Corona Virus: It's a Marathon, Not a Sprint

[Smoove_B]

I can only hope their cases reinforce just how important it is to be masked around people outside your own household right now, especially while indoors. And to wear the best mask you can get your hands on, ideally an N95 or close equivalent. If you can't acquire one of those, wearing a fabric mask over a surgical mask seems to be the recommended option now.

I know this a difficult time but the upcoming holidays have the potential to really launch this into the stratosphere. I'm not talking about death anymore, I'm referring to whatever % of vaccinated people that are going to need medical care because of breakthrough cases - people that will absolutely overwhelm our medical systems. Case in point - Rhode Island:

Rhode Island hospitals are teetering on the brink of disaster, the association representing emergency doctors warned in a startling letter to the governor and state Health Department.

“Any added strain right now will lead to collapse of the state healthcare system,” Dr. Nadine Himelfarb, the president of the Rhode Island chapter of the American College of Emergency Physicians, wrote in a Tuesday letter. “We, a collective group of emergency physicians, are terrified for the future of healthcare in this state.”

But it's this quote that you can't help but ponder:

“No one who is practicing medicine alive in this country right now has ever experienced what we’re going through right now,” the president of the Rhode Island chapter of the American College of Emergency Physicians told the Globe

Considering what we all just lived through over the last 2 years and what these people have already seen, that should give everyone pause.

[Kraken]

And yet, my friend who's a doctor in Mich. just posted a picture to Facebook of himself and his family, unmasked, at a sports stadium in Detroit. A couple of weeks ago they flew to Jamaica. Of course everyone is vaxxed and boosted, but he's smart enough to appreciate the risks that they're taking and know how the virus spreads. He works in a hospital and is painfully aware of the healthcare situation in Mich. There's nothing I can tell him that he doesn't already know.

I don't quite understand where he's coming from. Everyone in his family is out in the world regularly, so maybe he figures they're already so steeped in the virus, and it's so ubiquitous, that there's no point in trying to hide from it. His wife (also my friend) believes that everyone in their family has already had covid, although they never tested for it.

Next time we have a zoom call I'm going to ask for clarity. I hate to put him on the spot or sound judgy, but I want to understand their cavalier attitude. Maybe it's just fatalism.

[Smoove_B]

Next time we have a zoom call I'm going to ask for clarity. I hate to put him on the spot or sound judgy, but I want to understand their cavalier attitude. Maybe it's just fatalism.

Could be so many things - including a sense of deserved R&R, which is understandable. But I think more of it is the message everyone heard back in May of 2021, namely get your vaccines and then you're done -- you have no more obligation.

Now that we know vaccinations aren't stopping spread and we now have two variants that have evolved in such a way to (1) replicate faster, (2) ultimately achieve much higher numbers (Delta and Omicron) and (3) evade immunity (Omicron), the fact that we're not masking anymore is our undoing.

The masking message has completely been lost, even among doctors and staff. I went back in September to have my heart stress test at an outpatient center. Everyone there was wearing surgical masks. I was the only one wearing an N95 equivalent. I was half expecting them to ask me to take my mask off and put on the surgical mask because that's what the official policy states as requirement to enter the facility; most hospitals are the same. My mom is getting ready to go in for her 3rd heart ablation and that's all anyone is wearing.

My aunt went to visit a specialist a few months ago and once they were in the examination room, he took off his mask and told her to do the same - it was fine, they were both vaccinated. Thankfully she's a disciple of Smoove_B and told him not only was she keeping her mask on, but if he didn't slap one back over his face she'd be leaving.

That is what is making this all so difficult. The vaccine is modern marvel - truly. Absolutely amazing what was created in such a short (relative) period of time. But that we are unwilling to promote and accept masking? It's going to be a dark winter. As others have noted, I'm not afraid of the virus - I'm vaccinated and hopeful it will protect me. I'm more concerned I'm going to get into a car accident and be taken to a hospital that has been completely overwhelmed with COVID-19 patients....again.

I suspect that what happened to Elizabeth Warren (Corey Booker, Brian May) is because of that mask messaging and becoming too casual/comfortable in being unmasked around people that aren't in your immediate household.

