News for January 6 — Much More Information on Omicron

Much more information on Omicron: https://news.yahoo.com/what-the-latest-science-says-about-how-and-when-the-omicron-surge-will-end-100033294.html . This is the most information I’ve seen on Omicron in one place. It answers many of the questions we previously could not answer.

First, Omicron is incredibly transmissible, perhaps 4 times as transmissible as Delta. That is not good news, but it explains the explosive growth of the variant globally. You may recall that earlier data suggested Delta was nearly as transmissible as measles. In that case, Omicron would be the most transmissible virus known during the period of modern medicine. The comments by Harvard epidemiologist William Hanage in this article verify this conclusion.

Second, Omicron is now known to create milder disease than Delta. One reason is that Omicron is more infective of upper airway cells than Delta, but less infective of the lower airway. This is a logical evolutionary development, because virus in the upper airway is more transmissible and therefore more likely to survive. However, the lower level of infection in the lower airway reduces disease severity. In short, this is because you never want an infection in your lungs.

Recognizing both the milder nature of Omicron as a disease together with the increased immunity in the population now compared to when Delta emerged, Omicron is estimated have the chance of causing severe disease in a patient that is only 27% that of Delta. This is (relatively) excellent news. However, consider this calculation: 4 times 0.27 equals 1.08. In other words, if 4 times the number of people catch Omicron versus the number that caught Delta, we could expect 1.08 times the number of severe disease cases from Omicron as from Delta.

Now, transmissibility does not exactly translate to case numbers in the way the calculation describes, but that is not the point. The point is, as a ballpark estimate, Omicron may generate a similar number of hospitalizations as Delta did. Treatment protocols for COVID have improved significantly over the past two years, so these Omicron hospitalizations may result in fewer deaths per 100 cases than Delta did. However, because Omicron transmits so virulently, the strain on the US healthcare system may be worse than Delta because so many cases occur at the same time.

Additionally, oral antiviral pills should be available in much larger numbers in the spring as production ramps up. This could be a gamechanger in COVID disease progression, particularly among the unvaccinated.

Third, the really excellent news (which comes far into the article) is contained in a new study from South Africa: https://www.ahri.org/omicron-infection-enhances-neutralising-immunity-against-delta/ . While residual antibodies after a Delta infection do not provide much protection against Omicron (hence the breakthrough infections), Omicron antibodies do provide protection against Delta. This means that Omicron should push Delta out.

The article then hops in a direction parallel to prior speculation, which is that because Omicron peaked and then receded rapidly in South Africa, we may all be out of the pandemic after this wave of Omicron circles the globe. That is a possible outcome, but not the only one.

The pandemic has featured multiple waves in the same location, and differently timed waves in different locations. Thus, a variant could emerge in the Omicron line or from a different source entirely and continue the pandemic. As readers know, I do agree with making global vaccination a priority because the amount of global viral load is a key factor in the emergence of new variants. However, I also believe that we should prioritize vaccinating populations with immunocompromised individuals.

The evidence suggests that these variants with high numbers of new mutations emerge in immunocompromised individuals. These individuals are less able to overcome COVID, and so the infection lingers in their bodies. This gives the virus more opportunity to evolve than it has in a non-compromised individual.  As the newsletter has noted, South Africa has the largest population of HIV-positive individuals in the world. It is no surprise that several new variants emerged there.                                                                                                                   (lp, 12/6/21)

Additionally, when the pandemic ends, COVID will still be endemic in the US and global population. We don’t know what that looks like yet.

So, we would be wise to heed the counsel of the world’s most famous Yogi: “It ain’t over ‘til it’s over”. And COVID will never be over, at least with current medical technology, because we have only eliminated one virus from humanity. That virus, smallpox, had no animal reservoir.

New York seeing “milder” cases in Omicron surge: https://www.wsj.com/articles/new-york-omicron-cases-surge-mild-11641424050 .

WHO cautions against thinking Omicron is “mild”: https://www.msn.com/en-us/health/medical/who-director-warns-against-calling-the-omicron-variant-mild-even-if-it-s-less-severe-than-delta/ar-AASvLxW .

European health officials criticize shortened CDC isolation guidelines: https://news.yahoo.com/we-are-playing-with-fire-european-health-officials-blast-cd-cs-revised-covid-isolation-guidelines-184127274.html . At the least, there should be a negative COVID test before ending isolation. The AMA is not happy, either: https://www.msn.com/en-us/health/medical/the-american-medical-association-called-out-the-cdc-s-confusing-covid-19-quarantine-guidance-saying-it-could-put-our-patients-at-risk/ar-AASvtDE?ocid=hponeservicefeed .

