Will this just be a perpetual boy who cried wolf? I took fairly low precautions before getting my two moderna doses in Spring '21, and have taken no precautions since. My family and pretty much everybody I care about did similarly.
Nobody in my network even noticed Delta despite all the histrionics, and this feels a lot like a rerun.
Noah. You know statistically the majority of people aren’t close to anyone who died of Covid. 1 in 600 have died. Most people are close with maybe 100 people. Many a lot less than that. As a test, look at how many people are in your contacts, and how many are more than just an associate. I also don’t know anyone who died of Covid. And I travel a lot. I actually ask this question of most people I meet, and the majority also say no one close to them has died.
When you consider the age concentration of most deaths are in a very small age band. 65+ and the age distribution of who most people know. I.e. you know a lot more people close to your age, and fewer people who are older or younger, you end up with a situation people like my grandmother knows a lot lot of people who died of Covid. My mother knows one or two. I only know of people. My kids no zero people even remotely.
In one way it’s this phenomenon that has made it so difficult to convince people to take it seriously. I know a lot lot of anti-vaxxers. Single biggest issue is that media coverage does not match real world experience.
Anti-vaccine people are dumb. They don’t know how to evaluate risk.
But you reply sort of insinuated that him not knowing anyone that died of Delta or Covid makes him an outlier. He isn’t. A Reality is that public health officials in the media should take into consideration.
Man, if I were a smart economics or statistics student I would combine all this data, and come up with a model of the likely hood of any given person to have someone in their social network to have died of COVID.
Let's just say I am confident in my analysis that the majority of people have had no one in their social network.
Note: Peoples casual network is much larger. Recent studies have show an average of 611, median of 472 people in ones network, but their definition of network is a lot looser than close network. For instance, I have like 1000 facebook friends, and probably work with close to another 200 people a year. However, besides for incidental and casual conversations, how many people do I really know?
On another note, my research (googling) introduced me to the concept of Dunbar's Number. Which is based on the theory that our brains are only capeable of maintaining relationships with a maximum of 150 people.
Anyway, if I were a grad student who wanted to crunch all this data, my stated reason objective would to help public health officials and politicians better understand the disconnect between the public and concern about COVID.
Additionally, I think a visual model of the age distribution and potentially racial and gender mix of a persons social network would be useful in all sorts of other public policy areas.
And damn, I must be bored to write and research all this.
For the simplest model we can just use a binomial distribution with the COVID-19 death rate 1/500 as the trial chance, with the Dunbar's number 150 as the number of trials and calculate the cumulative chance of at least 1 death.
This simplest model is almost definitely wrong as it assumes the deaths to be distributed evenly in the population but in reality vaccinated population and unvaccinated population would have different chances of death.
With that in mind, the chance of knowing at least 1 person who died from COVID-19 is 0.26.
We can vary the chance of death to simulate the influence of vaccines.
In a population with a chance of death of 0.01, the chance of knowing at least 1 person who died from COVID-19 is 0.78.
In a population with a chance of death of 0.0005, the chance of knowing at least 1 person who died from COVID-19 is 0.07.
That part is easy. It's adding in the age homophily of social networks and the distribution of deaths that makes it hard.
i.e. The median American of age 40, knows a whole lot of people between the ages of 30 and 50, Then is increasingly less likely to have people in their social network 29 and under (low risk) and 51 and older (high risk).
I am just going to make up numbers.
Lets say 100 out of 150 social network are between 30 - 50. 45K total Covid Deaths.
25 people 29 and under (5,100 deaths)
25 people 51 and over (720K ish)
I am sure you can break these age groups down even more, like the dude will know more people closer to 50 than to 80.
(totally made up numbers here)
Lets say odd of knowing someone who died of Covid for 29 under is 1 in 100K. For 30-50 is 1 in 80 K. For 50 over its 1 in 200.
You now have to combine all these odds for to figure out the real chances this 40 year old knows someone who died of COVID. Probably very unlikely.
If you did the same thing for someone who was 60 years old. Then the odds are probably very likely.
All I know is that the 1 in 500 number is misleading. And most people have not had someone in their social network die of COVID.
