COVID-19 detected in United States

[bjdeming]

Or not. This is a British expert quoted, though, and it is difficult to say if it is truly an opinion or some of the "keep calm, carry on" attitude that occasionally did surface over there last year before the devastation began to be obvious:

"Despite those mutations existing in other variants, the vaccines have continued to prevent serious disease as we've moved through Alpha, Beta, Gamma and Delta," he said. [From context, I think it's all vaccines, not just theirs...BJD]

"At least from a speculative point of view, we have some optimism that the vaccine should still work against a new variant for serious disease but really we need to wait several weeks to have that confirmed.

"It's extremely unlikely that a reboot of a pandemic in a vaccinated population like we saw last year is going to happen," he added.

 

[bjdeming]

Meanwhile, in India, symptoms reportedly are mild thus far, at least for the vaccinated, and they're wondering why all the hype is going on already even though they are just starting to look into the Omicron situation.

 

[Jacob]

It's too early to know what will happen with Omicron, but the early reports from South Africa are encouraging. From what I've seen, all reported cases of it so far are mild or asymptomatic.

If it is indeed a milder strain, then it is actually good and we want it to spread worldwide and become the dominant strain. That's a big if though.

I won't personally make any guesses because there isn't enough reliable information on it yet.

 

[Evan]

It's too early to know what will happen with Omicron, but the early reports from South Africa are encouraging. From what I've seen, all reported cases of it so far are mild or asymptomatic.

If it is indeed a milder strain, then it is actually good and we want it to spread worldwide and become the dominant strain. That's a big if though.

I won't personally make any guesses because there isn't enough reliable information on it yet.

Most recent estimate I'm seeing is that Omicron is around 20% less likely to result in hospitalization. Seems probable that will be offset by its enhanced transmissibility and its increased level of immune evasion. I've seen a variety of sources peg Omicron as being anywhere from 2-4 times more transmisible than Delta.

Like you, I was initially quite encouraged and had a similar thought that if it was remarkably milder that the variant could ultimately result in us finally emerging from the Pandemic.

Unfortunately, I'm afraid that Omicron is about to lead to our worst numbers thus far. Hospital staffing is down. Remaining staff are exhausted or fairly new. Immunity is waning as booster adoption hasn't been anywhere near a level necessary to help forestall Omicron. COVID fatigue has lead to the vast majority of people reverting to pre-COVID behavior or close enough -- myself included.

I don't know that people have the will anymore to be able to do anything to counter Omicron. All we can do is hope that it causes fewer hospitalizations and deaths than expected as I don't think there's a way to impact its spread in any significant way. It's going to spread like wildfire until it runs out of suitable hosts. Vaccination can't and won't have a measurable impact unless and until a vax is developed that predictively covers future mutations. I know there's work underway in that area but it's going to have to overcome the mutation issue which is very very similar to why a universal flu vaccine has yet to be successful.

Even if we had decided to throw caution to the wind and had every vax maker currently producing a vax that was 100% effective against Omicron it would already be too late. Even after all the scaling up and capacity increases there's no way to produce enough let alone distribute them before a new mutation takes hold. A predictive vaccine covering numerous potential future strains is really the only way and I think that's still further away than we might think.

I'm afraid we're about to witness a shocking level of fatalism with Omicron as people simply can't take it anymore.

 

[bjdeming]

Most recent estimate I'm seeing is that Omicron is around 20% less likely to result in hospitalization. Seems probable that will be offset by its enhanced transmissibility and its increased level of immune evasion. I've seen a variety of sources peg Omicron as being anywhere from 2-4 times more transmisible than Delta.

Like you, I was initially quite encouraged and had a similar thought that if it was remarkably milder that the variant could ultimately result in us finally emerging from the Pandemic.

Unfortunately, I'm afraid that Omicron is about to lead to our worst numbers thus far. Hospital staffing is down. Remaining staff are exhausted or fairly new. Immunity is waning as booster adoption hasn't been anywhere near a level necessary to help forestall Omicron. COVID fatigue has lead to the vast majority of people reverting to pre-COVID behavior or close enough -- myself included.

