The Omicron Cloud
As the cloud of Omicron gathers it is critical to try to understand the impact it will have. As we've all learned over the past two years, there are many kinds of impacts. I want to concentrate on just a few.
Illness
Omicron is incredibly contagious. Initial indications are that it clearly increases hospital admissions. However, it is not clear hospital patient populations rise. In other words, people seem to be getting discharged faster. The symptoms being described are much milder - and are associated with the common cold. Looking at the South African data, admissions have increased - but not as rapidly related to cases as they did in previous rounds.
Death
There is no question at this point that Omicron is less deadly. Not just on a per-case basis, but overall. Death rates in South Africa rose with prior rounds of infection almost immediately following the rise in case loads. Separation in trends was realized (deaths slowed down) relative to cases, but deaths were not that far behind cases. With Omicron there is a rise in deaths, but it is far less substantial. The data in the US and UK is too early to judge, but it appears to be following the same trends.
If Omicron disrupts an existing Delta outbreak, it could actually cut deaths and illness by displacing the more dangerous variant. This could explain the early drops in the US and UK.
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Economics
As a disease, Omicron moves fast. South Africa appears to have peaked already. The last round in South Africa took 2 months to peak. Omicron has done it in 3 weeks. The post-peak drop off appears to be more vigorous as well - in line with a highly infectious disease very quickly spreading through a population and then running out of carriers. This is important because it suggests we'll have very good and complete data sooner than we would with a slower moving variant. This is important economically.
I believe a consensus will quickly emerge that Omicron is not nearly as deadly as feared. I also believe hospitalizations will be shorter and overall hospitalization numbers will flat line or drop as Delta is displaced. The political classes will want to be seen doing something so we have seen border closures (totally useless in countries with Omicron even if Omicron was bad). We might see lockdowns and other closures. Due to popular pressure, these initiatives will falter a short way into the wave. Politics will determine when. Areas with politics that emphasize collective sacrifice will find initiatives extended. Other areas may have no additional restrictions whatsoever. People will see vast numbers of cases, but many fewer effects, and increasing numbers will demand their governments move forward.
Society
I hope the bifurcation we're seeing will begin to shift. The Great Omicron Panic will wash up against the minor Omicron reality. As the cost of panic continues to ripple through the world population there will be additional emphasis on rebalancing the tradeoffs. The arrival of Pfizer's Plaxovid will also help - as it will enable intervention in the most high-risk cases and further cut down both deaths and opportunity for mutation.
Reducing the cost of panic is critical socially. Societies that are already being bankrupted by a lack of children are being faced with a severe drop in marriage formation. Just to give one example: in Australia, 30% of marriages are between people from different countries. During their extended shutdown, a significant percentage of family formation just stopped. In 2019, 113,815 marriages took place in Australia. In 2020, it was 78,898. Even countries will less severe lockdowns saw this. Many countries do not yet have 2020 data, but Scotland and Northern Ireland saw declines over 50%. Even Israel, which places extreme priority on family, saw a drop of 15%. Long-term these costs will be severe economically and in other respects. The sooner society can remain 'open' despite new variants the healthier it will be.
Conclusion
I believe Omicron will be a blessing. It will provide further immunity to vaccine reluctant and vaccinated people alike. It will do so at a much lower cost than the previous variants. It will probably not spell the end of coronavirus. After all, our immunity to coronaviruses seems to time out and there may be other variants that are not affected by prior Omicron infection. All that said, I think Omicron will provide a respite - perhaps a long enough respite to enable non-vaccine-based interventions like Plaxovid (or even aspirin) to acquire widespread efficacy.
The next few weeks will be hard, but the next few months could be eye-opening and very very positive.
I'm curious to know if it's worth getting a 4th shot. I believe Israel is the only place in the world doing this on a large scale.
#Omicron is more dangerous than you imply. According to the CDC, Omicron is expected to kill nearly 50,000 Americans over the next 4 weeks alone. It will threaten critical infrustructure and will likely hit medical professionals particularly hard since it is so easy to catch.
But is this more than were already being killed. So far the death rate is 20% LOWER than it was before Omicron on Dec 3rd.
50,000 deaths in 4 weeks? Holy cow! That sounds like a lot to me. How many people died per month with Delta? I thought it was less than that.
A boy in my son's school tested positive today. The school sent all the kids in the class home and told them to get a negative covid test before returning to school. But if they were just exposed, wouldn't the virus not be present enough in the students' bodies to test positive? Seems rather pointless. They could all test negative today, but positive tomorrow or the day after.
