B.1.1.529 Omicron variant

[Woodchopper]

So you won't need field hospitals in car parks for example.

They might still be necessary. A small percentage of a big number is still a etc etc

But for me at least it is a relief. A variant that was as intrinsically severe as Delta but much more contagious would be much worse news.

[lpm]

So, not just good news about Omicron, but... Omicron is good news? I.e. it pushes aside the more virulent Delta. Or is it a bit more complicated than that?

ETA: though of course it's a whole lot more infectious.

We're going to have to live with Covid for the rest of our lives.

But we'd rather live with Omicron-Covid than Delta-Covid, as it's inherently milder?

[Bird on a Fire]

So does getting omi stop you getting delta? Beyond the few days when you're staying at home.

I haven't quite followed why folks are taking about omi vs delta, rather than omi plus delta, in the long-term outlook.

[lpm]

It's unclear, in both theory and practice

Delta's getting crushed by the voluntary lockdown right now. Fallen from 50,000 to 20,000 cases per day already.

But a prior Delta infection doesn't stop Omi, so an Omi today might not stop a Delta in a few months. But you'd think boosters plus an infection or two will prevent Delta.

[jimbob]

It's unclear, in both theory and practice

Delta's getting crushed by the voluntary lockdown right now. Fallen from 50,000 to 20,000 cases per day already.

But a prior Delta infection doesn't stop Omi, so an Omi today might not stop a Delta in a few months. But you'd think boosters plus an infection or two will prevent Delta.

I'm worried about delta and then omni before Delta has finished

[Herainestold]

It's unclear, in both theory and practice

Delta's getting crushed by the voluntary lockdown right now. Fallen from 50,000 to 20,000 cases per day already.

But a prior Delta infection doesn't stop Omi, so an Omi today might not stop a Delta in a few months. But you'd think boosters plus an infection or two will prevent Delta.

I'm worried about delta and then omni before Delta has finished

The unvaccinated get Delta and the vaccinated get Omni. There are a lot more vaccinated out there, kindling for the conflagration.

[Woodchopper]

It's unclear, in both theory and practice

Delta's getting crushed by the voluntary lockdown right now. Fallen from 50,000 to 20,000 cases per day already.

But a prior Delta infection doesn't stop Omi, so an Omi today might not stop a Delta in a few months. But you'd think boosters plus an infection or two will prevent Delta.

Yes, it is unclear.

Just deleted a long post looking at alternative scenarios because I kept making more and more assumptions about stuff we don’t know about yet. It was all getting a bit complicated.

[Sciolus]

And we have ideal conditions for breeding delta/omicron hybrids.

[lpm]

I think the only missing information is number of days in hospital, plus deaths. The deaths stat matters less right now, because the crisis is more about healthcare collapsing and causing indirect deaths.

Everyone talks about admissions per day but I'd've thought numbers in hospital is a better metric. The limit on capacity isn't about processing new daily admissions into a computer.

If days in hospital are halved with Omicron as well as hospitalisations, then for UK it's 50,000 Deltas = 200,000 Omicrons. We can afford a couple of doublings from the 50,000 Delta level, which would give 800,000 Omicron a day. Any third doubling is my marker for NHS collapse.

[OffTheRock]

I think the only missing information is number of days in hospital, plus deaths. The deaths stat matters less right now, because the crisis is more about healthcare collapsing and causing indirect deaths.

Everyone talks about admissions per day but I'd've thought numbers in hospital is a better metric. The limit on capacity isn't about processing new daily admissions into a computer.

If days in hospital are halved with Omicron as well as hospitalisations, then for UK it's 50,000 Deltas = 200,000 Omicrons. We can afford a couple of doublings from the 50,000 Delta level, which would give 800,000 Omicron a day. Any third doubling is my marker for NHS collapse.

Just to complicate your marker slightly the collapse of the NHS won’t just be caused by the number of covid patients. The number of staff off with Covid or a patient developing covid while on a non-covid ward and causing a huge outbreak might collapse it first.

[Woodchopper]

I think the only missing information is number of days in hospital, plus deaths. The deaths stat matters less right now, because the crisis is more about healthcare collapsing and causing indirect deaths.

Everyone talks about admissions per day but I'd've thought numbers in hospital is a better metric. The limit on capacity isn't about processing new daily admissions into a computer.

If days in hospital are halved with Omicron as well as hospitalisations, then for UK it's 50,000 Deltas = 200,000 Omicrons. We can afford a couple of doublings from the 50,000 Delta level, which would give 800,000 Omicron a day. Any third doubling is my marker for NHS collapse.

Just to complicate your marker slightly the collapse of the NHS won’t just be caused by the number of covid patients. The number of staff off with Covid or a patient developing covid while on a non-covid ward and causing a huge outbreak might collapse it first.

