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

[Smoove_B]

Again, mainly for historic purposes, I share.

https://twitter.com/SalomonJA/status/14 ... 3846349828

The United States again recorded more than 61,000 COVID-19 deaths in February 2022. January and February this year have been the fourth and fifth deadliest months in the entire pandemic, exceeded only by the peak last winter before vaccines were widely available.

[Unagi]

See, I think I figured out your problem Smoove... You are looking at past data from the planet earth.... We are flying into the future on the USS-

[Smoove_B]

Speaking of the future, peep this modeling. Let's see how it holds up.

https://twitter.com/JPWeiland/status/15 ... 3424683008

BA.2 projections in the US:

Coming off of the massive omicron wave (Rt=0.64) will provide a lot of immunity to restrict BA.2 spread rate.

A good chance we may see a BA.2 wave in April-May. A lot of factors to consider:

A couple factors could push the wave higher:
Lower mask/distancing
Boosters waning

However, the shift towards spring weather will be beneficial. Hard to estimate whether the upward or downward pressure will win out.

A lot more uncertainty in wave size than the Omicron wave

[LordMortis]

Speaking of the future, peep this modeling. Let's see how it holds up.

https://twitter.com/JPWeiland/status/15 ... 3424683008

BA.2 projections in the US:

Coming off of the massive omicron wave (Rt=0.64) will provide a lot of immunity to restrict BA.2 spread rate.

A good chance we may see a BA.2 wave in April-May. A lot of factors to consider:

A couple factors could push the wave higher:
Lower mask/distancing
Boosters waning

However, the shift towards spring weather will be beneficial. Hard to estimate whether the upward or downward pressure will win out.

A lot more uncertainty in wave size than the Omicron wave

My bet is on the sort of spread discussed. The question is how severe it will be. We are at least down YOY on cases and deaths right now (I don't have easy access to hospitalizations), which gives me hope that it won't be as bad as I was believing a month ago. But April > May = post St Pats and Spring Break, young adult first of spring drinking, but it's too cold to be outside, craziness. The question for me is how much does inoculation and past spread keep things sane. It's still my hope that in 5-9 weeks that I can loosen up my personal guidance a bit... A lot... Until September re-evaluation. I'm so ready just not as ready as nearly every other person around me. We've largely gone maskless and without hygiene around here, except for medical work hygiene and office workers WFH. Still with that sort of abandon, we're finally down YOY with all of our metrics.

[Smoove_B]

I guess we'll see! Back to the fun part of the pandemic where we sit around and wonder what's next.

On the one hand:

There is strong evidence for brain-related abnormalities in COVID-19. It remains unknown however whether the impact of SARS-CoV-2 infection can be detected in milder cases, and whether this can reveal possible mechanisms contributing to brain pathology.

...

We identified significant longitudinal effects when comparing the two groups, including: (i) greater reduction in grey matter thickness and tissue-contrast in the orbitofrontal cortex and parahippocampal gyrus, (ii) greater changes in markers of tissue damage in regions functionally-connected to the primary olfactory cortex, and (iii) greater reduction in global brain size.

...

Whether this deleterious impact can be partially reversed, or whether these effects will persist in the long term, remains to be investigated with additional follow up.

So we don't really know how widespread this is or whether or not its temporary or permanent, but on the other hand we know that FREEDOM is immediate and forever.

[Smoove_B]

Yeah, I know...

In looking at what's happening overseas:



I'm sure it won't happen here. We're different. That's one thing I've learned over the last 2 years. There's really no predicting what's going to happen, certainly not by looking at what's going on elsewhere.

[hitbyambulance]

WOOHOO DELTACRON!

https://www.usatoday.com/story/news/hea ... 442062002/

sounds like a Transformers name

[LordMortis]

Yeah, I know...

In looking at what's happening overseas:



I'm sure it won't happen here. We're different. That's one thing I've learned over the last 2 years. There's really no predicting what's going to happen, certainly not by looking at what's going on elsewhere.

This is super spreader weekend and the weather is perfect for it. We just got a half inch of snow but that won't stop college kids and party townies from going out and celebrating the first weekend of spring aka St Patty's day weekend this Saturday wherein they will packed like sardines slobbering drunk and loud talking until they are ready pass out. Two week count down starts tomorrow.

