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

[Kraken]

Hopefully (I guess?) cases surged two to three weeks ago, and hospitalizations still haven’t started to surge?

Bad news there. They've doubled from 500 to 1000 current hospitalizations in MA month-over-month.

Yeah, the Halloween bump is present and accounted for, and thanksgiving is coming along right on schedule. We still expect/hope for a smaller percentage of cases to be severe-to-fatal.

[RunningMn9]

I tried explaining this to some guy on Twitter and when I was done, I think he got it. He was against doing anything just because cases were rising. I eventually got him to see that based on our experience with COVID so far, whatever we decide to do TODAY, will impact what happens about five weeks from now. The next five weeks are effectively baked in and you can’t do anything about it.

Cases are surging today? Hospitalizations will surge in about two weeks, and deaths will surge in about four weeks. There is nothing you can do to stop it. If you wait until deaths start surging, you’ve baked in 4-5 weeks of surge deaths before you can blunt it and reverse course.

The key is preventing a surge in cases. And every time, we do nothing to prevent a surge in cases. We do nothing to respond to a surge in cases, and we only sometimes respond to a surge in hospitalizations.

Maybe I spend too much time talking to SmooveB, but it’s madness.

[El Guapo]

[Isgrimnur]

My county:



At least ventilators aren't an issue anymore.

[Smoove_B]

The key is preventing a surge in cases. And every time, we do nothing to prevent a surge in cases. We do nothing to respond to a surge in cases, and we only sometimes respond to a surge in hospitalizations.

This is public health in a nutshell. When we advise about population-level future states (endemic diseases, outbreaks, chronic health conditions, etc...), we're called alarmist. If prevention paths are followed and nothing happens, people get angry that they wasted their money and resources - clearly nothing happened. If they do nothing and something happens, they get angry that we didn't warn them or that we can't respond to the orders of magnitude higher problem that now exists fast enough. If the middle ground occurs - we get some resources and do what we can to stem a developing problem but we still see a blip of population health problems, we're still called alarmists and told we're over-reactionary. It was never a big deal - it only affected a few people, etc...

American society as a whole does not value/understand/seek prevention. Everything is focused on the response - the sliver bullet, the quick fix.

I have lost track of the number of scientists and academics that have accurately predicted how this has all been unfolding. And every time it's the same - more cases, more hospitalizations, more deaths. Yes, it's better than April of 2020 and even April of 2021, but the core loop still holds.

Regardless, my unofficial observation is that a large segment of the population does not understand or care to understand about the idea of asymptomatic spread or that people can spread diseases before they develop symptoms. The idea of an incubation period is also similarly confusing. This would be so much easier if it was like the Black Death - I think people would grok that pretty quick (literally and figuratively).

[LawBeefaroni]

This might be one of the greatest summaries I've read in the last week:

...

Therefore, it would not surprise me if we start to see Omicron reinfections among those who were infected earlier with another variant but decided not to get vaccinated, or those who had only two doses of the mRNA vaccine but experienced waning immunity. The first Omicron case in the United States appears to fall into the latter category.

Yet the second case does not: vaxxed, boosted in early Nov.

Lot of speculation early on. We've seen the perils of jumping to early conclusions when it comes to messaging.

[Smoove_B]

Lot of speculation early on. We've seen the perils of jumping to early conclusions when it comes to messaging.

Yes, but it's been pretty clear for months now that everyone should have been offered a 3rd shot (or a second one if they were J&J), regardless of the arrival of Omicron. Now we're scrambling again as this new variant might make what was already a problematic situation (diminished immunity in a significant number of vaccinated people) even worse.

Messaging (overall) has been terrible. Let's talk about how the CDC is promoting handwashing right now instead of ventilation and masking - despite all evidence suggesting both are likely more important.

[Little Raven]

Yes, but it's been pretty clear for months now that everyone should have been offered a 3rd shot (or a second one if they were J&J), regardless of the arrival of Omicron.

That hasn't been clear to the WHO at all. It's STILL not clear.

As the still-mysterious Omicron variant reached American shores, the World Health Organization on Wednesday scolded wealthy countries that imposed travel bans and dismissed those that poured resources into vaccine booster campaigns when billions in poor countries had yet to receive their first shots.

The comments by W.H.O. officials reopened fraught questions of equity in how the world has handled the coronavirus pandemic since a stark divide over the availability of vaccines emerged between rich and poor countries earlier this year.

...

The W.H.O. also voiced skepticism about ambitious booster plans that it claimed come at the expense of first-time vaccinations in less wealthy nations. Britain this week announced a massive new campaign to deliver booster shots to all adults by the end of January. Other European countries and the Biden administration are also pushing these shots as a first line of defense against the variant, buying time for scientists to unravel its genomic code.