Definitely. Large numbers of personnel who are sick, quarantining or caring at the same time will affect the whole healthcare system (including care homes etc). That doesn’t just cover doctors and nurses, but everyone who is needed to keep it all running.

[lpm]

But didn't that also apply at the Jan 2021 peak?

For clarity, by collapse I don't mean small number of people routinely dying due to lack of nurses or people dying in the back of ambulances unable to get into A&E - I assume that is happening already/soon, seeing as it happened in Jan 2021. I mean the scenes from India - desperate families begging for a hospital to unlock its doors and admit a relative, people dying in the car park, active triage where 85 year olds are refused hospital treatment.

I'm sure Johnson has already budgeted many thousands of extra deaths from the coming stress on the NHS and the British public seems to agree with the approach. It's whether it goes beyond this "acceptable" budget.

[bob sterman]

But didn't that also apply at the Jan 2021 peak?

For clarity, by collapse I don't mean small number of people routinely dying due to lack of nurses or people dying in the back of ambulances unable to get into A&E - I assume that is happening already/soon, seeing as it happened in Jan 2021. I mean the scenes from India - desperate families begging for a hospital to unlock its doors and admit a relative, people dying in the car park, active triage where 85 year olds are refused hospital treatment.

There are layers of "triage" that mean the deaths don't happen in the car park and at the doors of the hospital. E.g.

- GPs refusing to visit elderly in care homes
- Ambulances not being dispatched to elderly in care homes.
- Elderly struggling to get any sort of appointment with a GP - let along a home visit.

[Woodchopper]

But didn't that also apply at the Jan 2021 peak?

For clarity, by collapse I don't mean small number of people routinely dying due to lack of nurses or people dying in the back of ambulances unable to get into A&E - I assume that is happening already/soon, seeing as it happened in Jan 2021. I mean the scenes from India - desperate families begging for a hospital to unlock its doors and admit a relative, people dying in the car park, active triage where 85 year olds are refused hospital treatment.

I'm sure Johnson has already budgeted many thousands of extra deaths from the coming stress on the NHS and the British public seems to agree with the approach. It's whether it goes beyond this "acceptable" budget.

The difference between January 2021 and January 2022 is that absent another lockdown the total number of infections this winter will be far higher than a year ago.

There will be far fewer direct deaths and serious illness in a vaccinated population facing Omicron. But there will probably be more indirect deaths and illness that would have been less severe otherwise.

As you write society in every country needs to decide the balance between healthcare provision, social contact and liberty. That balance is going to be different to what it was in 2019.

[WFJ]

They'll miss out on the Christmas number 1, but could the UK knock the US off the top of the daily new cases chart next week? It looks like it will depend on how quickly the omicron surges in New York, Florida and New Jersey increase.

[monkey]

They'll miss out on the Christmas number 1, but could the UK knock the US off the top of the daily new cases chart next week? It looks like it will depend on how quickly the omicron surges in New York, Florida and New Jersey increase.

Nah. The US is only just getting going. The States adjacent to the current outbreaky ones have already said "hold my beer"

[WFJ]

They'll miss out on the Christmas number 1, but could the UK knock the US off the top of the daily new cases chart next week? It looks like it will depend on how quickly the omicron surges in New York, Florida and New Jersey increase.

Nah. The US is only just getting going. The States adjacent to the current outbreaky ones have already said "hold my beer"

It would only be for a day or two, but from the case trajectories it looks like the UK's omicron peak could briefly pass the US's big delta background plus starting omicron surge, before the US races ahead again.

[Woodchopper]

People catching Omicron are 50% to 70% less likely to need hospital care compared with previous variants, a major analysis says.

The UK Health Security Agency says its early findings are "encouraging" but the variant could still lead to large numbers of people in hospital.

It also shows the vaccine's ability to stop you catching Omicron starts to wane 10 weeks after a booster dose.

Protection against severe disease is likely to be far more robust.
The report comes hot on the heels of data from South Africa, Denmark, England and Scotland which all pointed to reduced severity.

The latest analysis is based on all cases of Omicron and Delta in the UK since the beginning of November, including 132 people admitted to hospital with the variant. There have also been 14 deaths in people within 28 days of catching Omicron.

The report shows people catching Omicron are:
31% to 45% less likely to go to A&E
50% to 70% less likely to be admitted to hospital for treatment

However, a milder virus could still put pressure on hospitals.
The issue remains that any benefit of a milder virus could be wiped out by large numbers of people catching Omicron. The UK has set another daily Covid record with 119,789 confirmed cases.
There is also uncertainty about what will happen when Omicron reaches older age groups as most of those catching it and going into hospital so far are under the age of 40.

[…]

There are also signs that the effect of booster doses is waning.
Two doses of a vaccine were shown to offer limited protection against catching Omicron, which was then restored with a booster dose.

However, the report says this protection drops by between 15% and 25% after 10 weeks. This is still better than having no booster dose and the protection against severe disease or death is likely to be even greater.