Doesn't matter, facts aren't going to change the narrative.
you're doing good work :) always like to see sources cited. I saw a propagnda sticker on a lamppost the other day saying "imagine a pandemic so deadly it stops existing when you turn off your phone", which is quite persuasive rhetoric given the disjoint you describe.
Just to be clear. I am not a COVID conspiracist. Or an anti-vaxer. Get vaccinated. Get boosted.
Covid is like playing Russian Roulette with a 1000 round revolver.
Getting Vaccinated is like playing Russian Roulette with a million round revolver.
I know which one I would do.
But... I also get frustrated at the disconnect between real life and media/public health people.
There are other small things I notice. The media almost never shows personal stories of people who died, even though the number is large. I suspect its because the vast majority of people are older, and they just aren't as big of a media story.
Think back to the media stories on victims. Always young fathers, or a young nurse, or a some other person who is a good media story, who adds to the narrative, but who are statistically outliers.
Once again... Covid is bad. Get vaccinated. Follow precautions. Don't be that 1 in a 1000. Not worth the risk. However do keep things in perspective.
Another factor is that I and literally everyone I care about has been fully vaccinated since before delta. Deaths remain heavily concentrated in the unvaccinated, I don't really need to worry. Thus far just getting two jabs has been the uberprecation and I am skeptical that will change
Absolutely true. Vaccinated people will probably be more likely to have a social network that was vaccinated due to the homophily effects I mention above.
But.... vaccinated people have a higher median age, therefore this will increase the chances of them knowing someone.
My gut feeling is the vaccination effect outweighs the age effect.
I also had this sort of.... I don't care feeling. I don't give a F about masks attitude.
Got to confess, this omicron thing making me reconsider a little bit.
Noah, if we take ~June 1st as the start of the Delta wave in the US, that's about a month after everyone in the US who wanted a vaccine could get one. I completed my second round by end of April and I wasn't in a priority group. So the vast majority of deaths from Delta were among the *voluntarily* unvaccinated. Quite frankly I'm not sure why we should grief for adults who've made a conscious decision to avoid a free vaccine.
Err, umm, US deaths attributed to Covid are fast approaching 800,000. Estimated total US Covid deaths, based on the increase in death rates during the pandemic relative to the prior period, are past 1 million. Delta was first spotted in the US in May and became the dominant variant by August. There have been more than 160,000 deaths attributed to Covid since the beginning of August, and there have been probably well over 200,000 more deaths than occurred in the same months of pre-pandemic years. By comparison, US fatalities in WWII were just over 400,000.
Okay but I and all my loved ones are vaccinated and boosted so who cares? What point are you trying to make here by listing these Delta numbers? Thousands of unvaccinated people died of the virus because they didn't want take the free vaccine. No skin off my back.
The point for "listing these Delta numbers" is because the first poster referred to the Covid-19 response heretofore as the "perpetual boy who called wolf".
To be clear, I don't consider covid itself to be a "boy who cried wolf" nothingburger, but rather the cycle of new variants that get hyped up and turn out to mean essentially nothing to the already vaccinated (original vaccines) population
Well you chose the wrong metaphor. The metaphor you want might be that you and all your family friends are in brick houses so why should you mind the wolves eating some of the neighbors? And I'm vaccinated too and I sympathize. But Delta was more than just a slayer of the stupid in developed countries, it also ravaged the poor in the rest of the world, and slowed recovery globally. It is true that early fears that Delta would evade vax immunity turned out to be wrong, but that's not "crying wolf" that's intelligent concern when a new variant is spreading like wildfire, and it's an intelligent concern again now with Omicron, until we find out for sure one way or the other.
One barrier to the rapid expansion of booster shots, beyond production and distribution, is the growing wariness about day-after effects. I scheduled my booster on the day before a day when I had nothing scheduled. Sure enough, I spent that second day on my back (as I did with my second Moderna shot earlier this year). Anecdotally, I'm hearing more people who were eager vaccine takers earlier this year say they're putting off their boosters until they can plan a day off from work and family obligations. The problem here may not be limited just to those who had reactions to the first round of vaccines, since word-of-mouth accounts can drive more widespread concerns about those experiences -- or just give busy people people another reason to delay what they know they should do. I have not seen any data on how large that population who suffered these Day 2 effects is. And, although these effects are relatively minor, it they cause you to lose a day of work, that's significant. It seems to me that health authorities should be addressing this, not ignoring it. There are ways to overcome this problem, including working with employers to provide the boosters on a sequenced basis (employers may also become wary of incurring Day 2 absences from their staff if all are given boosters in the same week) and providing pay for those who miss work due to second day effects. But, not talking about it and not dealing with it is sure to slow down the needed uptake of boosters.