W.H.O. officials, however, said there was not yet evidence that boosters prevented illness and hospitalization in people infected with variants. They suggested that the reserve of vaccines stockpiled by Britain and other countries could be better used in places where a large portion of the population was not yet vaccinated.

[Smoove_B]

That's fair. I think the issue comes back to the spacing. If we look to our nearest neighbors (and possibly my future home) in Canada, my recollection is their overall case trajectory has been better because they spaced out the doses, meaning immune response was likely "stronger" after only two shots. Here in America, we opted for the faster plan given the uncontrolled spread and amount of death. That was likely the right move, but it meant that the 3rd shot (or 2+ J&J) were going to be necessary. If there wasn't high levels of circulation here in America (still, after almost 2 years) maybe the boosters wouldn't have been as urgent. But as long as the virus continues to circulate actively in various regions? Trouble.

The WHO is right in that we're now going to potentially be in a situation where we need to keep boostering while a significant number of people have yet to receive a single shot. And some hurdles have been removed in ramping up global vaccination, but that's a whole different area - one that is outside my wheelhouse. But advocating for a global response to a pandemic? That's kinda what the WHO does.

[geezer]

Yes, but it's been pretty clear for months now that everyone should have been offered a 3rd shot (or a second one if they were J&J), regardless of the arrival of Omicron.

That hasn't been clear to the WHO at all. It's STILL not clear.

As the still-mysterious Omicron variant reached American shores, the World Health Organization on Wednesday scolded wealthy countries that imposed travel bans and dismissed those that poured resources into vaccine booster campaigns when billions in poor countries had yet to receive their first shots.

The comments by W.H.O. officials reopened fraught questions of equity in how the world has handled the coronavirus pandemic since a stark divide over the availability of vaccines emerged between rich and poor countries earlier this year.

...

The W.H.O. also voiced skepticism about ambitious booster plans that it claimed come at the expense of first-time vaccinations in less wealthy nations. Britain this week announced a massive new campaign to deliver booster shots to all adults by the end of January. Other European countries and the Biden administration are also pushing these shots as a first line of defense against the variant, buying time for scientists to unravel its genomic code.

W.H.O. officials, however, said there was not yet evidence that boosters prevented illness and hospitalization in people infected with variants. They suggested that the reserve of vaccines stockpiled by Britain and other countries could be better used in places where a large portion of the population was not yet vaccinated.

OK, but that's mainly a logistical/equity hesitation, not an efficacy concern.

[malchior]

I'm glad this omicron thing isn't being sensationalized.. @ ABC 7 News in NYC

Headline: Omicron COVID case confirmed in Minnesota, patient had traveled to NYC

The Minnesota Department of Health (MDH) announced Thursday that it has a confirmed case of the COVID-19 omicron variant in a resident with a recent travel history to New York City.

Officials only identified the patient with the omicron variant as a vaccinated adult male who lives in Hennepin County.

They said he developed mild symptoms on November 22 and sought COVID-19 testing on November 24.

The person spoke with MDH case investigators and reported traveling to New York City and attended the Anime NYC 2021 convention at the Javits Center from Nov. 18-20.

They said he developed mild symptoms on November 22 and sought COVID-19 testing on November 24.

The person spoke with MDH case investigators and reported traveling to New York City and attended the Anime NYC 2021 convention at the Javits Center from Nov. 18-20.

[LawBeefaroni]

Ban cons.

[Smoove_B]

Sorry I can't help prove a link to a lab in China, but there's a new theory out that the Omicron variant might be what's known as a reverse zoonosis:

The theory goes that some type of animal, potentially rodents, was infected with the SARS-CoV-2 virus sometime in mid-2020. In this new species, the virus evolved, accumulating roughly 50 mutations on the spike protein before spilling back over into people.

Kristian Andersen, an immunologist at the Scripps Research Institute, is among those who has been raising the idea that Omicron may have emerged from a reverse zoonotic event.

(A zoonotic event is when an animal pathogen starts to infect and spread among people. A reverse zoonosis is when such a virus passes back into an animal species.)

The other theory is that it was circulating in someone with an incomplete immune response, trying antigen combos like a 15 year-old trying to break into a gun safe (apparently).

Again, normally I find this stuff absolutely enthralling to read about. Now? Not so much.

[Smoove_B]

Ban cons.