[Kraken]

Next time we have a zoom call I'm going to ask for clarity. I hate to put him on the spot or sound judgy, but I want to understand their cavalier attitude. Maybe it's just fatalism.

Could be so many things - including a sense of deserved R&R, which is understandable. But I think more of it is the message everyone heard back in May of 2021, namely get your vaccines and then you're done -- you have no more obligation.

Among my very small circle of remaining friends, everyone's risk tolerance is higher than mine. They're all traveling and dining out, as one must do when traveling. Some are going to museums, movies, and other entertainments.

I think your first reason applies to the friend I was talking about. We're all getting into our endgames, and they want to enjoy the time they have left. He has had cancer; she has various health issues. Eat, drink, and be merry.... I also don't sense any sense of obligation to the willfully unvaxxed. Fuck them and the deer they're cavorting with.

My other friends don't follow science news like I do, so it's probably the latter: They absorbed the take-home message. They're armored-up and being reasonably prudent, but they're not willing to squander their remaining good years hiding in a cave, like I do. I preferred my cave even before the pandemic, so I'm good. Fact is, I appreciate not being pressured to travel anymore. I hate vacations.

[LordMortis]

I suspect that what happened to Elizabeth Warren (Corey Booker, Brian May) is because of that mask messaging and becoming too casual/comfortable in being unmasked around people that aren't in your immediate household.

I hate it. I'm succumbing three times in one month during the worst surge we've had. Two lunches and dentist appointment. One lunch down. I got out in just over an hour. One lunch and one dentist appointment to go before sweet, sweet isolation during "holiday shut down." (Though I'll go gaming once or thrice with my super small mutually isolated circle)

Edit: Tomorrows lunch is cancelled! Sad for the reason why but happy I don't have to go!

[malchior]

Among my very small circle of remaining friends, everyone's risk tolerance is higher than mine. They're all traveling and dining out, as one must do when traveling. Some are going to museums, movies, and other entertainments.

Amongst my friends I probably have the highest risk tolerance. That's always been the case. Still I'm the most conservative about this latest outbreak because I've been following it closely. Most haven't. If they were saying fuck it before, they are screaming it now.

I think your first reason applies to the friend I was talking about. We're all getting into our endgames, and they want to enjoy the time they have left. He has had cancer; she has various health issues. Eat, drink, and be merry.... I also don't sense any sense of obligation to the willfully unvaxxed. Fuck them and the deer they're cavorting with.

I'm not hearing a sense of people feeling they deserve R&R. I'm hearing more and more a sense of the last sentence. Fuck the unvaccinated. I heard this loud and clear last weekend and this one. The opinions I'm hearing are along the lines of "I've been doing my part and they won't so let them die. I'm done with this mask. Give me a million shots but I'm finished with this bullshit." I heard it from 2 different groups. I haven't seen it in the "press" either or even heard it on Twitter. Maybe I'm not in the right channel but in my limited view it felt organic.

I'll still wear a mask and advocated for it because of the people who can't protect themselves. I'd say the vulnerable are unfortunately like many of our intractable divides are caught in the crossfire. The bottom line is that we are seeing signs that the vaccinated are absolutely finished with the unvaccinated. Unfortunately the unvaccinated have outsized political power. This may drive more dysfunction and encourage violence long-term. Those people have become the enemy. I actually heard some people saying that they wouldn't mind if some of those old, racists just died. "It'd help."

[LawBeefaroni]

We're supposed to visit my sister over the holidays. In the past few weeks, since returning from travel for Thanksgiving, they've had several parties in various restaurants (15-20 attendees) and attended several full capacity sporting and theater events. They're planning on going to see the new Spiderman movie in the theater (it's about to break box office records, WTF?). On the plus side, they're the second stop after the in-laws, who are only slightly more cautious (but much higher risk).

Oh, and here's something. The only time I've had any real friction with the mother-in-law was when we were visiting in December 2019. My son spiked a mild fever and we decided we shouldn't host the annual Christmas get together. Or more accurately, we shouldn't include my MIL's centenarian father. She was upset that we "ruined the party". I was trying to protect the vulnerable. So if we cancel this year I'm sure it's going to be a huge battle.

[Smoove_B]

So if we cancel this year I'm sure it's going to be a huge battle.

