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There's not yet any sign that it's less dangerous than delta, and a more infectious but equally lethal virus is going to kill a ton more people owing to the higher infection rate, especially among the unvaxxed or unboosted. It's a bit counter-intuitive, and we'll see what the real-world numbers bear out if you don't believe the models, but immunologist twitter's on the grim side right now.

> and a more infectious but equally lethal virus is going to kill a ton more people owing to the higher infection rate

Not necessarily, if the less infectious one was already infectious enough that nearly everyone was going to get it eventually.

There is a difference in mortality between everyone going to get it during the next five years and everyone getting it during the next five months.

Only to the extent that ICU shortages cause additional deaths. If the healthcare system can mostly handle the surge in hospitalizations, then it wouldn't make a difference.

Another factor to consider is that every one getting infected quickly, and partial herd immunity being established sooner, could expedite the repeal of COVID control measures, and the dissipitation of the climate of fear, which are both incurring significant health, quality of life, and economic costs.

The World Bank estimates that COVID and its associated policies has already pushed 97 million people into extreme poverty. UNICEF says "Schools still closed for nearly 77 million students 18 months into pandemic": https://www.unicef.org/lac/en/press-releases/schools-still-c...

In the US, fentanyl overdoses during the pandemic have surged to become the leading cause of death for the 18 - 45 demographic: https://thenationaldesk.com/news/americas-news-now/fentanyl-...

Scientists have long known that social isolation is deadly, and if there's one thing that COVID control policies increase, it's social isolation.

You're ignoring all the cases of PTSD and people leaving healthcare professions in all this. 18% of US healthcare workers have already left the field. [0] Nearly 1/4 of healthcare workers show signs of PTSD. [1] I don't know what the overlap is, but these are serious things regardless.

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[0]: https://www.beckershospitalreview.com/workforce/about-1-in-5...

[1]: https://medicine.yale.edu/news-article/burnout-alcohol-ptsd-...

This is yet another factor to consider yes. But this pales in comparison to the number of people whose mental health is being adversely affected by the lockdowns/social-isolation/climate-of-fear. Look at scope of the global mental health epidemic:

https://www.theguardian.com/world/2021/nov/23/pandemic-hits-...

I disagree. The fact that this is affecting healthcare workers makes it worse, because it reduces our ability to deal with the virus in the first place.

Any back of the envelope calculations showing how you reach the conclusion that this is worse than the harm the COVID control measures are doing?

How much harm do you think operating with 20% fewer healthcare personnel would cause? Put me down for that much.

Keep in mind, this isn't just 20% fewer people to deal with COVID, it's 20% fewer people to deal with, well, everything, for years to come. I'm sure someone's done the calculations on what the consequences of a decimated healthcare system are, if you want to go look for them.

I don't know, how much harm do you estimate that causes? Obviously it's harmful, but what we need to do is compare it to the enormous harm of lockdowns and other COVID control postures, some of which I've documented.

I don't see where you've documented anything any more thoroughly than I have. This is a web forum, not a policy paper. You gave your 2 links, and I gave you mine.

How much worse do you think everything you've listed would be if we had started with 20% fewer healthcare personnel? Well, guess what. That's how bad it will be from now on, because we couldn't all cooperate to take measures to ensure the healthcare system didn't get overwhelmed in the first place, and doesn't continue to get overwhelmed.

On the face of it, your example is dwarfed by mine. Healthcare workers make up only 0.5 percent of the population. That means the direct mental health effects of limitatons on civil/economic liberties via lockdowns are going to impact 200X more people than the direct mental health effects of more COVID ICU cases on healthcare workers.

That's why I asked how you could arrive at the converse conclusion that lockdowns are net beneficial for mental health.

Another factor to consider is that unusual strain on the healthcare system lowers the average level of care. For example right now, most planable surgeries are postponed. This is not without risk either.

> owing to the higher infection rate

This. Just to emphasize the point: As long as the number of cases continues to rise, the situation will become more and more threatening, even if the falatity rate when infectied is low. It just takes longer. But it is harder to get it under control.

In other words: a low infection rate combined with a high fatality (per infection) rate would be better than a high infection rate combined with a low fatality (per infection) rate.

I'm really afraid it will mutate into something more serious as well as being as virulent as it current is. That would be really really bad.

I keep thinking about this. If you combine the probabilities that the virus will evade vaccines along with it mutating to be deadly, the combination is probably a very small number. However, Omicron is spreading all over the world which increases the chance this happens.