Did you miss that the APHA had a convention a few months ago and there was an outbreak? I'm surprised it didn't make bigger news. They probably should have checked with some type of national public health organization to see if in-person conferences were a good idea. There was someone there that apparently tested positive after the fact and they had to blanket notify a whole bunch of people about it. There was a singing contest. Totally not making any of this up.

[El Guapo]

Ban cons.

Did you miss that the APHA had a convention a few months ago and there was an outbreak? I'm surprised it didn't make bigger news. They probably should have checked with some type of national public health organization to see if in-person conferences were a good idea. There was someone there that apparently tested positive after the fact and they had to blanket notify a whole bunch of people about it. There was a singing contest. Totally not making any of this up.

I guess we should consider ourselves lucky that no Fox News editor learned about that.

[El Guapo]

The big news today is my neighborhood is that a new restaurant recently opened up. One of the owners posted in the neighborhood Facebook group about how excited they are, everyone should check it out, etc. BIG MISTAKE. Some people went through his other posts (which were set to public) and found out that the guy is a MAGA anti-vaxxer conspiracy theory type. So, now everyone is like "well, I'm NEVER going there!"

Good times. My neighborhood can sometimes be a little overenthusiastic in its embrace of cancel culture, but I'm mostly fine with this, since you have to figure that he and probably some of his staff are unvaccinated.

[Kraken]

The big news today is my neighborhood is that a new restaurant recently opened up. One of the owners posted in the neighborhood Facebook group about how excited they are, everyone should check it out, etc. BIG MISTAKE. Some people went through his other posts (which were set to public) and found out that the guy is a MAGA anti-vaxxer conspiracy theory type. So, now everyone is like "well, I'm NEVER going there!"

Good times. My neighborhood can sometimes be a little overenthusiastic in its embrace of cancel culture, but I'm mostly fine with this, since you have to figure that he and probably some of his staff are unvaccinated.

On the other side of the coin, I had hoped that my fellow grocery shoppers would've resumed masking in light of all the omicron publicity, but nooooo -- fewer than 10% were masked today, same as all summer. Apparently the needle hasn't moved from "I'm fully vaxxed so I don't need to take precautions" here in the burbs.

We also have a new restaurant opening this weekend. This place has been making off-and-on progress for more than three years, and actually hung a Help Wanted banner back in February 2020. Now at last they're finally doing a soft opening. Wife really wanted to go, even though I banned indoor dining several weeks ago. Hell, I really want to go, too. Not gonna, though. Hopefully they'll have takeout.

[El Guapo]

I wonder if any neighborhood around here is more enthusiastic about masking than Jamaica Plain.

[Little Raven]

https://twitter.com/POTUS/status/1466507137027383300

I have no idea as to the wisdom or efficacy of this move.

[El Guapo]

I bet Republicans will welcome this entirely sensible public health measure in the midst of an epic pandemic.

[malchior]

Indeed

https://twitter.com/JonS253/status/1466429388505980936

*Though I don't really find this particular rule all that sensible. It sure looks like doing something to look like he is doing something.

[Smoove_B]

*Though I don't really find this particular rule all that sensible. It sure looks like doing something to look like he is doing something.

It's something and in theory would allow us to quickly move on any identified cases coming in.

Better would be to require vaccination and mask for all domestic travel. Best would be to actively push states to adopt universal indoor masking policies with ventilation guidance. I fear it's going to happen in fits and starts in various states (if at all) over the next month or so and two months from now we'll all be wondering how we are at this new unthinkable level of chaos.

Also, that Tweet back to Gym Jordan is *chef's kiss*

[El Guapo]

*Though I don't really find this particular rule all that sensible. It sure looks like doing something to look like he is doing something.

Doesn't it make sense, though? Presumably some amount of would-be travelers will test positive, and I assume at that point they wouldn't be allowed to get on the flight. Not a silver bullet or anything, but I would think this would both increase the number of cases that get detected and prevent some transmission and spread.

[malchior]

*Though I don't really find this particular rule all that sensible. It sure looks like doing something to look like he is doing something.

Doesn't it make sense, though? Presumably some amount of would-be travelers will test positive, and I assume at that point they wouldn't be allowed to get on the flight. Not a silver bullet or anything, but I would think this would both increase the number of cases that get detected and prevent some transmission and spread.

I am just assuming (with increasing evidence) it's already here. People have been traveling here with it for weeks probably. I guess it might have some value in dissuading travel.

*Though I don't really find this particular rule all that sensible. It sure looks like doing something to look like he is doing something.

It's something and in theory would allow us to quickly move on any identified cases coming in.

How would that work? They'll get a negative test or they won't travel, right? What your talking about would imply we'd be testing them when they arrive. Unless I'm missing the mechanism or practice at play.