How long does it take from exposure, to being able to test positive?
I believe it is up to 3 days with the new variant. Then again, there are apparently symptoms after 3 days with the new variant. A big improvement.
Is that the same for antigen tests? Or just rapid and PCR tests? He had to take an antigen test.
I don't know. Apparently they suspect the antigen aren't even detecting it. You are right though, it is all pretty pointless.
It's doubly pointless because I bet a lot of parents will lie and just say their kids tested negative, without even giving them one.
I get it. No one wants to wait in an hours long line for a test. And buying a home test can be hard to find and gets expensive. But it amazes me how even "careful" and "Covid conscious" parents can become so damn selfish when following the rules suddenly becomes personally inconvenient.
I'm pro spread. But I still did the daily tests required for my kids. Spent two hours in line on Sunday for an official test. Urg.
But the more Omicron spreads, the more likely it is to mutate again and create an even more dangerous variant.
The mutations have occurred within *SINGLE* patients. Single individuals with AIDS or TB - not mass collections. This is how you get 50 mutations in a whack with no intermediaries in the community. The disease mutates and mutates and mutates in *one person.*
The key is to protect and monitor people with specific conditions that enable this sort of mutation - not to worry about widespread that can only yield small mutations. In fact we want the most direct and fastest line we can have on relatively benign strains like Omicron so that we are protected before more dangerous mutations can develop in those individuals and spread.
Omicron is going to be the end of us. I don't mean literal death (deaths still seem to be low for now,), but our economy. In NY everything is shutting down. Flights, stores, even the subway is partially shut down. Too many people are sick to work, and the numbers keep growing!
A LOT of people are going to die from Omicron. It may be less deadly that Delta, but it is a helluva lot more contagious - meaning more people will ultimately die. And not only are hospitals becoming overwhelmed, they are becoming increasingly short staffed as well, as more and more health professionals become infected and call in sick. Soon the entire medical infrastrucure will collapse!
They estimate 30% of the US population got covid in 2020. How much more infectiousness actually matters.
The problem in the US is NOT ENOUGH Omicron. It looked like it was all Omicron then the CDC updated and there is a lot more Delta out there than thought. Updates in the UK and South Africa continue to show very very low death rates. FAR FAR lower than previous rounds of Covid despite increased contagiousness. ICU rates are actually down in the UK.
I read today that 95% of all US infections are now Omicron.h
Which might be why the death rate has now fallen.
Omicron started picking up in mid December. Deaths went up from the prior Delta wave and then settled down with Omicron - even as case loads went up 4X.
I don't consider 50,000 dead Americans over the next 4 weeks (according to CDC projections), to be "very low death rates."
This projection is qouting the CDC and taken from CNN's homepage right now.
The death rate is now LOWER than it was a few weeks ago, before Omicron. Maybe there will be 50,000 dead - but Delta would have killed more. It was killing more and with fewer cases.
So far, it looks like death rates are going down - even in the US. There was a Delta rush that drove rates up but is now being displaced by a far less dangerous Omicron wave.
I am so sick of Covid! When will it end? How does it keep mutating? And how much worse will the next variant be?
I keep reading how #Omicron is setting infection records across the US. Yet since we can't get a covid test ANYWHERE, the numbers must be much higher than reported. You can't get added to the official numbers if you can't be tested.
And don't forget that a lot of people are taking home tests to find out they have Covid. Those numbers are not included either.
That's a good point. But at least they can get a home test. They are sold out everywhere near me. I'm pretty sure I have it, but can't find any tests to make sure. And my doctor has no availability to see me either. Completely booked.
I have not been able to find tests anywhere either. Every place is sold out. They should be prioritizing people with symtoms - there are not enough tests for everyone!
I disagree. I think that if someone has symptoms, just assume you have it and stay home. Does it even matter if it is Covid or something else? Why get other people sick?
Instead, they should save the tests for people who know they have been exposed, but have no symptoms - those are the most dangerous as they will continue to walk around and infect countless others, without even knowing it!
I'm far from there (I have almost 30 home tests in my fridge), but the reports I've read say the rise in cases is much much higher than reported. Unfortunately, hospitalizations are rising but it could still be very much a net positive as other reports are showing great immunity post-Omicron. The higher the real caseload vs. hospitalization the less dangerous the virus.
Omicron is spreading so fast, maybe we'll finally be able to reach herd immunity when we couldn't with the less contagious variants.