I'm in the Grinch House because I've cancelled socializing on Christmas. My mom is scheduled for surgery right after the first of the year, so that's easy enough. My parents are actually ok with it. It's my MIL that's causing a problem. Last week she was in D.C. to go on a bus tour and have lunch and dinner with friends before flying home. Then she was going to fly here for Xmas and split time by traveling between our house (spending time with my parents as well) and my inlaws (and their extended family). She was going to visit with my SIL first and they are going to Philadelphia for the day - to enjoy Xmas in the city on Xmas eve. I felt like this was very quickly turning into a epidemiological question on an exam involving secondary attack rates so I voiced my concerns. But anecdotally, the number of people I'm hearing now that are getting sick - people that have said they've been careful - has gone up significantly in the last ~3 days. Again, it's not about dying, it's about getting the virus and potentially spreading it to someone of concern. But I'm the Grinch.

In worse news:

https://twitter.com/ErinBanco/status/14 ... 2093121539

NEW: Health officials say they can’t efficiently track and contain Omicron because the country still doesn’t have accurate and real-time data.

Over the past few months, Biden officials have relied on international data because they say it’s more reliable

I didn't expect the Biden administration to come in and fix problems with the CDC and state-level reporting, but this is jarring. It also makes the vaccinate only strategy even more confusing.

The administration’s dependence on international data underscores the extent to which the U.S. public health data infrastructure is still failing to produce real-time data on not only the spread of the virus but also the degree to which the virus evades the vaccine and the degree to which it impacts various American populations. It also raises questions about whether the American public health system, supported by state health departments, will be able to sustain itself under the inevitable deluge of Omicron cases that will pop up across the U.S. in the coming months.

[malchior]

'It is embarassing' is right. 2 years into this thing and we're still flying blind. My faith in our leaders ability to do anything right is essentially nil at this point.

[malchior]

Well my X-Mas plans just hit the COVID wall. My wife just called. My BIL's wife is 8 months pregnant. Last weekend they went to a wedding with a bunch of anti-vaxxers. (They're geniuses). Guess who is waiting for a COVID PCR test right now? Also, my wife's grandfather is in an assisted living facility after a bad brain bleed left him unable to walk. He started coughing uncontrollably while my MIL was there, my MIL had to call several times to get them to test him (solid sign!), and now we're waiting to see 1) if he has COVID and 2) how things go for her. I'm probably running a couple of our stockpiled tests over later now. In addition, my BIL's law firm had their X-Mas party on Friday and they just found out 5 attendees are positive this as of this morning. They're all killing me with this shit.

[Smoove_B]

I'm telling you, we are in worse shape (cases) in December of 2021 than we were a year ago, before the vaccines. People (understandably) believed the vaccinate and you're done messaging and now we're in trouble.

We've already learned the lesson of logarithmic exponential growth, now I think we're about to learn about rare events scaling at population level numbers.

EDIT: Jesus. I need more coffee. Or whisky in my coffee.

[malchior]

I'm telling you, we are in worse shape (cases) in December of 2021 than we were a year ago, before the vaccines. People (understandably) believed the vaccinate and you're done messaging and now we're in trouble.

We've already learned the lesson of logarithmic growth, now I think we're about to learn about rare events scaling at population level numbers.

That sounds right. My company cancelled our in-person event but I can't help but think we're the exception. My wife's company just got acquired and they had a big post-merger event last week too where they flew in salespeople from across the country. I can't help but worry that the next few weeks might end up being bonkers here.

[Smoove_B]

Whatever speech Biden thinks he's giving tomorrow, he should probably update it quick.

https://twitter.com/MarkLevineNYC/statu ... 0783601665

BREAKING: 15,245 new covid cases reported today in NYC. Up from 12,404 yesterday, which itself was a single day record.

Mask up, NY and NYC area OOers.

[Smoove_B]

Added bonus:

https://twitter.com/MoNscience/status/1 ... 9966540801

Welp, that escalated quickly.

Omicron now makes up 92% of sequenced cases in the New York and New Jersey region, based on the latest data from the CDC. That's up from the 13% reported last week.

Nationally, omicron is 73%, up from 12% reported last week.

[RunningMn9]

In the past eight days, about 10% of all NFL players have tested positive.

