outbreak! (ebola, sars, coronavirus, etc)

Indeed:

BREAKING: California will implement a statewide indoor mask mandate starting Dec. 15 through January 15. @Cal_HHS says Covid cases have risen 47% since Thanksgiving.

— Lara Korte 🎄 (@lara_korte) December 13, 2021

Omicron is about to become the dominant variant in London, but there's still uncertainty apparently as to whether it is more transmissible/has an advantage over Delta, per Dr Angie Rasmussen. I think everybody has solemnly agreed it has to be at least as transmissible, but the immune evasion piece makes that calculus a little bit difficult, as it's hard to tell how much of the spread is due to reinfection increase/evading some immune response and how much is its contagiousness.

the not knowing stuff is driving me nuts but I know scouring the web for morsels of info is less helpful than anythin gso.....on I wait.

rather than speculation, here is some information on the role of T-cells, of a more reassuring nature:

I am really angry about people repeatedly misrepresenting the role of T cells in COVID-19 to terrify people about Omicron so here's a thread on the evidence we have there. 🧵

tl;dr T cells are protective and essential components of the immune response against SARS-CoV-2.

— Edward Nirenberg (@ENirenberg) December 13, 2021

It's possible that omicron has a marginally lower R(0) than delta, but it seems pretty certain its R(0) is much higher than alpha's. I'm not sure how having a more precise knowledge of this would affect one's decision-making at the personal level.

I'd be down with this change here:

What Denmark did to cut the booster shot interval to 4.5 months was smart. That's when (~5 months) substantial waning shows up, not 6 months, the US policy, which will leave many not adequately protected vs symptomatic infectionhttps://t.co/uvYigpbtpu

— Eric Topol (@EricTopol) December 14, 2021

Completely agree with this. Six months was a convenient population-wide cut-off earlier when the stakes were lower. But there's a significant decline in efficacy that starts earlier, and with Omicron looming it makes sense to shorten the time-to-booster. https://t.co/PLaKA2vdY1

— Bob Wachter (@Bob_Wachter) December 14, 2021

Think the main reason it was so delayed before is that scientists didn't feel the waning had been proven. I think durability is better visible now.

Shot 5 for me in March? Lol

Some aggregate stats from Ireland:

More than half of people admitted to intensive care units between July and November were unvaccinated.

According to the Central Statistics Office's Covid-19 Insight Bulletin, unvaccinated people accounted for 54% of Covid-related ICU admissions over the last five months.

More than 9-in-10 (92%) also reported having an underlying health condition.

The median age of the unvaccinated patients who had contracted Covid and were admitted to hospital between July and November was 38 years.

The median age for vaccinated patients was 66.

Nationally, almost two-thirds (59%) of those admitted to hospital under the age of 24 had not been vaccinated against coronavirus.

The equivalent figure for those aged between 25 and 44 was 48%.

The average hospitalisation rate has stayed below 30 people per 1,000 confirmed cases since April.

At the same time, the average ICU admission rate has been less than five people per 1,000 confirmed cases.

Thanks - that's the sort of thing I'd been wondering about. (Assume 'unvaccinated' means not having had any jab at all?)

Sounds like a lot of the same people remain most at risk: underlying conditions, elderly, and/or unvaxxed.

good news on the Pfizer pill

yes, good news for the ROTW but i'm assuming the dead enders in the US will stick to horse paste.

Wow, just realized it's been like a month or more since I've seen or heard the word 'ivermectin'.

10. Hospital admissions (anecdotal data):
1. Most #Omicron admissions = unvaccinated people (16% of ICU admissions = vaccinated)
2. High % of incidental admissions (people going 2 hospital 4 things other than #COVID + test 4 admission + find out they have #COVID) pic.twitter.com/3fuCRvHXSH

— Mia Malan (@miamalan) December 14, 2021

^ real world data with VE against severe disease. Only has 2 vax estimates but has it at 70%.

Boosters likely to be important

Thanks - that's the sort of thing I'd been wondering about. (Assume 'unvaccinated' means not having had any jab at all?)