I don't know that people have the will anymore to be able to do anything to counter Omicron. All we can do is hope that it causes fewer hospitalizations and deaths than expected as I don't think there's a way to impact its spread in any significant way. It's going to spread like wildfire until it runs out of suitable hosts. Vaccination can't and won't have a measurable impact unless and until a vax is developed that predictively covers future mutations. I know there's work underway in that area but it's going to have to overcome the mutation issue which is very very similar to why a universal flu vaccine has yet to be successful.

Even if we had decided to throw caution to the wind and had every vax maker currently producing a vax that was 100% effective against Omicron it would already be too late. Even after all the scaling up and capacity increases there's no way to produce enough let alone distribute them before a new mutation takes hold. A predictive vaccine covering numerous potential future strains is really the only way and I think that's still further away than we might think.

I'm afraid we're about to witness a shocking level of fatalism with Omicron as people simply can't take it anymore.

I disagree.

There have been no deaths from Omicron through December 8, but the media is often covering it as if it was the latest apocalyptic horseman.

Yet if you parse those stories, they count "COVID-related deaths" but mention Omicron separately, though "death tolls" and "Omicron" are often together in the headline.

Reuters.com is probably Exhibit A for this hysteria mongering, but US-based agencies do it, too.

That's very bad journalism, and it's bad business, too, as the public isn't buying it anymore this late in the pandemic. COVID is here now, like the flu and common cold, and while people are going to get sick and die from all of these diseases, sadly, there is little more we can hope to prevent now with all the 2020-style COVID-19 precautions that some politicians are still pushing and even trying to make permanent.

I hope Omicron will turn out to be relatively benign, and if so, that it becomes the dominant strain here and world wide. That's all I can say, but very few people are even saying that.

I don't think masks will cut COVID cases down very much, but I still wear one since it doesn't hurt (and is state law still in stores, etc., even though Oregon seems to be going through a surge just now).

I got the vaccine, but I'm not going to get the boosters because I don't have faith in the system any more. They push boosters as if the vaccine is useless, and I suspect they'll push the next round of boosters as if this set is useless, ad infinitum. Hopefully, this will eventually just turn into a routine annually, like getting the flu shot, but right now the hysteria turns me off.

My bus service has been reduced because of a "nationwide shortage" of drivers, but no one ever looks into the possibility that these people all quit rather than have something they didn't want in their bodies forced on them.

People should get vaccinated, but they also should be talked into taking it. Force just turns people mule-headed, as anyone with kids could have told the vaccine-mandaters. Sigh.

I'll believe it's as bad as they say it is now when politicians and celebrities no longer are caught maskless at parties, etc. I'll believe it isn't mostly political exploitation of America's puritanical tendencies now (not that this is always a bad thing -- grew up among descendants of Puritans/First Congregationalists, but...Prohibition, for example, did not work out well), anyway, I'll believe it when the media starts doing in-depth coverage of the supply-chain crisis, its causes (including but not limited to COVID), and possible timely and longterm solutions to it, along with, and to at least as prominent a degree as, their COVID coverage.

I mean, it's Christmas season and look at the shelves. Where are the headlines about something that's affecting us all? The lack of coverage of this big news story at a very appropriate time of year for that coverage is amazing. Yes, I do think COVID, serious as it really is (as opposed to the apocalyptic way it is sometimes reported), is inappropriately being used to distract public attention from a really big economic problem that decision-makers really don't know how to handle.

Well, I'm ranting here; sorry. But I just had to say it.

 

[Jacob]

Most recent estimate I'm seeing is that Omicron is around 20% less likely to result in hospitalization. Seems probable that will be offset by its enhanced transmissibility and its increased level of immune evasion. I've seen a variety of sources peg Omicron as being anywhere from 2-4 times more transmisible than Delta.

Like you, I was initially quite encouraged and had a similar thought that if it was remarkably milder that the variant could ultimately result in us finally emerging from the Pandemic.

Unfortunately, I'm afraid that Omicron is about to lead to our worst numbers thus far. Hospital staffing is down. Remaining staff are exhausted or fairly new. Immunity is waning as booster adoption hasn't been anywhere near a level necessary to help forestall Omicron. COVID fatigue has lead to the vast majority of people reverting to pre-COVID behavior or close enough -- myself included.