[Smoove_B]

I am feeling pretty confident the national news this week is going to be dire.

[malchior]

I am feeling pretty confident the national news this week is going to be dire.

The only light is that maybe Omicron really is just milder? I'm not banking on it but that's about all we got now.

[Smoove_B]

The only light is that maybe Omicron really is just milder? I'm not banking on it but that's about all we got now.

"Mild illness" = not in the hospital. The spectrum of symptoms that people are going to experience under "mild illness" is going to vary, and a % of those are absolutely going to need to be triaged to determine just how bad they are and another small % of them hospitalized when their situation turns worse. Vaccinations improve your chances, but immunity is always a guess because it comes down to your individual response to the pathogen.

...then add in the people that will have Long COVID after this Omicron wave rolls through (both vaccinated and unvaccinated) and it's about to get out of hand real quick.

As was pointed out upstream, if Omicron is the same or less severe as Delta, it's still going to be a problem because of how quickly and easily it is spreading. It will absolutely overwhelm medical function and waylay a significant number of people that aren't going to die but are going to be unable to work or function for days, maybe a week, maybe longer.

[Max Peck]

On the bright side, total victory against the Delta variant is imminent.

[Smoove_B]

On the bright side, total victory against the Delta variant is imminent.

That's certainly very Monty Python-esque in looking on the bright side of life.

[Smoove_B]

Figured out how to get into space, but can't seem to come up with a plan to control COVID-19 in the workplace.

At least 132 employees at the SpaceX rocket factory near Los Angeles have tested positive for COVID-19, making it the site of the largest recent countywide workplace outbreak tracked by local health officials.

According to a report released by the Los Angeles County Department of Public Health on Monday, the Elon Musk-led company currently accounts for nearly 30% of workplace COVID-19 cases in the county. The list includes 37 companies who have three or more confirmed cases each, with a total of 452 cases.

The SpaceX corporate headquarters in Hawthorne employs nearly 6,000 people.

Should I send him a copy of my resume and see if he wants to hire me as a consultant? I think I'm going to do this.

[Isgrimnur]

[Smoove_B]

Speaking of Texas:

HOUSTON — After warnings of an omicron surge over the holidays, Harris County has reported its first death caused by the omicron variant of COVID-19. It's also the first known omicron death reported nationwide.

...

According to Hidalgo, the patient was a man in his 50s who was not vaccinated and had an underlying health condition.

If you dig through the press release, they also indicate he previously had COVID-19. That fact should likely be in every major news story about what happened to this guy.

[Kurth]

Smoove, I'm wondering if there's a point where, from a public health perspective, it's better to just admit defeat in terms of trying to contain a virus as contagious as Omikron. I haven't studied the numbers, but from what I'm seeing reported, it seems like that fight is lost. We know it's incredibly transmissible, and it appears to be raging pretty much unchecked through our population. Are we past the point of no return here, or do you think that -- assuming we could get people to comply -- masking and social distancing and closures would do any good given where we are right now?

Not trying to be defeatist or overly fatalistic, but is it better at some point to just rip the band-aid off and start finding ways to better live (and survive) with something like this than it is to contain it?

[Alefroth]

Smoove, I'm wondering if there's a point where, from a public health perspective, it's better to just admit defeat in terms of trying to contain a virus as contagious as Omikron.

Of course not, for the reasons he's repeatedly listed.

[Kurth]

Smoove, I'm wondering if there's a point where, from a public health perspective, it's better to just admit defeat in terms of trying to contain a virus as contagious as Omikron.

Of course not, for the reasons he's repeatedly listed.

I was under the impression that Omikron is spreading exponentially faster than prior variants. Isn't that a significant variable that would impact the answer to the question? I've been following this thread, so, of course, I know what Smoove's prior perspective has been about how public health should respond. I only asked because this seems like a quick moving and fluid situation. Didn't seem crazy to me to wonder if he analysis changed.

[Alefroth]

I'm pretty sure he's weighed in on what the effects of overwhelming the health care system with a more contagious strain would look like. I just can't see the public health system just throwing in the towel ever. What would that even look like?

[Victoria Raverna]

What is the point of admit defeat? And how does that look like? Not doing anything and let people die?