Nationally, almost two-thirds (59%) of those admitted to hospital under the age of 24 had not been vaccinated against coronavirus.

new neutralization data for COVID, including how Moderna fares after 3 shots against Omicron (it's pretty good news):

2 new reports: up to 100-fold increase in neutralization activity vs Omicron after 3rd dose vaccinehttps://t.co/imiVfD52qXhttps://t.co/BkYOUoPsZy pic.twitter.com/ssLN1NSAAr

— Eric Topol (@EricTopol) December 14, 2021

some good news: Walensky said we're up to 2 million vaccines a day, some of the highest numbers since spring.

_Nationally, almost two-thirds (59%) of those admitted to hospital under the age of 24 had not been vaccinated against coronavirus._


I might be being pedantic but calling 59% “almost two-thirds” is a bit of a stretch

maybe if we advertised them as vaccines that inject McDonald's quarter pounders into you directly, we'd get up to 5 mill

Nah, like 5G, quarter pounders are a highly-desirable resource only when they aren't being crammed into your veins by the gubmint.

Things are starting to feel depressingly familiar…

In response to an increase in COVID-19 cases and evidence of the Omicron variant, Cornell is moving to Alert Level Red and announcing a number of immediate measures, including final exams moving online as of noon, Dec. 14.https://t.co/Scj0FZBEuA

— Cornell University (@Cornell) December 14, 2021

*sigh*

Wow, just realized it's been like a month or more since I've seen or heard the word 'ivermectin'.

have you tried being represented in the United States Congress by Ron Johnson

That Cornell thing is kind of what I was getting at about leadership basing decisions off of pure case counts. I don’t know a lot about the situation in New York State and how bad the hospitals/ICU situation is around Ithaca, and there are plenty of other factors I’m sure I know nothing about. That said, it’s surprising to see an institution with a vaccine mandate and, presumably, a very high rate of vaccination take this step. They even explain that they aren’t yet sure there actually is a lot of Omicron in what they sampled, but they are “proceeding as if it is”.

Not saying it’s the wrong decision, just seems a not great sign that we are going to see a lot of preemptive shutdowns even before we wrap our arms around Omicron.

Supposedly preliminary data suggests risk of hospitalizations is 29% less than ancestral strain, but really that calc could go either direction when we get more clinical outcomes

https://www.cnn.com/2021/12/14/health/omicron-variant-south-africa-details/index.html

One of the most salient lessons of this pandemic has been that college kids will gather and mingle in large, closely packed groups, both indoors and out, often unmasked, the instant they have the chance. They will also consume alcohol in unwise quantities, but we knew that long before the pandemic. The officials at Cornell may have taken this into account.

Well, yeah. But by that logic every campus should be shut down every single time there’s a spike, but that’s not sustainable or realistic at this point. And I’m not arguing that sometimes going remote isn’t the right decision. It’s more that seeing that news makes me think it won’t be the last and the more schools shutdown, the more employers shutdown and… well, considering we’ve killed pretty much all of the paltry, half-assed safety nets we established last year, I really worry what additional shutdowns are going to do to people in precarious financial positions. I also don’t see any of these shutdowns being approached in a measured, consistent, rational way, rather they will be half measures that don’t effectively stop the spread as much as they might otherwise and end up punishing the poor more than anything else.

I don’t know, it’s just that seeing decisions like this made in a (seeming) panic, in the middle of finals week with almost zero notice, doesn’t exactly inspire confidence that we’ve learned a lot about dealing with another huge wave. Maybe I’ll be proven wrong this time.

DePaul already announced they're coming back from break online

https://depauliaonline.com/56003/news/depaul-is-returning-to-online-classes-for-first-two-weeks-of-winter-quarter-to-combat-potential-covid-19-surge/

I know following Topol can be a mess, but I was really struck by the two graphs he’s shared this evening showing Cornell and Denmark.

The country with the highest cases/capita in the world now is Denmark, with 77% of its population fully vaccinated, 23% boosted, soon to be Omicron dominant.
(The US is 61% vaccinated, 15% boosted, avg ~120,000 cases per day, w/ >66,000 hospitalizations) pic.twitter.com/RG2MVk8tfb

— Eric Topol (@EricTopol) December 15, 2021

The O signature is a |@Cornell, graph by @AnilOza16 @cornellsun pic.twitter.com/4CNYCZcQSn

— Eric Topol (@EricTopol) December 15, 2021

I’m trying not to dwell on the doom and gloom but, this seems bad. Very bad. Even if it is 29% less severe.