And this being an RNA virus it can and will change again, and what the parameters of that next version will be is anybody's guess.

That is not what typically happens though. There's no reason to expect it. It would be an anomaly

Except that happens all of the time, there's plenty of reason to expect it and it wouldn't be an anomaly.

From the AP's "Viruses can evolve to be more deadly" article[1]:

> Day said there are documented cases of animal viruses that evolved over time to become more lethal, including myxoma virus in rabbits and Marek’s disease in chicken.

> Some viruses provoke severe symptoms in their hosts that make it easier to transmit the virus to others. But those same symptoms can wind up killing the hosts.

> Adalja said one example is Ebola, a deadly virus that spreads through the blood and body fluids of infected people. Another example is norovirus, which causes diarrhea and vomiting, and leads to hundreds of deaths each year in the U.S.

> “The virus, speaking anthropomorphically, just wants to spread and have its genes replicated,” said Adalja. “If the best way for it is to spread by causing severe symptoms it will continue to do that.”

[1] https://apnews.com/article/fact-checking-011488089270

That's not the norm, that's the unexpected anomaly

No, that's the norm. The people that are repeating the 'viruses evolve to become more benign' line are about 40 years behind the times in terms of science as it is currently accepted.

Viruses evolve to spread as efficiently as possible, what happens to the host after they have spread is from a viral evolution point of view utterly irrelevant. So they can and do evolve to be more lethal. Maybe it takes a bit longer before you die but that's perfectly fine.

> No, that's the norm.

How is the norm for viruses to continue to become more lethal? That does not align with anything I've ever heard. That link doesn't even claim that, and that's a baseless "fact check" done by a mathematician acting as a false authority.

> How is the norm for viruses to continue to become more lethal?

The norm is for viruses to end up somewhere in the middle, but chances are that the lethality is still very high. The whole idea that viruses evolve to be less lethal simply isn't true and very much outdated.

> That does not align with anything I've ever heard.

That is possible, it is a pretty persistent thing but it has been dealt with decisively since the 80's:

https://www.researchgate.net/publication/224043344_Coevoluti...

In a nutshell: it is likely that viruses (and other parasites) change once they have made their jump to a new species. This change is mostly random, selection pressure will lead to maximizing for R0, which may or may not lead to a lower level of lethality but this is by no means guaranteed. Some outliers may evolve to become more lethal, some other outliers may evolve to be (much) less lethal, but for the bulk an intermediary level of lethality (which can still be very high) is the normal outcome.

This is experimentally confirmed over and over again over the timescales that we have been doing these.

The shortest way in which you can condense all this is: "to a virus it is replication that matters, not what happens to the host after it has replicated". Of course viruses don't have any conscious plan but the evolutionary mechanism selects for (more) successful reproduction so it will seem like that from the outside.

Truly deadly virus's don't kill a lot of people. Evolutionally speaking, it's not to their advantage to do so.

Take Ebola (a well known virus, with very high mortality). It's very hard for Ebola to spread. It tends to make people obviously sick, and also kills quick, both of which make it much much easier to control. I'm guessing you don't spend a lot of time or energy avoiding Ebola.

Contrast to AIDS, which did not make people sick, and so was easier to catch from a seemingly healthy person. From an AIDS perspective weakening the immune system against other diseases was a flaw in the plan. Once it became rampant though there were (and are) behavioral changes to reduce the chance of infection. Those behaviors are now "normal" because, well, AIDS.

The "common cold" / flu etc are all covid, or covid-like viruses that constantly mutate and constantly do the rounds. We develop immunity over time and they mutate into milder (but more infectious) versions. We take steps to avoid these, but meh, if you get it you get it.

Some behaviors from this pandemic will remain (stop letting - or worse requiring - obviously sick people come to work for example) - others will fall away (I don't see the mask thing sticking around forever...) We'll probably work from home more than we did before, but that was already a trend, this has just accelerated it. Even when we get back to normal I don't think I'll be flying to a city for random meetings anymore.

But HIV/AIDS does kill a lot of people.

Technically it doesn't - people don't die Of Aids they die With Aids.

But that's semantics. The point is that Aids has a long time between infection and death, thus encouraging spread.

Which is why you can't say that "Truly deadly virus's don't kill a lot of people." They can, and they do, there are many examples besides HIV.

Yes, my original statement was incomplete. More accurately I should have said that truely deadly viruses don't kill people _quickly_.

