Outbreak caused by the SARS-CoV-2 Omicron variant in Norway, Nov to Dec 2021

Reduce transmission. Nobody serious ever said they would stop transmissions because they were found not to during their testing last year.

The end goal of any measure, including vaccine passes, has always been the same: preventing a large number of deaths. Vacccines still prevent a large number of deaths, both directly (strongly reduced risk of death from Covid) and indirectly (reduced strain on the healthcare system). These hold true even if vaccines only effect outcomes after getting Covid and have zero effect on transmission rates at all, they're not up for discussion. As such there really isn't much of an ethical dillema here. There is plenty of data available on all of these points. Whether someone somewhere incorrectly touted vaccines as stopping transmission at any point isn't worth discussion, it's just another one to add to the list of "uninformed statements made about vaccines" which is billions of lines long at this point.

Of course vaccines are about harm reduction. How can that be "not true" in any frame? What is even the logical alternative? Are we trying to reduce the infection count because smaller numbers are aesthetically more pleasing?

I'm not sidestepping the issue. There is no difficult ethical dilemma here, and nothing changed with the new variant.

If there was a mistake regarding the vaccines, it was to discuss vaccination as optional opposed to the clear ethical obligation that it is. Just like no one is entitled to store unstable explosives in candlelight in a shed next to their neighbour's house.

Vaccines did stop transmission before delta. That's why many countries weren't big on vaccine passes, we just needed to get higher than the herd immunity threshold and it was fine, a few antivax wouldn't have changed the equation that much.

Now, herd immunity is just a dream, we can't count on the vaccinated to protect the unvaccinated anymore. So, plan B, and as it turns out, the key of plan B is also vaccines, but now we need 100% vaccinated, not 60%, so, vaccine passes.

Maybe it will change if we get better treatment, or if the virus mutates to be less lethal to those with no immunity. But for now, get vaccinated or stay at home.

This is the issue with discussions like this. Arguments about any medical intervention is always about statistics, there are essentially no 100% measures, but you and others always frame this as either or questions that's either completely naive or dishonest. So yes vaccination was also stopping the spread, but nobody thought it would 100% prevent a vaccinated person from getting infected. However it does significantly reduce infection rates and severity of the illness. The hope/assumption was that if sufficient people get vaccinated and the infection rate for vaccinated people drops enough it will stop spreading of covid. AFAIK It's unclear yet if that we haven't stopped the spread is due to insufficient vaccination rates or insufficient drop of infection rates for vaccinated people. This analysis is further complicated by the advent of new variants like omikron.

Last time I checked, invaccinated patients were vastly over repredented in hospitalization and ICU occupation. No indication, but hard facts.

If vaccines prevent serious cases and hospitalization for a large percentage of people, and they do, we would be all good if vaccination rates reach sufficient levels. Until they do, the very limited ICU capacity will be taken up overpropertionally unvaccinated. And we will continue to have problems.

> the overall vaccine outcome is not one that solves the problem in any meaningful way.

Only if you think that "people not dying" isn't meaningful, anyway.

But it did prevent the index patient from becoming seriously ill (i.e. hospitalised). It most likely reduced the initial dose of all that got infected by patient-0 [0]. And it most likely prevent _any_ of the invected to become hospitalised either.

Now you can make the argument (or at least attempt to make this argument), that it would have been _better_ for patient-0 not to be vaccinated, because then, maybe, patient-0 would already have been sick and not at that party. Unfortunately this is the main problem of Covid in the first place: A significant portion of the downstream infections are generated before the onset of symptoms.

So yes, the vaccine didn't prevent much of the spread [1], but it still reduces the amount of strain put on the health care system. Somewhere upthread there was the question: "How do the few unvaccinated overwhelm the hospital system?" The answer is: We can't deal with 1% of society being in the hospital. So getting 5% of all unvaccinated there and having 20% unvaccinated is already too much!

Last year we managed, because we radically cut down on all interactions and delayed the spread that way. We _can_ do that again. But then this Christmas party just wouldn't have happened at all!

[0] Note this is still somewhat a conjecture, as actually getting clean data for this is nigh impossible. [1] I'd still take the 30% reduction, but it's an upper bound and can still decrease. So yeah, let's call this "doesn't help slow down the spread"

The theory that vaccinated people are less careful with socialization and pay less attention to symptoms is the exact same argument being made about masks. This makes agreeing or disagreeing with the theory a bit socially complex.

If we agree that protections like vaccinations and masks do effect people to behave more risky, then the benefit of masks need to be balanced towards that negative effect.

If we disagree that protections like vaccinations and masks do effect people to behave more risky, then the benefit of vaccinations need to be questioned.