God, I hope the third time is the charm and I so dead wrong this time.

Also I feel for the refugees and their hosts in Eastern Europe. I can only imagine the spread going on there.

[El Guapo]

At work for the first time since the start of the pandemic there appears to be real chatter about a return to the office. We've been *able* to go in without permission for maybe 6 months or so at this point, but no requirement or pressure to go in (and the few times that I've gone in its been fairly deserted, although chatter suggests that attendance has picked up somewhat in the last month or so). Currently the agency wide telework order goes through June 9th so no mandatory return sooner than that, but management and the union are in discussions about the terms of a return to work.

Now, pre-pandemic everyone was entitled to telework two days out of every week (and after doing that for a year, you could request permission for additional days). So I figure that's the minimum, such that I wouldn't have to go back more than three days out of every week. Of course one complication is that everyone has been telework for every day of every week for more than a year, so logically you'd think that everyone would be able to telework at least three days a week, but I also figure that the use of logic in this process is going to be limited.

We'll see. If I had to guess they'll start by requiring everyone to come in two days a week, with the ability to get exceptions / additional telework time based upon medical need (e.g. immunocompromised member of the household). And also three months away is enough time with everything opening up now that if everything goes tits up and/or some horrible new variant comes in then there's the non-zero chance that the telework order just gets extended. Or if management and the union can't come to agreement maybe it gets extended as the status quo.

[LawBeefaroni]

I'm in the office 5 days a week but our current mandate is two days. I think it may go to 3, but there's a chance it stays at 2.

I'm stuck going daily since my son goes to school here but when he "graduates" kindergarten I'm going to WFH a few days.

[ImLawBoy]

I'm designated as a full time office worker (my choice), but I've been working from home almost exclusively since October. I went into the office yesterday to finalize a few things before I start isolating myself more in anticipation of surgery soon. We've got people designated as virtual, flex, or full time office, with flex anticipated to be in the office 2-3 times per week. Unless someone needs to be in the office for some reason, everyone is free to make their own designations.

Of course, we're also moving offices in the middle of all of this. Our lease is up this year so they're working on moving us to a new building. Crossing my fingers that they're upgrading (or have already upgraded) the ventilation in the new building. We'll have a lot less space than we currently do, so even though all of the attorneys have their own offices where we can close doors, it will be a tighter fit overall.

[Smoove_B]

For those keeping track:

https://twitter.com/EricTopol/status/15 ... 9077130240

The next wave in Europe has begun

[Isgrimnur]

[malchior]

Week long lockdown in Shenzhen announced. That'll have some impact on our supply chain issues but remains to be seen how significant.

Edit: Another city Dongguan also announced lockdowns. These regions are close to Hong Kong which is struggling with an outbreak.

https://mobile.twitter.com/RencapMan/st ... 30764.html

[Smoove_B]

But have they considered just ignoring it?

[LordMortis]

But have they considered just ignoring it?

I hear there's a paste freely available through vet clinics that is doing wonders fighting the virus. Some people are even taking it prophylactic. Also, as soon as it's sunny, I think it's just going to go away. Like that. It'll look like a miracle.

13ish days until I hope I'm wrong and everyone else is right.

[malchior]

But have they considered just ignoring it?

I know right!

I got to a little more reading and love how the conspiracy theorists are tying this to Ukraine. To wit, China is using "absurd" COVID zero policies to sanction the west.

That crazy aside, we'll get another glimpse at seeing if our policy approach is built on a fallacy or not about not being able to control COVID. They seem to have had success even with an inferior vaccine. But then again it might get out of control and indicate it's just too challenging. I guess we'll see what happens soon enough.

[Smoove_B]

Breakdown of what's happening in Hong Kong right now

https://twitter.com/jburnmurdoch/status ... 0869214213

NEW: I’m not sure people appreciate quite how bad the Covid situation is in Hong Kong, nor what might be around the corner.

First, an astonishing chart.

After keeping Covid at bay for two years, Omicron has hit HK and New Zealand, but the outcomes could not be more different.

After accounting for lag between infection & death, *1 in 20* cases in Hong Kong currently ends in death.

To put that into context, HK’s case fatality rate (NB different to infection fatality rate) is currently higher than England’s pre-vaccine peak. Two years into the pandemic.