It'll still be temporary, but if we can encourage less powerful variants to continually circulate then we'll get a big benefit. Getting a cold every few months because of continual exposure is better than facing a deathly illness every year.
How do we "encourage" one variant over another? I don't see how we have any control over that.
Israel might decide to do just that - requiring no testing or isolation for the asymptomatic.
We do it almost implicitly. When people are sicker, they don't go out. If they are facing limited symptoms, they do.
And we *don't* put controls on asymptomatic people.
It's great that Omicron isn't as dangerous as Delta. But while Omnicron may be killing a smaller percentage of those it infects, it is still killing healthy people.
Omicron is much more contagious and more resistant to vaccines. It sounds like many hospitals are on the verge of being overwhelmed - so the number of serious cases are more serious than you are implying. And if hospitals are overwhelmed, it will unleash a Pandora's box of other problems and related deaths.
Hospitalizations are at 208/million. They peaked at 400 in January and reached 300 in August. We aren't there yet.
ICU admissions are at 50 and not rising quickly (they were rising more quickly before Omicron). They were at 78 in September and 86 in January.
This makes me feel much better about Omicron. I was literally freaking out about it!
Don't freak out. As more data comes in it looks like hospitalizations are rising some - but not as much as past waves. Notably, ICU admissions don't seem to be rising yet. Again, they'll probably rise some but this is a much less dangerous variant.
Thanks for writing this, but I don't see how it answers my question from your previous article. Once again: If Omicron is much more contagious (I've read 10X as contagious!, but not as deadly, won't it still kill more people? If it infects 10 times as many people, even if it's half or 1/4 as deadly, more people would still die simply because so many more people are infected, no?
In fact I just read on the homepage of CNN that two new studies confirms that Omicron is much milder - one report said it is 66.67% less likely to lead to hospitalization than Delta, and the other report said 80% less likely. Very encouraging! But it also goes onto say that it is so much more contagious, that it is still likely to overwhelm hospitals. That's a big problem. And the more people who get it, the more people there are to spread it.
10X contagious means two things.
1) It spreads more easily. This doesn't seem to matter much, Delta spread plenty easily. Short of island-nation isolation non-infection was much more a matter of luck (or ignorance) than anything else. It is estimated over 100 million Americans had corona by the end of 2020! So everybody gets it. So 'more contagious' actually means....
2) People get it faster. It'll rip through the population much more quickly. But if hospitalizations in SA (which has only 25% full vaccination) are 80-90% lower, then in the US they are probably 90-95% lower. So even getting it faster could see a lower hospital burden - especially if it displaces Delta cases.
SA saw a rise in hospitalization, but not intensive care. These were much shorter, lighter, stays. Look at US hospitalizations - it has almost flattened in the last week and a half as Omicron has taken over. It has flattened at levels significantly lower than those just a few months ago. The UK has seen a slight rise (again, nothing like previous rounds) despite a burst of Omicron.
The data points to a lighter hospital burden. This is a far better virus. It displaces worse variants. If it and its ilk cycle through the population we will have a much more maneagable reality going forward.
I don't see how having yet another variant can be a good thing. I've read that people can actually be infected by more than one variant at the same time, so it's not like this will help us achieve herd immunity. We've already learned that's impossible - immunity is too short lived, and too variant specific.... and there are a whole lot of variants!
Judging by the improvement in death rates, Omicron is displacing Delta. In other words, it is crowding it out. If we can encourage weaker variants then we can renew our immunity through repeated exposure to weaker variants. It is kind of like the 1918 Flu. It killed 50 million people out of a world population of 1.9 billion (corona has killed 5-15 million out of a population of 7.7 billion). People didn't become immune to the flu, though. It still hits every year. The strains just weakened. We know enough now to encourage weaker strains and discourage stronger ones. Just being asymptomatic will make a strain better at spreading.
So we can and should encourage weaker strains, just like breeding more useful animals or fruit.
It won't eliminate the virus, but it could minimize the impact of the virus.
So you are saying that if I get Omicron, I will recover easily (even if not vaxxed), and though I can sill be infected by Delta, an infection would be both less likely and less serious?
The data looks like this. Cases are shooting up, but hospitalizations and deaths aren't. This suggests you are *far* more likely to have a light Omicron case than a difficult one and that it is displacing more serious varients. It is like a vaccine that gives you a pretty brutal cold and that you get whether or not you want it.
If you are elderly/infirm etc.... it can still be dangerous. But even so, it is far less dangerous.
From your mouth to God's ear!
This sounds rather promising.