[Max Peck]

To me, giving up and making no attempt to slow down the spread of the virus looks like Daniel Wilkinson. People dying of easily treatable ailments because there is no longer a functioning healthcare system to provide lifesaving care for ordinary citizens. The wealthy and powerful will, of course, be fine.

If you don't remember who Daniel Wilkinson was, here's a refresher:

Veteran dies of treatable illness as COVID fills hospital beds, leaving doctors "playing musical chairs"

When U.S. Army veteran Daniel Wilkinson started feeling sick last week, he went to the hospital in Bellville, Texas, outside Houston. His health problem wasn't related to COVID-19, but Wilkinson needed advanced care, and with the coronavirus filling up intensive care beds, he couldn't get it in time to save his life.

Wilkinson was airlifted to Houston, but it was too late.

"They weren't able to do the procedure on him because it had been too long," his mother told Begnaud. "They] told me that they had seen air pockets in his intestines, which means that they were already starting to die off. They told me that I had to make a decision, and I knew how Danny felt; he didn't want to be that way. And, so, we were all in agreement that we had to let him go."

Roughly 24 hours after he walked into the emergency room, Daniel Wilkinson died at the age of 46.

Kakli told Begnaud that if it weren't for the COVID crisis, the procedure for Wilkinson would have taken 30 minutes, and he'd have been back out the door.

[LawBeefaroni]

Well shit.

Biden hopes to reassure Americans that if they are vaccinated, they can still proceed with their holiday plans without fear of becoming seriously ill. Conversely, he wants to tell those who have not yet received shots of the potential for severe illness or death in the coming months.

"The President will tell the American people if they're vaccinated and follow the precautions we all know well, especially masking while traveling, they should feel comfortable celebrating Christmas and the holidays as they planned," a senior administration official said ahead of time, previewing a speech that Biden hopes will reassure anxious Americans ahead of the festive season.

More lives sacrificed on the altar of approval ratings.


On a personal level, going to be hard to convince everyone to cancel holiday plans now, Biden says it's all good.

[malchior]

I thought he'd go all in on vaccines but this goes much further. You won't get seriously ill? That's the criteria now? I mean this sounds pretty fucking irresponsible. This country is a mad house.

[Octavious]

He failed the minute he told people it was ok to take masks off in the summer. There's no going back after that. Hell it's like covid ww3 out here in NJ and Murphy is doing jack shit.

[malchior]

It's also a useless message as the biggest predictor of vax vs. no vax is political affiliation.

Edit: If you have access to the Economist, the article is a solid summation of the year in COVID and it reminded me they had a great article about how the Republicans have basically tied Biden up into knots on COVID response (i.e., at a state level they are doing things to encourage non-vaxxers to stay non-vaxxed). I've quote the end of the second piece where the communists at the Economist mention that the courts appear politicized. It doesn't seem too hard to draw a line from all these realities to a COVID surrender speech. He is trying to say if you don't want to listen I can't be blamed. But we all know that won't work.

https://twitter.com/TheEconomist/status ... 7983776778

The administration required that by January 4th all employees of the federal government and of companies with more than 100 workers must be vaccinated or tested regularly. But a ruling by the Fifth Circuit Court of Appeals in New Orleans in mid-November has for now blocked the mandate for private employees. There is a possibility it could be reinstated. After challenges were filed all over the country, a lottery assigned the matter to the Sixth Circuit Court of Appeals in Cincinnati. However that court rules, the mandate may wind up before the Supreme Court, says Walter Olson, a legal scholar at the Cato Institute, a libertarian think-tank.

Mandates requiring full vaccination for health-care workers (in facilities receiving government funding through Medicare or Medicaid) and vaccination or testing for federal contractors are also stalled. Many appeals courts are reading federal authority “exceptionally narrowly, in ways that are surprising to those of us who have been in this field for some time,” says Wendy Parmet, professor of law and public policy at Northeastern University.

But the real constraint may be politics. Even if Mr Biden eventually prevails in the courts, Republican politicians could further delay or sabotage his mitigation strategies—and use them as a wedge issue to mobilise their supporters for the coming midterm elections. Over the past few weeks, four states (Florida, Iowa, Kansas and Tennessee) modified their eligibility for unemployment insurance to include people fired for flouting vaccine requirements. Unemployment insurance is usually reserved for those who have been fired through no fault of their own.