Either way we are questioning the effectiveness of masks and vaccinations, two topics which is quite controversial to question.

that is probably because the first to be vaccinated are the old, weak or diseased people and the unvaccinated are children with strong immune systems.

Seasonality is just one of many factors that affect the spread of COVID. Blindly comparing the situation now with one year ago really doesn't make any sense.

Vaccine efficacy against infection has been measured in a lot of studies, for example [1, 2, 3]. It has also been shown that being vaccinated reduces viral loads after infection, even with the delta variant [4, 5]. There are also a few studies on household transmission [5, 6] that show that transmission between vaccinated individuals is significantly less likely.

[1] https://www.nejm.org/doi/10.1056/NEJMoa2114228

[2] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410

[3] https://www.science.org/doi/10.1126/science.abm0620

[4] https://www.nature.com/articles/s41591-021-01575-4

[5] https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

[6] https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6...

Last year had the original variant and this year delta. In addition last year most countries already were in lockdown since October while this year lockdowns just started mid December. In addition there are still less hospital space taken by covid patients conpared to last year, although the problem here is also mass resignation of medical staff.

How is that not much better on all fronts?

Early as in "apparently that person has an infection building up, there's a small risk of it getting very bad, do we get out the rare, expensive early treatment pills full of side effects for this one?"

I've heard one tiny statement about that question, it sounded like strong focus on practicality. Like cases already in treatment/observation for unrelated reasons (but likely increased risks). Certainly no "oh, your test pinged positive? Here, have these for five days" anytime soon.

Or just user error, though that could fall into a technical reading of "guest evaded taking one at all".

At least in my social and work circles, it's pretty normal to take a test before attending a larger gathering, or meeting more vulnerable people.

But then, Denmark has an average of 17 tests per person, the highest in the world by some margin.

Norway is 1.6 per person, Finland 1.5 and Sweden 1.4.

Based on what evidence you making that statement. For myself living in Sweden I can say that almost everyone does a self test when they have even the slightest of symptoms. Also I would argue of all places in the world, Scandinavia is probably the place where one would find the lowest propability of lying about a test.

I know someone who just got a positive PCR test and still got two negatives on at-home test kits.

I think you mean false positives? Or are they just bad all-round?

Relatively high yes, but with emphasis on the relatively; I would be surprised that there would have been more than 3 false negatives.

And only the one person returning from South Africa would have needed to actually be a false negative. The rest may have been true negatives.

Do you have a source for this? Everything I've read about omicron until now is "we don't know".

How does ADE come into this when it's just about transmission? From what I understood, ADE is mostly about severity of illness, and the severity looks to be down across the board.

I agree. For all we know, it seems covid has mutated into a common cold virus.

The Health Minister reported that South Africa saw 1.7% hospitalisation in the second week of the omicron wave vs. 19% hospitalisation in the same week of the delta wave [1]. Hoping the trend towards milder disease continues to pan out.

[1]: https://www.bloomberg.com/news/articles/2021-12-17/s-africa-...

I’m sure in a few weeks we will discover there was already widespread domestic transmission of Omicron, in Germany.

When Omicron was initially discovered, the United Kingdom promptly closed its borders to several African countries—but oddly not whiter infected countries like The Netherlands.

This was of course pointless politicking, and did nothing to stop the spread of Omicron in the UK, which was already established.

If only the UK had instead chosen to implement decent sick pay, or immediately ramp up the booster program, or implement work from hone guidance. Instead the UK let it rip fir three weeks, before suddenly panicking.

This is not really true. Tests taken by professional test centers have only been chargeable for sth like 2-4 weeks in November for unvaccinated people - this attempt to let unvaccinated people pay for their play did not work out very well, so tests are free for all again. There also is no shortage in test kits, you can buy them by the hundreds in regular supermarkets.

Maybe the decision is purely political? As you explain, it's not logical at all.

Not too late for politicians to be seen doing something. Just remember, in times of crisis, they did something, and they did it in public!

The data in question is anonymised patient data. I believe this is not available publicly, only statistics.

Apparently this person is a retired NHS manager of some sort, probably got the data via an old colleague. If the data were public this argument could be definitively proved or disproved, but until then we need the pinch of salt that I noted in my comment.

Before Omicron, South Africa had COVID under control with very little measures and a low vaccination rate. The only reasonable explanation is that a large fraction of the population has already been infected and acquired immunity that way. This means that data from South Africa is probably not a good measure for how dangerous Omicron is for people without prior immunity.

No I don’t, but it’s not unlikely that omicrons risks for the individual could be similar to previous strains. Then there’s also high transmissibility. When following the precautionary principle we shouldn’t act expecting the best but the worst.