I don't know that people have the will anymore to be able to do anything to counter Omicron. All we can do is hope that it causes fewer hospitalizations and deaths than expected as I don't think there's a way to impact its spread in any significant way. It's going to spread like wildfire until it runs out of suitable hosts. Vaccination can't and won't have a measurable impact unless and until a vax is developed that predictively covers future mutations. I know there's work underway in that area but it's going to have to overcome the mutation issue which is very very similar to why a universal flu vaccine has yet to be successful.

Even if we had decided to throw caution to the wind and had every vax maker currently producing a vax that was 100% effective against Omicron it would already be too late. Even after all the scaling up and capacity increases there's no way to produce enough let alone distribute them before a new mutation takes hold. A predictive vaccine covering numerous potential future strains is really the only way and I think that's still further away than we might think.

I'm afraid we're about to witness a shocking level of fatalism with Omicron as people simply can't take it anymore.

I don't see anything in the data so far on Omicron to suggest anything close to what you are suggesting. The data out of South Africa certainly suggests a much larger decrease in hospitalizations than 20%. The hospitalization rate there was 19% of detected cases with their Delta wave, and it is currently at 1.7% for Omicron. On top of that, of that smaller percentage admitted, the cases are significantly milder on average. Here's a chart for the CFR of hospitalized patients in South Africa. Outcomes are MUCH better for that small percentage of people that are hospitalized with it.

 

[Jacob]

On a slightly different note, Omicron is a significantly different variant as far as mutations go from all the other variants up to this point. I'm surprised it hasn't raised more questions, or maybe it isn't publicly acceptable yet to ask why it is so much different. (this isn't a comment on vaccines in any way)

 

[Evan]

I don't see anything in the data so far on Omicron to suggest anything close to what you are suggesting. The data out of South Africa certainly suggests a much larger decrease in hospitalizations than 20%. The hospitalization rate there was 19% of detected cases with their Delta wave, and it is currently at 1.7% for Omicron. On top of that, of that smaller percentage admitted, the cases are significantly milder on average. Here's a chart for the CFR of hospitalized patients in South Africa. Outcomes are MUCH better for that small percentage of people that are hospitalized with it.

I'm not suggesting anything. I'm stating verbatim the most recent estimate I had seen at the time of my posting. I cannot find the exact link, but with release of the Imperial College study this morning and the 29% estimate from SA linked below I don't need to.

It's important to compare apples to apples. Omicron is new. Delta is not. With the lag that occurs between positive cases and hospitalizations, not to mention hospitalizations and deaths, it is quite the confounding variable to compare a variant many many many generations along to a variant only a few generations in.

More importantly, data from South Africa has another confounding variable that must be dealt with. Low vaccination rates during Delta versus much improved vaccination rates with Omicron. Furthermore, Gauteng in particular was estimated to have a 60% incidence of COVID antibodies in their population due to previous spread of Beta and Delta. I couldn't say it any better than this statement from below:



Cannnot mistake 60% population level immunity due to previous Beta/Delta exposure + much higher vax % for Omicron being less severe. The United States has a much lower level of population immunity due to previous exposure to COVID particularly in that Beta barely spread here and that's the best natural immunity for Omicron. Our much larger population also means we have way more unvaccinated individuals as well.

A few other add-on or supporting points:

1. Your data is not for South Africa. It's for the Tshwane Metro in Gauteng which makes up around 20-25% of Gauteng's population.

2.

3.


4.


5.

 

[Evan]

I disagree.

There have been no deaths from Omicron through December 8, but the media is often covering it as if it was the latest apocalyptic horseman.

Yet if you parse those stories, they count "COVID-related deaths" but mention Omicron separately, though "death tolls" and "Omicron" are often together in the headline.

Reuters.com is probably Exhibit A for this hysteria mongering, but US-based agencies do it, too.

That's very bad journalism, and it's bad business, too, as the public isn't buying it anymore this late in the pandemic. COVID is here now, like the flu and common cold, and while people are going to get sick and die from all of these diseases, sadly, there is little more we can hope to prevent now with all the 2020-style COVID-19 precautions that some politicians are still pushing and even trying to make permanent.

I hope Omicron will turn out to be relatively benign, and if so, that it becomes the dominant strain here and world wide. That's all I can say, but very few people are even saying that.