It's not about the importance of one's work but about the importance of one's paycheck, at least for lower income, front line workers. Those I know would welcome the day off but, depending on their employer's policies, they might not get paid for it.
Best case scenario is that omnicron has mild symptoms, low mortality, and infection creates a long lasting broad immunity especially if paired with vaccinations. Theoretically it could burn itself out with little consequence, even theoretically creating herd immunity against all Covid-19 variants.
Yeah… we can wish.
One thing that hasn’t been mentioned is this variant most likely came about in a vaccinated person. The number and type of mutations were evolved specifically to beat vaccination antibodies.
This does not mean that I am anti-vaccine. I already have my booster. Just that there is this assumption that vaccines alone can beat this thing. This is a naive assumption.
One question I haven’t seen answered is do natural immunity antibodies do better against this variant?
I am also curious whether there is a trade off between antibody escaping spike mutations and it’s danger to the human body.
Regardless, I have zero faith that our CDC and FDA will make smart quick decisions.
Vaccines can beat the kind of behavior you describe, but only if everyone is vaccinated. The problem occurs when you have a thriving infected population intermixing with a vaccinated one. The emergence of any variant that can penetrate the protection provided by the vaccine, affords itself a massive breeding ground.
Yes. First few mutations to vaccinated to non-vaccinated back to vaccinated, etc... Partial vaccination very likely contributed is one way, but then it would probably have a trail that connected it with other strains. This one is completely disconnected. One virologist suggested that it could of mostly evolved within a single vaccination person who carried for an extended period of time while it sort of mutated to survive. Perhaps someone with a compromised immune system that wasn't quite strong enough to beat into submisssion.
It's probably not that that matters a lot in this case.
Some viruses most probably can replicate in the tissues they first colonize, ie nasal epithel for Sars-Cov-2, and create a very large amount of viral particles - enpough to lead to very high viral shedding levels and to become a superspreader, when infected cells so to say burst without giving any symptoms and involving other organs in the process.
The four versions of Coronaviruses responsible for the common cold are in this category, for instance, as well as several other usually very mild upper repiratory viruses plus rotavirus and novovirus.
Many viruses, those we have produced sucessful vaccines against that give reasonably long lasting herd immunty if at least 1 - (1 / R0) fraction of people are inoculated with them, such as measles, mumps, polio and so on need to travel to target organs through lymph before they begin their replication.
Nasal epithel do usually not have high levels of certain types of antibodies that are useful for forcefully stop local infection and if I understand things correctly - this was brought to my attention just recently - this makes the viruses that replicate directly at their site of entry into the body able to replicate without much hindrance even in individuals that have a high degree of acquired immunity.
The viruses that have to travel through lymph to begin replication produces an immune response that quickly shuts down virus replication - whatever their target organ tissue might be - in inoculated indivduals and individuals that have acquired immunity through infection and thus these persons do not become contagious even if infected asymptomatically.
This is why we see so small differences, practically none, of virus levels in nasal epithel - from where it is spread by aerosol in the case of Sars-Cov-2 - in naive individuals and people who have acuired immunity.
Besides, coronaviruses are known to often produce reinfection, ie giving a immunity that wanes quickly even after immunity acuired by infection. Immunityy acuired by infection most probably lasts under 18 months and the Pfizer vaccine have a hard time keeping a 50 % level of effciency 3 months after Inoculation for Delta.
So it does not matters how many are vaccinated, unless we can get a vaccine that gives an efficiency so near 100 % to in practice be 100 % for at least seversal months - ie it cannot wane to 75 % at three months since very few will wanna get vaccinated every three months except probably or possibly those over roughly 65-70 years of age. It will need to stay above 85 % out to at least 4 moths to have any cvhance at all of getting compliance from the public.
