Omicron, the science only, please

[Juvenal]

From the perspective of someone who was tracking bi-weekly increases on the first wave to share with students, those are jaw-dropping increases. The daily acceleration of Omicron is comparable to the biweekly acceleration on the original strain. Delta took months to become dominant.

It takes a couple weeks for a booster to become useful. Now is the time. Not tomorrow, and certainly not next week.

Please.

The U.S. Faces Another Covid Christmas as Omicron Fuels a Rise in Cases
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On Monday, the Centers for Disease Control and Prevention reported that Omicron, which accounted for less than 1 percent of new Covid-19 cases in the United States as December began, now accounts for nearly three-quarters of new cases, underlining how stunningly infectious it is.

Omicron has already won in the US.

Omicron took less than three weeks to overcome Delta, which means my envelope calculations at six weeks, which I thought were aggressive, were instead highly conservative. Additional data suggest that Omicron isn’t so much less deadly as it is less selective. Everyone is getting it including the young, driving death rates down by weighting in healthier individuals. More, those who were fully vaccinated as little as three months ago are at risk of breakthrough infection, and those who were fully vaccinated six months ago are at high risk.

[Juvenal]

UK gov't now reporting 14 omicron deaths (PDF). Pretty detailed presentation, but ATM my brain is too foggy to ascertain whether it gives enough info to tell whether the deaths are "with" or "from" omicron. Cross-posted from the "Covid vaccine effectiveness" thread.

Thanks for that.

The data won’t show what you’re looking for, in part because it’s not a meaningful medical distinction. If someone died with Covid who wouldn’t have died without Covid, they died from Covid. That’s the same criteria as used for any other disease. Definitions didn’t change for Covid.

What it does show is why estimates for how long Omicron would take to overcome Delta were so far off. I was figuring doubling times of three to four days. The actual doubling times — in the UK, a realistic proxy for the US — is under two days. Compare that to doubling times of over a month for previous variants. From these figures and Monday’s estimates from the CDC, I now expect almost all cases in the US will be Omicron by the end of the week. I further predict Delta will have effectively vanished in the US by the first week of January.

This won’t affect the lag between infection and death, which should still be about a month. There’s an argument that says a slower moving infection in the lungs could stretch that out, but at the same time, that would allow a larger window for the therapeutics now coming online, so for my estimates, that’s a wash.

I’m going to keep on poring over the daily figures, but as of now, I’m counting down toward January 20, by which time the Omicron signal should become dominant in US death counts. The figure of interest for me is a daily average of 1000 deaths because it’s so easy to spot and would definitively show that Omicron is sufficiently less virulent to be a net positive for the US healthcare system.

Hope for the best, prepare for the worst.

If you’re reading this, get boosted, please.

[shunyadragon]

I hope you are correct, much as I like Dr. Risch. A more transmissible but less virulent variant would be a relative good.

FWIW, here is the quote from Dr. Risch: "The fact is that the transmissibility index has been studied by a very smart professor in France, Jacques Fantini, who calculated that its transmissibility is comparable to the alpha and beta variants. And it's about a third of what Delta is. So it's less transmissible than delta."

From the transcript here.

This seems to be a presentation of the Fantini work he cited.

Yes, the fatality rate and hospitalization is lower for the Omicron variant, but the rate of fatalities and hospitalization with the resulting complications is still at pandemic levels. Hospitals are being overwhelmed by Omnicron cases as this variant replaces all other variants. The present trends of the spread of the Omicron variant cannot be considered 'relatively good,' because it is indeed far more transmissible based on present evidence.

Source: https://www.cnbc.com/2021/12/23/omicron-traumatized-and-exhausted-hospital-staff-face-new-wave-of-covid-cases.html

Traumatized and exhausted hospital staff face new wave of Covid cases as omicron rips through U.S.

Hospitals across the country are bracing for another wave of Covid-19 cases that promises to be just as bad, if not worse, than the early days of the pandemic.

But this time, they are facing it with fewer nurses; and the staff that remains is exhausted after almost two years of fighting Covid. The health-care industry lost 450,000 workers from February 2020 through November, mostly nurses and residential-care employees, the Bureau of Labor Statistics reported earlier this month.

What’s more, the highly mutated and contagious omicron variant can more easily infect vaccinated employees than previous strains. That threatens to further exacerbate the staffing shortage by sending workers home to isolate, even if they have mild or no symptoms.

Retaining enough workers is Dr. Shereef Elnahal’s “biggest concern right now by far,” he said. At the University Hospital in Newark, New Jersey, where Elnahal is president and CEO, the number of employees out of work due to Covid has doubled for the last three consecutive weeks in a row, he said in a phone interview.

“It’s a concern that actually exceeds my concern over omicron-specific hospital admissions based on the trends that we’re seeing,” he said.

© Copyright Original Source

There is not any 'relative good' in terms of the continuing fatalities,hospitalizations, and health complications as the pandemic continues.

[shunyadragon]

AFAICT from Google, there are currently *zero* confirmed deaths "from" omicron. I find *one* confirmed death "with" omicron, in the UK, with no data released about the victim's age, sex, BMI, underlying health status, vax status, reason for hospitalization, or direct cause of death.

A reference worthy of updated the Omicron variant continuing pandemic.

Source: https://www.forbes.com/sites/joshuacohen/2021/12/22/the-omicron-variant-may-be-less-severe-but-higher-transmissibility-may-cancel-out-the-effect-especially-in-the-us/?sh=3c58851f713d

The Omicron Variant May Be Less Severe, But Higher Transmissibility May Cancel Out The Effect, Especially In The U.S.