I don't think masks will cut COVID cases down very much, but I still wear one since it doesn't hurt (and is state law still in stores, etc., even though Oregon seems to be going through a surge just now).

I got the vaccine, but I'm not going to get the boosters because I don't have faith in the system any more. They push boosters as if the vaccine is useless, and I suspect they'll push the next round of boosters as if this set is useless, ad infinitum. Hopefully, this will eventually just turn into a routine annually, like getting the flu shot, but right now the hysteria turns me off.

My bus service has been reduced because of a "nationwide shortage" of drivers, but no one ever looks into the possibility that these people all quit rather than have something they didn't want in their bodies forced on them.

People should get vaccinated, but they also should be talked into taking it. Force just turns people mule-headed, as anyone with kids could have told the vaccine-mandaters. Sigh.

I'll believe it's as bad as they say it is now when politicians and celebrities no longer are caught maskless at parties, etc. I'll believe it isn't mostly political exploitation of America's puritanical tendencies now (not that this is always a bad thing -- grew up among descendants of Puritans/First Congregationalists, but...Prohibition, for example, did not work out well), anyway, I'll believe it when the media starts doing in-depth coverage of the supply-chain crisis, its causes (including but not limited to COVID), and possible timely and longterm solutions to it, along with, and to at least as prominent a degree as, their COVID coverage.

I mean, it's Christmas season and look at the shelves. Where are the headlines about something that's affecting us all? The lack of coverage of this big news story at a very appropriate time of year for that coverage is amazing. Yes, I do think COVID, serious as it really is (as opposed to the apocalyptic way it is sometimes reported), is inappropriately being used to distract public attention from a really big economic problem that decision-makers really don't know how to handle.

Well, I'm ranting here; sorry. But I just had to say it.

Your argument is that because a report posted on December 10th, covering cases identified between December 1st - 8th, didn't show any deaths that Omicron must not cause serious illness? During COVID the average from diagnosis to death has averaged around 20-21 days. Of course that report wouldn't have any deaths in the 43 cases reported. Likewise, the average interval from diagnosis to hospitalization is around 10 days. Again, of course that report would not have many if any hospitalizations (it had 1).

As for the rest, you started out by saying you disagree but then go on to confirm exactly what I said about a high level of fatalism leading to people not caring anymore. So...thank you, I guess???

 

[Evan]

6.


7.


8.


The bad news is we won't have to wait long to see what Omicron is going to do.

 

[bjdeming]

Your argument is that because a report posted on December 10th, covering cases identified between December 1st - 8th, didn't show any deaths that Omicron must not cause serious illness?

...

As for the rest, you started out by saying you disagree but then go on to confirm exactly what I said about a high level of fatalism leading to people not caring anymore. So...thank you, I guess???

No, and you're welcome.

We'll just have to agree to disagree. I apologize for the rant, though. I've just been so frustrated about this COVID coverage and had to let it out. (Also guess a little of that indignation about ratings expressed over in another thread must have rubbed off on me. Anger is like a spark in a fireworks factory -- when it happens, anything is likely to go off anywhere, depending on internal priming. But it doesn't shed much long-term light, also like fireworks.)

 

[Jacob]

Wish we had better data in the US as far as variant proportions go, but I think it is safe to assume that Omicron is the dominant variant now in southern Florida. In fact, southern Florida is probably quite similar to Gauteng because they were hammered by Delta during about the same time frame, and up until the last couple weeks had very low spread in general across the area. Their current case data looks about like Gauteng did a couple weeks ago. Another couple weeks of data from both Gauteng and the Miami area should give a clearer picture of where we are heading.

 

[ghost]

Sean Payton... HC of the Saints had Covid last year and has since been fully vaccinated. He now has Covid again

 

[Evan]

Good thread traveling to unravel some of the confounding variables associated with Omicron in Gauteng. Bottom line...we need more data, but, unfortunately, by the time we have it Omicron will have had several weeks of explosive growth.



Update on first confirmed Omicron death:

Underlying health issues, previously infected with COVID once before, and unvaccinated.