Former Biden advisers advocate need for new pandemic strategy: https://www.msn.com/en-us/news/politics/former-biden-advisers-call-for-new-covid-strategy/ar-AASvpCZ?ocid=hponeservicefeed . More: https://www.msn.com/en-us/health/medical/biden-s-former-health-advisers-urge-him-to-change-covid-strategy-accept-new-normal/ar-AASvyOj?ocid=hponeservicefeed . And: https://thehill.com/policy/healthcare/588651-former-biden-transition-advisors-call-for-change-in-covd-strategy .

Moderna CEO warns fourth COVID shot may be needed due to decline in protection over time: https://www.cnbc.com/2022/01/06/moderna-ceo-says-people-may-need-fourth-covid-shot-as-efficacy-of-boosters-likely-to-decline-over-time.html . This is certainly a possibility. We are just now getting experience on the efficacy of the third shot (first booster) over time.

COVID shuts down Star Trek: Picard production: https://www.dailymail.co.uk/tvshowbiz/article-10377311/Star-Trek-Picard-production-shuts-50-cast-crew-members-test-positive-COVID-19.html .

The latest news on the “twindemic”: https://www.today.com/health/health/flu-and-covid-fluorona-twindemic-rcna10715 . So the latest news is that someone combined the words “flu” and “coronavirus” to create the name “flurona”. Otherwise, actual cases of co-infection remain relatively rare.

Navy begins discharging sailors not complying with vaccine mandate: https://www.stripes.com/branches/navy/2022-01-06/navy-sailors-coronavirus-vaccine-mandate-separated-4201864.html .

WSJ: Omicron stresses US food supply: https://www.wsj.com/articles/conagra-ceo-says-omicron-will-stress-food-supply-chains-11641496251 . By the way, this is what inflation sounds like.

WSJ: Italy mandates COVID vaccines for residents over 50: https://www.wsj.com/articles/italy-mandates-vaccines-for-older-people-u-s-surge-continues-11641473067 .

NFL healthcare fraud results in prison sentences: https://sports.yahoo.com/former-washington-rb-clinton-portis-sentenced-to-6-months-in-prison-for-healthcare-fraud-224939138.html .

January 6: The Big Lie insurrection one year on. Short version: The truth, according to Bill Barr, is that the claims of an illegitimate election are “BS”: https://www.aol.com/news/factbox-trumps-false-claims-debunked-110959258-172512802.html . WSJ: Biden accuses Orange Julius of spreading “a web of lies”: https://www.wsj.com/articles/biden-leads-commemorations-of-jan-6-capitol-riot-11641465004 . ACCUSES? The Journal needs to do a better job of coming to grips with the truth. This is a disservice to their readers, and to American democracy.

Redistricting battles headed by the North Carolina gerrymander: https://www.msn.com/en-us/news/politics/judges-decision-on-north-carolina-voting-map-could-affect-control-of-u-s-congress/ar-AASvzs0?ocid=hponeservicefeed . North Carolina’s maps have been an almost constant battleground for almost 20 years. The Supreme Court has regularly struck down the legislature’s maps, and the North Carolina legislature basically does not give a damn. The new Supreme Court alignment may change this dynamic.

Update on Kazakhstan upheaval: https://apnews.com/article/business-europe-russia-moscow-kazakhstan-3349e68089ccdbcd08e76a5e8fd4a909 . WSJ: More: https://www.wsj.com/articles/kazakhstans-government-resigns-amid-unrest-over-fuel-prices-11641386544 . Still more: https://www.wsj.com/articles/kazakhstan-protests-fuel-prices-11641407060 . And: https://www.wsj.com/articles/kazakhstan-unrest-and-russias-intervention-transform-ties-with-moscow-11641498408 . Also: https://www.wsj.com/articles/dozens-killed-in-kazakhstan-as-authorities-crack-down-on-unrest-11641462504 .

Peter Bogdanovich passes at 82: https://variety.com/2022/film/obituaries-people-news/peter-bogdanovich-dead-dies-director-1235148166/ . WSJ: More: https://www.wsj.com/articles/peter-bogdanovich-director-of-paper-moon-dies-at-age-82-11641501037 .