Joshua Cohen

STRF/STAR MAX/IPX
Preliminary data suggest that the Omicron variant is less severe than its predecessor, Delta. But, Omicron’s much higher transmissibility may cancel out the effect.

Furthermore, based on past experience with previous waves, such as Delta, the U.S. will likely suffer more from the Omicron wave than other wealthy, industrialized nations.

Varying degrees of decoupling of cases, hospitalizations, and deaths

Since the vaccine rollout began last winter, vaccines have blunted the impact of successive Covid-19 waves, by protecting people against severe illness. Though vaccines aren’t a panacea, the odds of becoming critically ill with Covid-19 are between 8 and 12 times greater if unvaccinated.

And so, in heavily vaccinated countries, there have been varying degrees of decoupling between cases, hospitalizations, and deaths. However, the extent to which there has been an unlinking across Covid-19 indicators has not been uniform across countries. This is due to multiple factors, including a wide disparity in vaccination rates. In countries such as the U.K., with a higher vaccination rate than the U.S. and significantly better protection of the at-risk and over 65 population, we observe a much greater degree of decoupling during the Delta wave.

Omicron is rapidly displacing Delta to become the dominant variant in parts of Europe and North America. Scientists have determined than the new variant reduces the effectiveness of two doses of vaccine, especially as immunity wanes over time. But, previous levels of protection against severe disease are apparently restored with booster shots. Going forward, the extent of decoupling of cases and hospitalizations, for example, will depend in part on how well the overall population is boosted, and how successful the booster campaigns are at reaching at-risk sub-populations.

Scientists have also discovered that the Omicron variant is significantly more transmissible than Delta. In addition, breakthrough cases in the vaccinated (and even the boosted) appear to be fairly common with Omicron. At the same time, preliminary evidence indicates fewer people who contract the Omicron variant of the coronavirus require hospitalization. Initial estimates suggest that the hospital stay risk is 40%-45% lower than Delta. It’s unclear why there seems to be a reduction in severity. It may be due to mutations of the Omicron variant. Indeed, an updated analysis of Omicron by the Imperial College London suggests the variant’s mutations have made it a modestly milder virus than Delta.

Nevertheless, epidemiologists and policymakers are concerned that even if Omicron is milder, the sheer number of cases – due to much higher transmissibility - could overwhelm healthcare systems.

Suppose Omicron is 50% milder, if there are twice the number of cases in a particular jurisdiction it will wind up with the same increase in hospitalizations.

We see that hospitalizations are rising in countries being impacted by Omicron, merely a couple of weeks after it began taking off in terms of spread. On Wednesday, December 22nd, there were 1,061 admissions in hospitals in England, the highest number in more than 6 months. In the U.S., hospitalizations are steadily climbing as well. Some of these hospitalizations are Delta cases, but an increasing number are Omicron-related.

© Copyright Original Source

Longer article informative.

[Juvenal]

South Africa’s huge omicron wave appears to be subsiding just as quickly as it grew
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NAIROBI — South Africa’s huge wave of omicron cases appears to be subsiding just as quickly as it grew in the weeks after the country first announced to the world that a new coronavirus variant had been identified.

South Africa’s top infectious-disease scientist, who has been leading the country’s pandemic response, said Wednesday that the country had rapidly passed the peak of new omicron cases and, judging by preliminary evidence, he expected “every other country, or almost every other, to follow the same trajectory.”

“If previous variants caused waves shaped like Kilimanjaro, omicron’s is more like we were scaling the North Face of Everest,” Salim Abdool Karim said in an interview, referring to the near-vertical increase in infections that South Africa recorded in the first weeks of December.

This could be very good.

You always want to err on the side of caution, but this could be the end of the pandemic. In South Africa, says here, 70 percent of the population was previously infected. In the US, a similar percent have either been infected or been vaccinated. My envelope says we could reach a state where everyone in the US has been exposed inside two months. At which point herd immunity isn’t even a concept.

That said, people who don’t have to die from this are still dying from this. Even when the vaccinations aren’t preventing illness, they’re still saving lives.

[Juvenal]

Omicron less likely to lead to hospitalization, U.K. study finds
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People infected with the omicron variant were up to 70 percent less likely to be admitted to a hospital than with previous strains, according to the study, which was released Thursday by the UK Health Security Agency (UKHSA). But the protection boosters provide against infection also fades more quickly against omicron than delta, by about 15 to 25 percent.

U.S. now reporting more infections than during delta summer surge
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The United States logged a seven-day average coronavirus case count of 168,981 on Wednesday, amid a nationwide spike driven partly by the omicron variant, Washington Post figures show. That surpassed a summer peak average of 165,187 infections Sept. 1., as the delta variant was surging.

The tally comes as preliminary data suggests that omicron is significantly more contagious than other variants. The latest surge is the second-largest wave of the pandemic, behind the spike in infections between November 2020 and January 2021. On Jan. 12, the United States marked a record seven-day average of 248,209 cases.

So numbers, preliminary numbers, but numbers nonetheless. If the UK study holds up, then the hospitalization rate for Omicron will be 30 percent of Delta’s. On the other hand, Omicron has already exceeded Delta’s peak cases. Delta had been declining in the US before this latest surge, which is no longer being driven by Delta. Omicron is now driving Delta out of existence.

But it’s the cume cases we need to consider in order to determine whether Omicron will cause a net reduction in total mortality. I’ve tried, but I can’t estimate that well enough to make a projection. Based on the UK figures, all I can say we need the cume cases from Omicron to be less than 3 times that of Delta to be sure it’s less deadly overall.