Ebola for example gets you sick, and you die quickly. This results in it not spreading well.

AIDS kills you very slowly (over multiple years) so it has lots of time to spread (fortunately for us it's hard to catch).

So the perfect virus would have the transmisabilty of Omicron, but with no symptoms for years - then by the time the first person dies we all have it already.

Fortunately we haven't seen that one yet (in my lifetime anyway) and to some extent worrying about it is fruitless because there will be pretty much nothing we can do about it.

You may as well be worried about every other ELE - asteroids, alien invasions etc.

> Evolutionally speaking, it's not to their advantage to do so.

There are no goals, paths or planning in evolution, evolution is the result of chance. Selection pressures are what keep the effects of genetic mutation in check. The selection pressure that might cause a virus to become weaker is the result of the virus literally dying in all of the corpses it creates, while weaker strains potentially live on in the hosts they didn't kill. People aren't dying in droves because of COVID, so that selection pressure doesn't exist, and the virus is free to mutate into more virulent forms.

Also, evolutionary timelines span many, many human lifetimes. In that time, a virus could very well become more fatal, wipe out entire species and die off itself like the majority of species in the history of the Earth, or it could become endemic in a different species afterwards and live on.

It's obviously mutating all the time. But if a particularly lethal version mutated into being it would quickly kill the host, thus not spreading far, if at all.

Thus natural selection optimises for forms that spread but don't kill.

> Thus natural selection optimises for forms that spread but don't kill.

It may also find an unlucky local optimum where it shows no symptoms for a period while already being highly transmissible and then slowly kill or leave the survivors with permanent damage.

This is part of why AIDS is so bad. We're just lucky that AIDS is hard to catch outside of well understood behaviours.

Mix AIDS with Omicron and you can stop bothering to save a pension.

This is simply incorrect. There are plenty of viruses that end up with an intermediary grade that may well have very high lethality. Once a virus has spread what happens to the host is irrelevant, including death. See May and Anderson's paper from 1982: Coevolution Of Hosts and Parasites.

https://www.researchgate.net/publication/224043344_Coevoluti...

DOI:10.1017/S0031182000055360

> Truly deadly virus's don't kill a lot of people. Evolutionally speaking, it's not to their advantage to do so

The Black Death (1) and the Spanish Flu would like to have a word. Humans eventually evolved sufficient immunity to defend against the pathogen, but significant proportions of the population died before that happened.

(1) not a virus, IIRC, but the same evolutionary pressures should apply

I'm not a doctor but I belive the Black Death is bubonic plague, a bacterium. While yes that will evolve as well, the natural selection on bacteria happens on a very different time scale to a virus.

And hoping not to start a thread on antibiotics and superbugs, but bacteria do naturally select as well.

The Spanish Flu followed a similar path to Covid, it started deadly but then naturally selected to become less deadly. Its also somewhat unusual because of the numbers of displaced persons at the time returning home, the lack of basic medical knowledge etc.

But here's my point. The Spanish flu has mutated now to be basically Flu. It's not "deadly" anymore (for some definition of deadly). Non deadly mutations naturally select over deadly mutations.

It would depend on method of transmission. Bubonic plague was spread by rats. The hosts could be very ill or even dead; it didn’t matter.

Respiratory viruses that only or mainly have human hosts need ambulatory vectors.

Corona has other hosts, some of which seem to be unaffected by it.

virulent means serious (in its effects), not easily spread.

that's what he is writing.

There are lots of signs that it's less dangerous than delta, but too early to make definitive conclusions.

However hospitals are reporting fewer numbers,shorter stays, etc, so the signs we do have are encouraging.

The parent comment's point about increased infections still stands. Omicron might be less dangerous to the individual but its a disaster at the population level because many more infections mean many more hospitalisations even if more mild.

If it's milder, it can cause fewer hospitalizations while infecting a larger proportion of the population. It depends on how much milder, and how much more transmissive.

It would need to be less serious than the flu to not be a complete disaster - Omicron COVID spreads multiple times more efficiently than any strain of the flu does.

Many western countries you've had 10-20-30% of the population actually diagnosed with covid in the past. 60-70% vaccination rate.

That leaves only 10-20% of the population at risk of severe covid if vaccination and previous infection mean milder illness potentially.

Add to this that SA with 25% vaccination is seeing less hospitalisations.

Omicron in most western countries doesn't have many people left to infect. Those that do will see milder illness.

I don't see how this will threaten healthcare systems any more.