One more study. More transmissible than Delta though impact is different:

For those asking whether this is good/bad news, simple answer: I don't know. While omicron may infect the lung cells less efficiently, a higher viral load may worsen immune response. We discussed the pathogenesis w/ @KindrachukJason @KrutikaKuppalli https://t.co/aAYXx8tR8a

— Muge Cevik (@mugecevik) December 15, 2021

thanks, was waiting several days for Muge to post a thorough update

the metro last night had a bit on how the main omicron symptoms that are being seen are different from the taste / fever / cough of earlier, classic covid.

(i'm wondering if it might evade not just vaccination but *testing* because of this?)

now now

I feel like Omicron evading testing means we wouldn't already have the data we do have. I'm not sure that's a worry.

Honestly what kept me up last night were the reports of areas with Omicron breakouts seeing doubling of cases every 2-3 days. That's just... crazy. Even if it is significantly milder, the sheer numbers of cases we are likely to see, coupled with the 40% of America that refuses to get vaccinated, terrifies me. If similar rates hold up here, and there is yet little argument about why it wouldn't, I don't see how our healthcare system doesn't get completely overwhelmed by mid-January. And considering very few states/municipalities have the political will for much more than indoor mask mandates, if that, I fear a surge that will dwarf all the others. The only silver lining I see is that hopefully deaths won't spike nearly as bad as cases.

yeah we're fucked

^^^ almost what I posted instead, tbh

i’m not sure this is right. yes there will be a huge wave of omicron, the question is how many people will need care. if it’s as bad as normal flu then it’s going to be pretty ugly. but it might not be. mine is like a mild cold.

You've had it already right? That would contribute to how severe it is for you this time around, per reports.

xpost - I'm glad to hear yours is mild! Hope it stays that way and I'm sorry to see it hit you again.

I am very hopeful that it does remain "mild" for the vaxxed, but the sheer numbers of unvaccinated in the US mean that there is still a fairly huge population that could get hit hard enough to overwhelm our hospitals.

yeahi dunno. i had it in march 2020.

when i say we're fucked i mean hospitals are going to be jammed for the next 6-8 months in this country and we are going to be wearing masks for the next year and i could also see some quarentining happening

right. and if you need something done that’s non-covid related well good luck with that, cause uncle steve considers it his god given right to get hospitalised with covid if he wants to

correct

the metro last night had a bit on how the main omicron symptoms that are being seen are different from the taste / fever / cough of earlier, classic covid.

(i'm wondering if it might evade not just vaccination but *testing* because of this?)

xxp koogs:

The great majority of marketed PCR kits are expected to work fine with Omicron, despite Omicron's high number of mutations concentrated in its S gene. See figure 1 in PCR performance in the SARS-CoV-2 Omicron variant of concern?. Most kits don't target the S gene at all. Only 2 of 39 kits have known issues. One oddball kit for CoV-2/Flu A/Flu B/RSV is predicted to give screwy Cts. And the TaqPath Combo kit has a known S gene target failure (SGTF) with Omicron, but as it also tests for the viruses orf1-ab and N genes, it doesn't produce many false negatives.

TaqPath's SGTF has been used as a proxy for Omicron prevalence in South Africa, the UK, Denmark and Ontario. In the UK, about half of PCR testing uses TaqPath, so only half of PCR test results may indicate the variant.

Tbh if it’s as mild as they say and people are thinking it’s a cold they’re probably not bothering to test and therefore throwing off the fatality and hospitalisation rates.

hospitalization rates, while climbing, are still well below where they were at this same point during the Delta wave in South Africa.

whether this is due to mildness of illness or actual strain being milder is still being evaluated, but it definitely means proportionately less people getting infected are receiving severe incomes.

problem is the transmissibility being as high as it is means that could still be a very high number and overwhelm health care systems.

lots of folk in my state seem to forget it is indeed a two-part equation - transmissibility+virulence/severity, not just the latter.

as Howard Forman put it, "individual" risk may be lower now, but the public health risk not so much (ie health care system).

there's also the issue in the US of how Delta is still kicking our ass so we may get a fun hybrid wave

78,610 new cases in the UK today

Deaths are still falling. Hope that trend remains that way. Hospital admissions slow or falling too.