Shortly after Mr Biden said on November 29th that the Omicron variant was cause for concern, Republican politicians began discussing ways to subvert new and existing anti-virus regulations. J.D. Vance, a Republican Senate candidate in Ohio, encouraged politicians to shut down the government until Mr Biden backs off vaccine mandates. Others discussed ending mask mandates in schools and elsewhere.

Nearly every attempt the Biden administration has made to mitigate the coronavirus has been undermined. “The US is virtually ungovernable,” says Mr Gostin. Ms Parmet agrees, pointing to the rulings against vaccine mandates for health-care workers. For decades, she notes, the federal government has required much from health workers: to wear gloves, to get screened for tuberculosis and to take other steps to protect public health. With covid, the federal government has suddenly become hobbled. “The courts are adding to the ungovernability. I fear they have become players in the culture war,” says Ms Parmet. “And to do that during a public-health crisis…It’s bananas!” Mr Biden probably feels the same way.

[Smoove_B]

I'm pretty sure he's weighed in on what the effects of overwhelming the health care system with a more contagious strain would look like. I just can't see the public health system just throwing in the towel ever. What would that even look like?

The professional outrage that has been occurring online and an social media over the series of statements that have been released has been quite strong over the last ~5 days. The statements are beyond offensive and relegate a significant portion of Americans to untold pain and suffering. I am absolutely astounded at the language - turning this into a us/them proposition - and to come from the highest office in the nation is just...its stunning.

Smoove, I'm wondering if there's a point where, from a public health perspective, it's better to just admit defeat in terms of trying to contain a virus as contagious as Omikron. I haven't studied the numbers, but from what I'm seeing reported, it seems like that fight is lost. We know it's incredibly transmissible, and it appears to be raging pretty much unchecked through our population. Are we past the point of no return here, or do you think that -- assuming we could get people to comply -- masking and social distancing and closures would do any good given where we are right now?

We already lost so many battles - elimination, eradication and yes now containment. There is no way you're ever going to hear any public health professional just advocate for completely giving up, no. Because there are still immunocompromised people. Children under 5. Parents taking care of children under 5. Marginalized people. To embrace the message that is being floated now is to give up on all them and that is just...awful. Not to mention allowing this to just wash over everyone ("if you're vaccinated, you're fine") is still going to give some people Long COVID - a disease we still don't fully understand.

This has been a slow build for weeks. It started with the "no one saw this coming" messaging that started a few weeks ago when Omicron emerged. Then doubling-down on the "pandemic of of unvaccinated" as we are slowly soft-sold on this Great Barrington Debate repackaging.

What happens next is the reality of the course that has been set by federal, state and local elected officials and leaders. But public health as a profession isn't by any means endorsing or supporting the path we're on - not by a longshot. What that means in a practical sense? Hard to say.

Not trying to be defeatist or overly fatalistic, but is it better at some point to just rip the band-aid off and start finding ways to better live (and survive) with something like this than it is to contain it?

This is a statement and attitude of the privileged - people that have little to lose. This is the mantra of a very specific class and group of Americans and has been floating around since March of 2020, though more or saying it now. If this is truly the society we are turning into or have become, I just don't even know what to say anymore; it's soul-crushing. That we would collectively choose the path of death and untold suffering because masks are too much to ask?

[Smoove_B]

Latest from The UK:

Once again we have seen a new variant of the Covid virus emerge, and health officials are warily eyeing the data from around the world. With Omicron, a key question is whether infections are as severe as those caused by previous variants. Many are speculating that it could be inherently milder, especially after several preliminary reports from South Africa seemed to suggest fewer hospitalisations and less severe symptoms.

In my opinion this judgment is premature. Especially in such a rapidly changing situation.

Accurately estimating the severity of a new infection is a nightmare. Especially at such an early stage. However, there are some things we should keep in mind when evaluating the numbers coming in.