[Smoove_B]

How would that work? They'll get a negative test or they won't travel, right? What your talking about would imply we'd be testing them when they arrive. Unless I'm missing the mechanism or practice at play.

Yeah, that's a good point. I thought I'd heard the testing would be on our end (that we'd be testing arrivals), but that Tweet doesn't indicate that. Maybe I'd heard a proposal that we were going to randomly test arrivals? It's all blurring together for me.

In theory it should still help but I really do think we need to have a domestic policy...which I know won't happen until after the New Year (at the earliest) because otherwise the airline industry would collapse during their $$$ season.

[Smoove_B]

More data analysis for MA:

https://twitter.com/BioTurboNick/status ... 9040465925

An interesting feature of this week's map is the gradient between risk levels seems to be larger.

The greater Boston area is faring better than the rest of the state, by population.

The % positive map is getting kind of scary.

[Smoove_B]

For the OHIO folks

https://twitter.com/jake_zuckerman/stat ... 9578901512

Yikes. Ohio's test positivity rate is running red hot.

Right now, about 15.5 of every 100 covid tests is coming back positive.

That's nearly a peak. All time high came Dec. 6 at 15.9/100

[malchior]

In theory it should still help but I really do think we need to have a domestic policy...which I know won't happen until after the New Year (at the earliest) because otherwise the airline industry would collapse during their $$$ season.

Right I wouldn't argue it does absolutely nothing. It'll net some people who were going to travel COVID positive aware of it or not. And the enforcement on this is easy. The airlines will police it at departure like they do other travel documents. But the idea that it'll help with omicron? That seems very dubious to me but I don't think my particular concern is of much interest to experts who have real problems to think about.

[malchior]

Right now, about 15.5 of every 100 covid tests is coming back positive.

That's nearly a peak. All time high came Dec. 6 at 15.9/100

So we're running near the peak from before vaccines were widely available. Things are going super well.

[Smoove_B]

And so my CO peeps don't feel left out - Omicron detected:

The Colorado Department of Public Health and Environment announced Thursday it had confirmed the state’s first case of the COVID-19 omicron variant in an Arapahoe County woman who recently traveled to southern Africa.

The CDPHE said the woman was fully vaccinated but had not yet received a booster dose. She is experiencing minor symptoms, according to the department. The variant was identified through sequencing Thursday morning, officials said.

[El Guapo]

In theory it should still help but I really do think we need to have a domestic policy...which I know won't happen until after the New Year (at the earliest) because otherwise the airline industry would collapse during their $$$ season.

Right I wouldn't argue it does absolutely nothing. It'll net some people who were going to travel COVID positive aware of it or not. And the enforcement on this is easy. The airlines will police it at departure like they do other travel documents. But the idea that it'll help with omicron? That seems very dubious to me but I don't think my particular concern is of much interest to experts who have real problems to think about.

Oh, yeah. I don't expect that it will help much with omicron. More that it will marginally help control COVID spread generally.

[The Meal]

Thanks, Smoove.

[Smoove_B]

I would like to report better things, but (from last night)

https://twitter.com/BNODesk/status/1466590184984780803

BREAKING: U.S. reports 139,424 new coronavirus cases, the biggest one-day increase since September

It's sure looking like things are going to escalate right before Xmas week. We'll have to see how this trends over the next ~5 days (after weekend reporting lag).

Remember when we crossed 100K for the first time? Now it's not even news.

[Isgrimnur]

[Smoove_B]

Everything is super

https://twitter.com/BNODesk/status/1466815516002201610

BREAKING: South Africa reports 16,055 new coronavirus cases, up 468% from last week

Please folks, get those boosters *and* upgrade to the best mask you can afford/acquire that includes filtration (N95, KN95, KF94, etc...) - not just the basic surgical mask - if you're going to be spending time indoors around people with unknown vaccination status.

[Smoove_B]

For visual learners

https://twitter.com/rid1tweets/status/1 ... 4445040645

[Isgrimnur]

[Blackhawk]

For visual learners

https://twitter.com/rid1tweets/status/1 ... 4445040645

The labels really threw me until I remembered that there is a southern hemisphere.

[Smoove_B]

Yeah, me too.

I'm beginning to think it's everywhere. Amazing how quickly we're finding it, eh?

https://twitter.com/NinaAhmadPHL/status ... 9619375107

Please add Pennsylvania to this list.

I just saw Missouri also is announcing they found it too, connected to domestic travel. The good news is that vaccinations, masking and ventilation should all help to address this. The bad news is that we're only focusing on one of those things.

[Blackhawk]

It's amazing what you find when you decide to start looking.