And such a vaccine will probably never be discovered, due to how our immune system works and the fact that coronaviruses are almost notrious for giving quickly waning immunty (although I guess it's possible the fourth or fifth booster with a Delta-targeted and Omicron-targeted vaccine might reach that kind of efficieny - Note that now people have only ever gotten at msot two boosters as of today - althoug I would bet aginst it.
Add a very high mutuation rate and we have a situation comon to those with vaccines for the common cold, which have never successfully been achieved (Where four types of common cold are caused by viruses from the Corona family)
Sars-CoV-2 is one nasty virus that is very hard to handle.
PS. I stress to note that I am very pro-vaccination, everybody who is over 50 and doesn't get vaccinated are taking a completely unneccesary chance with their lifes and considering the existence of Long Covid - where vaccines probably lower the risk for Long Covid maybe 2,5-3 times compared to post-infection in non-vaccinated persons - people between 20 and 50 should get vaccinated as well. I also think you could make a case for vaccination on the IFR rate of COVID for those over 40 - you don't want to have to go through ICU care since that often gives cognitive deficits.
The only group I am strongly against vaccinting are children where I feel the vaccine hasn't been tested enough yet and people under rougly 10 years of age have a very different immune system compared to adults and rougly only when people leave the teens their immune systems functions the same as an adults, so I feel that vaccination for at least those under 15 is highly unethical when we know that vaccination does not lower the contagiousness of an infected individual and I have not seen data that vaccines are benefical for the children themselves as the NNT (number needed to treat) is so extremely high and the Pfizer vaccine at least has a unusally high level of side effects and also the possibility of negative long term effects - especially concerning for children - is completely unknown.
How would you know that it evolved specifically to beat vaccination antibodies rather than antibodies from prior infection or antibodies from monoclonal antibody treatments. Vaccination rates were extremely low in Africa when omicron was evolving.
The reason is the sheer number of mutations, and this variant isn't directly related to other variants. If mutated in a non-vaccinated population, there would be no evolutionary reason for this many mutations. Any mutation would be outcompeted by standard variants. Read this thread...
Yes. The person that omicron evolved also likely didn't live in South Africa. Most African countries have almost no surveillance testing, so it could have been spreading around many countries before it made it to South Africa & Namibia. Most African countries are less than 10% vaccinated, which further reduces the chance that it evolved in a vaccinated person.
I don't see anything on that thread that suggests the omicron variant evolved in a vaccinated person. They say that selection of variants is driven more by antigenic selection. The selection of variants is different than the specific person it evolved in. Antigenic selection is about escaping antibodies which includes antibodies from prior infections, not just from vaccination.
True. But antibodies from natural infection are different than antibodies from vaccines. Vaccine antibodies attack a specific spike area. This variant mutated specifically in this spike and not others.
Neutralizing antibodies- whether from infection, monoclonal treatment, or vaccination- are only neutralizing if they bind to a protein that stops the virus from gaining access into a cell. If given an mRNA vaccine, you only create antibodies to the spike protein, as that's all that's presented to your b-cells. For an infection, you create antibodies to every novel protein your b-cells encounter, but the only ones that are neutralizing are the ones to the spike protein. Monoclonal antibodies are selected for their ability to be neutralizing, to bind to the spike protein. Basically, all three provide an evolutionary pressure to change the spike protein.
South Africa is reporting that this variant seems to be outcompeting the Delta variant, even though their population is only about 28% vaccinated. It could be this is more like Delta where some of the mutations just happen to help it spread faster.
The vaccines target spike, and most of the mutations here are on spike. Actually many of the variants seem to be mutating spike. Check out Dr. Geert Vanden Bossche.
True, but the antibodies you create that don't bind to the spike protein aren't neutralizing antibodies. The spike protein is what gains access to a cell, so if there's an antibody bound to it- whether monoclonal antibody, vaccine induced antibody, or infection induced antibody- it can't bind to the ace2 receptor and can't enter the cell. While there are certainly other evolutionary pressures applied on the cell as well, it makes sense in all cases that the spike protein is under a lot of evolutionary pressure to mutate around neutralizing antibodies. I don't think this really tells us much
I don't understand urging a third shot of a vaccine developed a year ago immediately after acknowledging that our #1 concern is that Omicron's mutations make it highly likely to escape existing immunities and [said] vaccine.