...

ou cannot simply compare Omicron with Delta by adding up the numbers of cases and hospitalisations for each over a short timeframe. The numbers of Omicron cases have been growing faster – much faster – than those of Delta, and it takes time for people to become seriously ill. To accurately gauge the severity, we will need to compare the numbers of cases that end up in hospitalisation or death. Mortality is often assessed as death within 28 days of diagnosis, and Omicron was reported to the WHO less than 28 days ago. We cannot afford to wait to find out exactly how dangerous it is.

There is a widespread belief that infectious diseases evolve to become less virulent, leaving many hopeful that Omicron will be less severe for everyone, regardless of age or vaccination status. This is false. Viruses do not necessarily get selected to be milder or more severe. If virulence (the severity of the disease) is not connected to transmission (the factor that makes a virus successful or not) there’s no real link between the two in most real situations. The great majority of Covid transmission occurs before people become seriously ill, and so the virus has already moved on.

Again:

The growth rate of Omicron is such that even if it is milder in most cases, cases can still rapidly add up and threaten the NHS. The UK has a healthcare system already struggling with decades of underinvestment and which was teetering on the brink after months of Delta. People seem to forget that nearly 20,000 people have already died from Covid in the UK since “freedom day” in July. The virus has been much more manageable, but that attrition has not been without consequence.

Finally:

Even if, and it is an exceedingly big if, Omicron is milder than Delta, that is no reason to relax. The transmission properties alone make this serious. The difference between a caress and a slap is largely in the pace with which it is given.

He also wrote a similar OpEd for The Washington Post and an American audience.

[malchior]

He also wrote a similar OpEd for The Washington Post and an American audience.

I just don't get how you go from the opinion in this article to don't change your holiday plans. A middle of the road approach simply seems to divide the difference. It feels like he is rolling the dice again. It's feels like negligence. Again.

[Smoove_B]

Because the shopping season, travel and Xmas are all happening right now. Hospitalizations and deaths? That's talk for mid January!

I mentioned it last week - the evidence that monoclonal antibodies do not work against Omicron. There's only one specific type, and it's currently being hoarded and rationed. Front line medical people would have to say what the criteria are for use at this point; I have no idea.

As bad as it's been (during Trump, during the transition, during Biden), this is a whole new level of awful that's potentially about to hit.

[Defiant]

I was under the impression that Omikron is spreading exponentially faster than prior variants.

<nerd technicalities> I haven't looked at it closely but I don't think it's spreading "exponentially faster" than prior variants - growing exponentially faster than an exponential growth would I *think* would mean that it had factorial growth. I think they all spread exponentially (at least, when people don't use interventions to slow it down). What I heard is that Omicron is growing three times as fast as Delta (which would still be exponential).
</nerd technicalities>


What I want to know is, is that increase in spread due just to immune evasion (which gives the virus a whole lot bigger pool of potential victims), or is the disease itself more contagious on top of that (eg, it gets through masks better/travels farther/lingers in the air longer/etc)

[Smoove_B]

What I want to know is, is that increase in spread due just to immune evasion (which gives the virus a whole lot bigger pool of potential victims), or is the disease itself more contagious on top of that (eg, it gets through masks better/travels farther/lingers in the air longer/etc)

A little of both, I believe. It replicates quickly (like Delta) so human hosts are ejecting magnitudes of order more virons into the environment much sooner. On top of that, Omicron is able to evade the immune system making disease (and additional spread) more likely. Everyone is focused on the boosters and how great they are (and it's true), but when you look at the % population of people that are booster protected? Overwhelmingly we have more people unvaccinated + 1 dose + 2 doses than with 3, so an immune-evading virus that ramps up production quickly is concerning. I think we have about 60% of the population vaccinated with at least 2 doses but less than a 1/3 with three. So ~70% of the American population at increased risk (with variation of risk in that 70%). Not good.

And I'm not even going to mention the chatter I saw yesterday about the booster perhaps only being highly effective for ~90 days against Omicron because of how Omicron works. Still waiting for more info.

[Smoove_B]

https://twitter.com/BioTurboNick/status ... 8425499648

Just curious if any of the "Omicron is just a cold, deaths aren't rising in South Africa" people are talking about the significant increase in reported deaths in South Africa yesterday.

It's almost like...there's a lag time between when cases start rising dramatically and when we actually observe hospitalizations and deaths. I should tell people about this.