There are no suggestions that a fourth dose will be rolled out in the UK anytime soon and there will be discussions over whether to wait for an update vaccine.

https://www.bbc.co.uk/news/health-59769969

[Woodchopper]

Here’s the source for the above: https://assets.publishing.service.gov.u ... ing-33.pdf

And thread by the excellent Meaghan Kall: https://twitter.com/kallmemeg/status/14 ... 89958?s=21

[Gfamily]

I'm seeing people claiming that being vaccinated has primed the body to make it easier for Omicron to get a foothold, in that when the O variant attacks, the body makes antibodies to the D variant instead.

Which is why they're claiming that vaccinated people are more likely to get infected with O than unvaccinated people.

It seems unlikely, but is there a presentable response to this?

[shpalman]

I'm seeing people claiming that being vaccinated has primed the body to make it easier for Omicron to get a foothold, in that when the O variant attacks, the body makes antibodies to the D variant instead.

Which is why they're claiming that vaccinated people are more likely to get infected with O than unvaccinated people.

It seems unlikely, but is there a presentable response to this?

Vaccinated people aren't more likely to get infected with O than unvaccinated people.

(Once you correct for there being many more vaccinated people than unvaccinated people.)

[OffTheRock]

People catching Omicron are 50% to 70% less likely to need hospital care compared with previous variants, a major analysis says.

The UK Health Security Agency says its early findings are "encouraging" but the variant could still lead to large numbers of people in hospital.

It also shows the vaccine's ability to stop you catching Omicron starts to wane 10 weeks after a booster dose.

Protection against severe disease is likely to be far more robust.
The report comes hot on the heels of data from South Africa, Denmark, England and Scotland which all pointed to reduced severity.

The latest analysis is based on all cases of Omicron and Delta in the UK since the beginning of November, including 132 people admitted to hospital with the variant. There have also been 14 deaths in people within 28 days of catching Omicron.

The report shows people catching Omicron are:
31% to 45% less likely to go to A&E
50% to 70% less likely to be admitted to hospital for treatment

However, a milder virus could still put pressure on hospitals.
The issue remains that any benefit of a milder virus could be wiped out by large numbers of people catching Omicron. The UK has set another daily Covid record with 119,789 confirmed cases.
There is also uncertainty about what will happen when Omicron reaches older age groups as most of those catching it and going into hospital so far are under the age of 40.

[…]

There are also signs that the effect of booster doses is waning.
Two doses of a vaccine were shown to offer limited protection against catching Omicron, which was then restored with a booster dose.

However, the report says this protection drops by between 15% and 25% after 10 weeks. This is still better than having no booster dose and the protection against severe disease or death is likely to be even greater.

There are no suggestions that a fourth dose will be rolled out in the UK anytime soon and there will be discussions over whether to wait for an update vaccine.

https://www.bbc.co.uk/news/health-59769969

I’m 12 weeks post booster. I’m guessing a lot of NHS staff and more vulnerable groups might be too.

[Woodchopper]

I'm seeing people claiming that being vaccinated has primed the body to make it easier for Omicron to get a foothold, in that when the O variant attacks, the body makes antibodies to the D variant instead.

Which is why they're claiming that vaccinated people are more likely to get infected with O than unvaccinated people.

It seems unlikely, but is there a presentable response to this?

I’ve seen the graph at the top of this blog post shared round social media with the claim that ONS figures show that vaccinated people are more likely to catch Omicron: https://dailysceptic.org/2021/12/22/tri ... ata-shows/

But as the blog states, it’s because, as pointed out by shpallers, there are far fewer unvaccinated than vaccinated people.

As for vaccines having primed people immune systems to work against other variants, that is likely. But what’s happening is that Omi immune escape is making a vaccinated person a bit more like someone who is unvaccinated. Given that vaccination still protects against severe illness there’s no reason to think that people would be better off unvaccinated.

Interestingly enough, Originally Antigenic Sin is apparently a thing: https://journals.asm.org/doi/10.1128/mSphere.00056-21 https://en.wikipedia.org/wiki/Original_antigenic_sin
But I don’t understand enough about it to say more.

[Woodchopper]

Here’s an example of the social media b.llsh.t: https://twitter.com/aginnt/status/14737 ... 88098?s=21

[shpalman]

Here’s an example of the social media b.llsh.t: https://twitter.com/aginnt/status/14737 ... 88098?s=21

The Daily Skeptic link explains:

Note that this is the probability of an infection being Omicron given a person is infected, so it doesn’t tell us how likely a person is to test positive in the first place. This means it doesn’t tell us that the vaccines are making things worse overall, only that they are making it much more likely that a vaccinated person is infected with Omicron than another variant.

ETA so it's not exactly what I said, that it being an issue of there being more unvaccinated people. Rather, it just says that if a person is infected, in the case of a more vaccinated person, it's more likely that they'll be infected with Omicron.