Infections provide the opportunity for new variants of concern to arise. To reduce the risk of new variants of concern, we should have been reducing infections by vaccinating humanity as a whole.
Time to waive the patents, kick technology transfer up a gear, and point out that when The Russians™ or Iranian Hackers® "steal" vaccine technology, that's Good Actually. The best time to vax the planet was a year ago. The second-best time is now. Vax the planet!
In any event, even if what you said were true, it would weigh against the standard objection to junking "intellectual property" in this situation (that it would lead to the First World's big vaccine manufacturers losing business to other manufacturers; if there are no such "other manufacturers" then no business can be lost to them). And the moral course of action would be to scale up those manufacturers that were capable of mRNA production, not to merely scoff about "magic".
I do have a problem in that you start the article with the *alarming* statement, "it’s spreading fast, and taking over very quickly from the Delta variant." (Without reference I might add)
... then buried further down, a more off-hand comment of .. "That said, the more dramatic graphs you’ve seen about Omicron spreading like wildfire may overstate the speed of its spread"
Dr Scott Gottleib is <hopefully> likely more correct, here.
Overall, yes I'd agree.. and with CDC's notable <mostly> absence while the world is thrown into an anxiety ridden panic these past 4 days, the WH & CDC messaging needs to step it up 200%
Your call to ramp up vaccine manufacturing reminded me of the book "Destructive Creation" by Mark Wilson. Just as the US government financed, owned and even operated much/most of the war "machine" that was the foundation for winning WWII, we need the US government to finance and "own" vaccine manufacturing plants and have the private companies operate them. No rational company will build the capacity to quickly make all the vaccines needed just so billion dollar facilities will be idled in 2-3 years.
As the great-grandson of the man who ran that operation in WWII, the government did not "own" or "operate" most of the war machine. Rather, FDR hired the President of General Motors for $1 a year to figure out how to produce what was needed and then convince the manufacturers to retool to build what was needed. This started well before we entered the war. The government financed it by purchasing the tanks, planes, munitions, etc. that were produced. The government owned essentially nothing and the only operation it did was submitting orders for what was needed.
You have family lore, which is great. The author would disagree with you and suggest that your argument is the result of the Chamber of Commerce's successful marketing campaign. Try reading the book and challenge your preconceptions.
The political climate was a lot different then. Both D & R's did not like all the "blood money" millionaires that came out of WWI. So there were lots of laws, passed prior to the war that not only limited upfront the profit firms could make but that the contracts could be renegotiated if the government found that the profits ended up being greater than forecast.
Only the government had the ability to finance the construction of new plants and industries- it is not like Boeing in 1940 could go out and raise the money to build a plant for an unknown number of bombers for an unknown number of years based on unknown and changeable contracts with the government. New industries like synthetic rubber plants for all the tires needed in the war were started from scratch. Other industries like the the shipyards for cargo ships needed to be built and expanded way beyond any peace time requirements. In the middle of a depression only the government could own and build many of those plants.
I am not arguing that the government did it with it's own people, lots of private sector business men worked for the government for reduced salaries, brought their expertise and managed government owned plants or negotiated contracts for contractors to run plants. Or you had the Navy which built most of their ships in their own yards and repaired same in their own yards and the Army which had its own munition manufacturing and armories.
You absolutely are correct at how it developed over the course of the war. I took issue only with the terms "owned" and "operated". This isn't family lore though. I'd suggest reading Freedom's Forge, by Arthur Herman, which is an account of both my great grandfather's role and that of Henry Kaiser.
Well, they might do if the government agree to pay them a handsome price for each dose. Though I'm loathe to admit it, sometimes it is prudent for governments to overpay private companies for medications, so that they don't have to bear the initial burden of the R&D costs.