 

[Evan]

Wish we had better data in the US as far as variant proportions go, but I think it is safe to assume that Omicron is the dominant variant now in southern Florida. In fact, southern Florida is probably quite similar to Gauteng because they were hammered by Delta during about the same time frame, and up until the last couple weeks had very low spread in general across the area. Their current case data looks about like Gauteng did a couple weeks ago. Another couple weeks of data from both Gauteng and the Miami area should give a clearer picture of where we are heading.

I would imagine it is since nationally it has become dominant.



Not related to this tweet but been seeing some data from the UK that although Omicron is becoming dominant it isn't exactly displacing Delta. Meaning Delta infections seem to be occurring at a similar rate irrespective of Omicron's growth.

Couple of interesting studies out stating that Omicron doesn't appear to have as much affinity for certain lung tissues which could result in in causing milder cases in some populations. However, it seems to be more infective in the upper respiratory system potentially causing more severe disease in asthmatics and those at risk for upper respiratory issues.

I think it's always going to be like -- meaning that different variants are going to impact different population groups more or less depending upon underlying health conditions and how a specific mutation targets immune invasion or its infective pathway.

I've been concerned about reinfection in the USA due to low levels of previous Beta exposure here, and that most of those previously infected who are unvaccinated are likely to have little remaining immunity other than T cell immunity for Omicron. Seems like those with natural immunity from Delta or Original COVID likely need at least 1 MRNA if not a full series to get their immunity to a level that will protect against severe disease with Omicron. Especially if there's an underlying health issues.

My main concern is people who previously had more than a mild case of COVID whose damaged health will make them much more susceptible to a bad reinfection with Omicron ESPECIALLY if they have any underlying health issues, are unvaccinated, or have some of the usual comorbidities typically seen with severe cases of COVID. The usual comorbidities and underlying health issues may be a bit different with Omicron than Delta or Original COVID as I alluded to earlier.

I see nothing thus far that would cause me to walkback the idea that we're going see major healthcare system issues again throughout the country. Especially if medical personnel test positive at a high rate and staffing shortages are exacerbated. Next 6-8 weeks is not going to be an ideal time to have a heart attack, stroke, or get into a car accident.

 

[bjdeming]

Wish we had better data in the US as far as variant proportions go, but I think it is safe to assume that Omicron is the dominant variant now in southern Florida. In fact, southern Florida is probably quite similar to Gauteng because they were hammered by Delta during about the same time frame, and up until the last couple weeks had very low spread in general across the area. Their current case data looks about like Gauteng did a couple weeks ago. Another couple weeks of data from both Gauteng and the Miami area should give a clearer picture of where we are heading.

Here's an interesting article about Gauteng and the possible peak in South Africa. It certainly is all happening fast.

 

[Jacob]

I would imagine it is since nationally it has become dominant.

I'm a bit suspicious of those numbers at the moment, as the last two weeks are modeled estimates. I've seen those NOWCAST projections be off by a pretty decent percentage once the actual data comes in. I suspect it is closer to the lower bound of that estimate (34%) at the moment, as outside of a couple places (NYC) the northern wave has been a pretty smooth rise and fall in the last couple weeks. Even so, that's still a rapid progression and would be the dominant one in a matter of another week or two even if I'm right.

Based on the case increases in the last week or so of the coastal areas, I might have to walk back this statement. Hadn't really looked closely at NYC/RI/NJ area outside of hospitalization data, which the rapid increase isn't reflected well in yet.

 

[Jacob]

Cases in Gauteng, SA have continued to plummet the past few days. New admissions into hospitals are starting to fall, so if this is indeed the peak there, hospitalizations and ICU numbers should be peaking very soon.

GP is Gauteng Province. Here's where ICU numbers stand currently, compared to the two previous waves

 

[Jacob]

More good news today out of South Africa. This preprint (link to study) suggests people that get Omicron in South Africa are 80% less likely to be hospitalized than if infected with previous variants. Those that do end up being hospitalized with Omicron now are 70% less likely to develop severe disease compared to those being hospitalized in the previous Delta wave.

We don't know exactly how much to attribute to Omicron being intrinsically milder, vaccine immunity, or natural immunity, but it is likely a combination of all three. Data out of the UK and Denmark is also suggesting a much milder disease than Delta.

 

[Jacob]

New study out of the UK suggests a 60-70% reduction in risk of hospitalization with Omicron when compared to Delta.