen, so we will never know for sure.
This doesn't answer the OP question, but if someone claims to have an answer, they are probably lying, because we don't really have facts to back that answer up.
I think this one might be The One. Everyone will be immune soon, perhaps, one way or the other. But if Omicron and Delta compete, then it seems plausible that the existing vaccines would at least help a bit with the severity of symptoms.
Of course, once this happens, people will forget it ever happened and ignore the next warning signals.
> Dr ANGELIQUE COETZEE, the doctor who alerted the world to the Omicron Covid variant, says we are over-reacting to the threat
https://www.dailymail.co.uk/debate/article-10256373/Dr-ANGEL...
most researchers i've heard on the topic only said "we will have to pay close attention to it", which sounds pretty reasonable from my uneducated perspective.
They say we are over-reacting because many places are doing more than paying attention to it, making policy decisions and instituting additional restrictions based on unproven fears about it, not just paying attention to it.
The South African scientists who discovered it don't have more authority on the topic than everyone else, but they have as much or more than many. They have more than, say, me. They probably have as much as most other scientists in the field, since they're on the ground with access to evidence, and for longer than anyone else.
That's not how epidemiology or even science works. There are so many variables at play that a response in one region might not make sense in another region, and the same goes for the virus's behavior.
By then it's too late. Obviously.
That's the problem with exponential growth. Not much seems to happen until suddenly it all happens at once, and the only chance to prevent that was a few weeks ago.
Is your suggestion, what, to impose the strictest restrictions possible everywhere, forever, just in case, because by the time we know it's really necessary it's too late, so we should always do it without knowing it's necessary?
Like, what do you think should trigger restrictions? Just finding a variant? Should all the variants Alpha through Mu have triggered global worldwide lockdown, because if they had turned out more dangerous than they did, by the time we had found that out it would have been too late? Basically we should lock down until there are no more variants? (Will that ever happen?)
Threat level ORANGE!
The first doctors seeing HIV cases in California without knowing what it was, yet alerting the medical community, were not the same people who brought us the current medication that controls it
Her position on the front lines is very important. But the decision on how dangerous the variant is should be given to those who specialize in just that (and would probably suck at diagnosing you with a stomach ulcer)