Small comment on your Delta chart: do we have data showing that southern US states wouldn't have a summer wave if Alpha remained as the prevalent strain? We're now seeing COVID establish a seasonal pattern with southern states getting hit first (hot outside, everyone stays inside) and northern states getting hit next (cold outside, everyone stays inside). Does modeling exist for what the summer wave was expected to be with the Alpha strain in place, given what we now know about real-world vaccination and masking rates?
There is also the possibility (and I would even say it's the most likely) that the existing vaccines will protect from hospitalization and death just as well as against delta, if that's the case then this whole pandemic is basically over and the world can move on (minus some dead anti-vaxxers). Omicron looks like such a mutant monster that I can't imagine something worse coming along.
A variant that is twice as infectious is *far* more dangerous than an infection that is twice as deadly. If it’s twice as infectious and only half as deadly it will end up killing far more people, because infectiousness is exponential while deadliness is only linear (it doesn’t matter how deadly a virus is if you never get it, and infectiousness determines how many will get it).
A variant that is much more infectious but less deadly may crowd other variants out (and build natural immunity). Between being less deadly, availability of vaccines, and better treatments, the best-case scenario is that Omicron is "no worse than the flu".
I disagree with that assessment of the math, at least if it's true that:
(1) The base level of infectiousness (i.e., before doubling) is already at the level at which approximately everyone can expect to be exposed to an infectious dose.
(2) There's some level of durable immunity after a first infection.
I submit that existing variants of SARS-CoV-2 already meet both conditions.
Yeah, I've got an assumption that either R is low enough that a significant fraction of the population would avoid it, or there's an ongoing vaccination process that will give a substantial fraction of the population protection from the worst outcomes if they get vaccinated before they get infected.
I think that was true early in the pandemic when most people had no immunity. However, delta is already infectious enough that everyone is going to get infected. Being more infectious means the last few people without immunity get infected faster.
We have no good data on infectiousness, so we are just speculating. Not particularly helpful from a policy perspective, or just to have a level-headed, non-alarmist approach to fighting Covid. If it turns out that this is less virulent, alarmism will undermine trust in public health.
Nicely done. My guess is that Omicron won't be as dangerous as we fear, but it's impossible to know, and we certainly need to be prepared. One hopes that CDC and FDA will finally get their act together.
> But another reason, which Topol acknowledges, is that some public health officials in the U.S. saw boosters as taking away vaccine doses from developing countries.
This is incorrect. The FDA was very explicit about why they did not recommend the booster for everyone. The reasons did not include concerns about the rest of the world (I think it’s pretty clear from the lack of urgency in expanding vaccine manufacturing that western agencies simply don’t care about the RoW, which is the context in which the WHO chief’s comments about booster should be read).
Their concerns were (a) lack of data, (b) concerns about younger people, and (c) most ridiculously, “first shots are more important than boosters”. The primary problem, once again, was provinciality, where they were discounting studies and experiences from outside the US.
While you are right that expanding manufacturing should be the answer to not enough shots, in the absence of such an expansion in manufacturing, boosters taking up shots which could be sent abroad was a sound justification for denying boosters.
Heck, in this hypothetical world where western boosters were sent to other countries to be used as first shots, the vast majority of boosters would have actually gone to South African countries which could have potentially even prevented the development of Omicron until a few months later. Omicron reinforces the concept that getting the RoW first shots is more important than boosters.
Of course, I personally was still in favor of boosters for the simple reason that history showed that boosters would not, in fact, be redistributed to the RoW, but in fact would continue to be hoarded until they expired anyways.
The site does not appear to allow me to paste links, but you can Google it. There’s a flurry of articles from last month talking about the US hoarding approximately 500mm vaccines, which, it’s easy to do the math, is far greater than any possible need (especially considering that at this point US needs can almost certainly be met by a small proportion of US manufacturing capacity itself, not requiring a reserve at all).
Some of these articles might also mention that until early October approximately 15mm vaccine doses were discarded in the US because they expired, and considering the vaccines last about 6-7 months before expiring, that number is only going to rise keeping the 500mm doses the vast majority of which will go unused, in mind.
You're right. One group I trust is doctors without borders, and here's the numbers from them: "Even while factoring in third-dose boosters for high-risk groups, high-income countries are hoarding an estimated 870 million excess doses—nearly 500 million in the US alone. The rapid redistribution of these doses to low- and middle-income countries could save nearly one million lives by mid-2022."