> Omicron in most western countries doesn't have many people left to infect. Those that do will see milder illness.

And here we are with hospitals being overwhelmed in Germany and France, for example, despite high level of vaccination and a lot of people who already had the virus previously. In France we have more people going to the ICU per day than during the last peak, and at the current rate we'll reach, and probably pass, the previous two peaks soon

All it takes is a few thousands of 50+ years old unvaccinated people to use all the ICU beds. In France we have 2m+ people over 50 who didn't even get the first dose, 1% of these 2m people would be enough to use every single ICU beds in the country

There is the sign! https://www.theguardian.com/world/2021/dec/15/omicron-found-...

> There's not yet any sign that it's less dangerous than delta, and a more infectious but equally lethal virus is going to kill a ton more people

This is only true if it’s a novel virus

Hospitalizations are not flat. They're doubling roughly every week [1], and are at close to 50% of their Delta peak [2].

[1] https://www.nicd.ac.za/wp-content/uploads/2021/12/NICD-COVID...

[2] https://yourlocalepidemiologist.substack.com/p/omicron-updat...

The first link seems to show a flattening. Where are you seeing a doubling per week here?

Ignore the last bar (2021.50) - there are reporting delays, and the total goes up as more data comes in. The following day [1] shows it at 6887, +1292 for the day, and the day after [2] shows it at 8019. This is good practice for any very recent (< 1 week old) data - expect there to be reporting delays, and that the most recent totals will be updated in the future.

If you look at the bars for 2021.46 - 2021.49, there's a clear exponential trend with a doubling time of about a week, going from 715 to 1446 to 3994 to 7558.

[1] https://www.nicd.ac.za/wp-content/uploads/2021/12/Datcov19_N...

[2] https://www.nicd.ac.za/wp-content/uploads/2021/12/Datcov19_N...

> We need to super-nova this thing

Is there a precedent for "us" doing this? Surely some pandemics have "super-nova'ed" themselves, but having "us" encourage faster and wider spread as policy seems risky and unusual.

People used to throw chicken pox parties to infect their kids at a young age because, while there is some risk to the young, it's much more dangerous to get chicken pox as an older person.

Do you know any other diseases where there's virtually no risk to young children but very high risk to the elderly?

Lots of them - polio, tuberculosis, chickenpox, influenza, ebola, typhus, salmonella, etc. There's a recent paper on this here:

https://www.nature.com/articles/s41597-020-00668-y

You forgot covid.

I'm not going to go so far as to say we throw Covid infection parties :) But things like travel restrictions, should (and in some cases are) being lifted.

I appreciate the need for govts to be seen to do something "new variant? quick, lock the borders..", but as data emerges that this is "the one to get" there's no need to inhibit the economy in the name of public health, when that inhibition leads to a worse, not better outcome.

Our best case scenario right now is that a) the virus spreads really fast, and b) it's not lethal (or at least no more lethal than anything else in life.)

Ultimately we all need to build up immunity from this thing - whether that's via vaccines or contractions everyone is free to take their pick. but 5 years from now we'll all have anti-bodies for it one way or the other...

i agree, no lockdowns or travel bans, but less drastic NPIs seem to be the way

Comparing the relative effect on a low vaccination coverage country with a high one seems slightly irrelevant no? i.e. delta variant is much less of a hospital burden in a high vaccinated country, therefore the relative danger of omicron could be much higher. If omicron was truly 'super weak' - wouldn't you expect to see the SA numbers go down?

I’ll continue to lean more cautious than optimistic with a variant that has the potential to start re-infecting our mostly vaccinated elderly populations at alarming rates. Our hospitals and medical staff need a reprieve as they already have a concerning backlog of non Covid related treatments.

Encouraging why?

A month from now a new vaccine-escaping variant could emerge from some squirrel in Haiti that's a billion times more transmissible than Omicron and a thousand times more lethal than Delta.

The fact that this particular variant isn't an absolute catastrophe doesn't mean that a new devastating variant isn't around the corner.

But that has never not been true in every time and in every place. Why get existential dread about it now?

Clearly we should spend all our energy, always, worrying about the near-uncontrollable realms of bacterial and viral evolution.

First death from omicron in US wasn’t vaccinated per breaking news just now.

Lots of people died this week from flu and the common cold as well, so let's not freak out just yet.

I've heard that the Pangolin variant could be 10x more potent than the Haitian squirrel variant. Why is everyone still going out, lock us down now !