[stessier]

Other big news in that thread was that Foxconn shut down as the whole province was locked down. Wow - I hadn't heard that.

[LawBeefaroni]

Breakdown of what's happening in Hong Kong right now

https://twitter.com/jburnmurdoch/status ... 0869214213

NEW: I’m not sure people appreciate quite how bad the Covid situation is in Hong Kong, nor what might be around the corner.

First, an astonishing chart.

After keeping Covid at bay for two years, Omicron has hit HK and New Zealand, but the outcomes could not be more different.

After accounting for lag between infection & death, *1 in 20* cases in Hong Kong currently ends in death.

To put that into context, HK’s case fatality rate (NB different to infection fatality rate) is currently higher than England’s pre-vaccine peak. Two years into the pandemic.

Omicron fuck hard on the unvaccinated. This is more support for vaccines, right?

[stessier]

Omicron fuck hard on the unvaccinated. This is more support for vaccines, right?

The thread says yes and the mRNA ones seem to be a bit better too.

[Smoove_B]

Omicron fuck hard on the unvaccinated. This is more support for vaccines, right?

Yes. And potentially the people are claiming "natural immunity" based on prior illness.

Lots and lots of the people I follow believe we're in a window right now here in 'merica where vaccination + people that had Omicron in January/February makes it feel and look like we're doing great. However, there is real concern over the number of people that only have 2 shots (not 3), plus diminished immune response for people that received their 3rd shot 6+ months ago, plus those that are claiming they're protected based on prior (recent illness) is going to make the next wave much larger than it needs to be.

This is what happens when the virus is in constant circulation and we refuse to do anything to limit spread. Yes, the Chinese-sourced vaccination they received in Hong Kong isn't as good as the what we had here (or in the UK), but the fact that we're two years into this, plus vaccinating people and you're still seeing something like Hong Kong is...concerning.

[stessier]

This is what happens when the virus is in constant circulation and we refuse to do anything to limit spread. Yes, the Chinese-sourced vaccination they received in Hong Kong isn't as good as the what we had here (or in the UK), but the fact that we're two years into this, plus vaccinating people and you're still seeing something like Hong Kong is...concerning.

Is it though? It's pretty well explained - COVID 0 policy + low vaccination leads to what they are seeing. It might be concerning that the vax rate is so low, but messaging on that topic is clearly not easy.

[Smoove_B]

It's still concerning, yes. When I say "in circulation", I'm speaking broadly about the pandemic we're still in (despite what you might have read). It's not unexpected, no. But concerning? Yes.

[Smoove_B]

Also, Andy Slavitt posted an overview of what he thinks will happen:

https://twitter.com/ASlavitt/status/1503412039389102083

In the US, cases are still down. But 2 things are worth watching.
-Only 10% of cases are BA2 and since BA2 spreads approx 30% faster than omicron, expect it to follow Europe -About 1/3 of our early warning wastewater sites are showing increases. As we have seen throughout the pandemic, the US haas followed Europe by several weeks in our waves of cases. That may happen again here.

But what happens next is going to be different in every country based on what happened this last year.

The factors that will influence how a rise in cases might look in the US are:
-the proportion of the country with prior omicron infection
-the percentage of non-omicron infected who are vaccinated, or if higher risk, boosted
-the state of US hospitals

-An estimated 45% of the US has had omicron recently. That should be highly protective
-Those fully vaccinated but who haven’t had omicron should be vulnerable to infection from BA2, but largely won’t be hospitalized or worse

Those without prior infection would be at most risk of infection.

Those who haven’t been infected but also aren’t vaccinated or boosted will be at highest risk of hospitalization.

So we could see lots of cases, but an even lower portion of ppl hospitalized than last wave.

We'll see.

I think his final post is telling:

For vulnerable populations— from kids under 5 to those who are medically fragile to those who have chosen not to get vaccinated— things haven’t changed. Only the people around them have.

And in case you're feeling bored and want to see the list of what is considered "medically fragile", check the CDC. Of note:

Heart conditions

Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get very sick from COVID-19.

That is ~122 million adults, or close to half of all adults. Seems reasonable.

[malchior]

Other big news in that thread was that Foxconn shut down as the whole province was locked down. Wow - I hadn't heard that.

This is part of why the Shenzhen lockdown is a big deal. Foxconn is but one of several significant players there. If it goes a few weeks, we'll be seeing cascading supply chain failures again in high-tech manufacturing.

[Smoove_B]

In case you wondering (I know you weren't) if we learned anything. Like...anything.

https://twitter.com/nicoleateran/status ... 1143859208

The White House asked for $65B for pandemic preparedness.

The Senate released a draft bill that includes less than $2B.

[El Guapo]

Found out via Facebook that covid tore through the family of a college friend of mine. Everyone got it - my friend, his wife, their three kids, his two siblings, and his parents. All vaccinated and I think boosted. On top of that my friend's dad had to be hospitalized for three days, but apparently remesdevir (sp?) did the trick and he's now out of the hospital fortunately. I know the father has been battling cancer for roughly a decade, so not totally shocking that he apparently got the worst of it.

So weird since the pandemic is over.

[Jaymon]

Heart conditions

Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get very sick from COVID-19.

That is ~122 million adults, or close to half of all adults. Seems reasonable.

I have had high blood pressure since march 2020. I think it might be stress related.

[Smoove_B]

I now have two good reasons to relocate to Scotland.

https://twitter.com/BNODesk/status/1503745217689800708

Scotland reverses decision to drop mask mandate in certain public places due to rise in COVID cases

[Kraken]

I needed an x-ray today. The first thing reception did was ask me to replace my mask with one of theirs and sanitize my hands. At least health care facilities are still trying.

[Smoove_B]

I needed an x-ray today. The first thing reception did was ask me to replace my mask with one of theirs and sanitize my hands. At least health care facilities are still trying.

Replace your N95 or KN94 with a surgical mask? In other words, use one that's of lower quality?

[Kraken]

I needed an x-ray today. The first thing reception did was ask me to replace my mask with one of theirs and sanitize my hands. At least health care facilities are still trying.

Replace your N95 or KN94 with a surgical mask? In other words, use one that's of lower quality?

But who knows where it's been?

[Grifman]

A new variant is now here. Covid doesn’t care if we are tired or wish/think the pandemic is over or need to “move on”.”. It’s here and continues to mutate. We are on our way to another surge but people just don’t care:

https://twitter.com/drericding/status/1 ... 61985?s=21

[malchior]

I needed an x-ray today. The first thing reception did was ask me to replace my mask with one of theirs and sanitize my hands. At least health care facilities are still trying.

Replace your N95 or KN94 with a surgical mask? In other words, use one that's of lower quality?

https://twitter.com/rachael_levy/status ... 2214688776

Did anyone also mention that because the demand for masks dropped precipitously that several of the manufacturers are switching to different products or closing down? The Biden administration has been a complete let down for expectations that they'd improve public health response. Our readiness for future pandemics really looks like it won't be any better despite many lessons learned in human lives. It's a disgrace. But not a surprise.

[Pyperkub]

They have in the past had me put one of their surgical masks over my n95.

[LawBeefaroni]

They have in the past had me put one of their surgical masks over my n95.

We had to do that because people were coming in with all sorts of masks and we could inspect everyone so the rule was you had to wear a surgical mask. If you wanted to keep wearing the mask you walked in with you could, but you had to put a surgical mask over it. Getting into debate at the door over was getting to be way too much for staff.


We still require masks in all patient areas.

[Smoove_B]

Yeah, exactly. Don't want to take off the mask you came in with - no problem. Slap this disposable surgical mask on over whatever you're wearing so we can all see from 30' that everyone is in compliance.

[Smoove_B]

Well it's a good thing we're doing everything we can right now to protect kids under 5

https://twitter.com/ASlavitt/status/1504104159703797764

NEW: CDC report says omicron hospitalized children 0-5 at 5 times the rate of Delta.

[Smoove_B]

https://twitter.com/nytimes/status/1504424902681628678

President Biden’s Covid czar, Jeffrey Zients, is stepping down. His replacement, Ashish Jha, could signal a new pandemic approach for Mr. Biden.

Probably not. Dr. Jha is a medical doctor with a public health add-on degree. He has no practical experience working in "boots on the ground" public health - the kind of skillset we need right now to be in charge. He's definitely someone that should be at the federal table right now providing guidance, but as the person in charge? Not convinced this is a good move. Better than Zients, but color me skeptical over this change.