Shit... What part of this is dumb, and what part pure scared selfishness?
I agree that the CDC and FDA *ought* to fast-track variant-specific boosters for coronavirus, but how confident are you that the CDC and FDA actually have changed enough so that variant-specific will indeed receive approval soon enough that we can avoid a repeat of March 2020?
Good recap. Should the FDA literally do the boosters like an annual flu shot approval? Or is there some other fast protocol the FDA should use for Omicron?
Also, should Moderna and Pfizer start switching over their manufacturing lines as soon as they have a candidate, or should they wait for FDA approval? If we do want them to start the switch early, should the Administration compensate them for the risk with an advance purchase order, like they did with Warp Speed?
We need fast booster approval, and fast booster manufacturing, both. I'd love to read anything you can turn up about how to make those happen.
The FDA already said they would approve boosters like annual flu shots. They are testing the current vaccines against omicron to see how much efficacy is reduced. I think those results would determine how important it is to switch over production to the new omicron vaccines. We still have a couple months left in the current delta wave, so I don't know if we want to halt production of current vaccines just yet.
Very dated article showing how wrong the forecasts on omicron were. In the UK there was an unwillingness to accept RSA science and I suppose in the US also.
Will this just be a perpetual boy who cried wolf? I took fairly low precautions before getting my two moderna doses in Spring '21, and have taken no precautions since. My family and pretty much everybody I care about did similarly.
Nobody in my network even noticed Delta despite all the histrionics, and this feels a lot like a rerun.
"Nobody in my network even noticed Delta despite all the histrionics" <-- Congrats on not knowing any of the hundreds of thousands who died of it.
Noah. You know statistically the majority of people aren’t close to anyone who died of Covid. 1 in 600 have died. Most people are close with maybe 100 people. Many a lot less than that. As a test, look at how many people are in your contacts, and how many are more than just an associate. I also don’t know anyone who died of Covid. And I travel a lot. I actually ask this question of most people I meet, and the majority also say no one close to them has died.
When you consider the age concentration of most deaths are in a very small age band. 65+ and the age distribution of who most people know. I.e. you know a lot more people close to your age, and fewer people who are older or younger, you end up with a situation people like my grandmother knows a lot lot of people who died of Covid. My mother knows one or two. I only know of people. My kids no zero people even remotely.
In one way it’s this phenomenon that has made it so difficult to convince people to take it seriously. I know a lot lot of anti-vaxxers. Single biggest issue is that media coverage does not match real world experience.
Anti-vaccine people are dumb. They don’t know how to evaluate risk.
But you reply sort of insinuated that him not knowing anyone that died of Delta or Covid makes him an outlier. He isn’t. A Reality is that public health officials in the media should take into consideration.
First, apologies for my poor grammar, I was on my phone. I decided to get references for all my statements.
First. It's actually 1 in 500 who have died of Covid. Wow that's a lot. https://www.washingtonpost.com/health/interactive/2021/1-in-500-covid-deaths/
Second, age distribution of deaths: https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/
Third: age distribution of US population: Skewed fairly young. Median age 38-39.
https://www.statista.com/statistics/241488/population-of-the-us-by-sex-and-age/
https://www.statista.com/statistics/241494/median-age-of-the-us-population/
Forth: Homophily of social networks: i.e. a persons social networks are more likely to closer to their own age.
http://aris.ss.uci.edu/~lin/52.pdf
Fifth: Size of social networks: Maximum of 153 with a mean of 124. https://pubmed.ncbi.nlm.nih.gov/26189988/
Man, if I were a smart economics or statistics student I would combine all this data, and come up with a model of the likely hood of any given person to have someone in their social network to have died of COVID.
Let's just say I am confident in my analysis that the majority of people have had no one in their social network.
Note: Peoples casual network is much larger. Recent studies have show an average of 611, median of 472 people in ones network, but their definition of network is a lot looser than close network. For instance, I have like 1000 facebook friends, and probably work with close to another 200 people a year. However, besides for incidental and casual conversations, how many people do I really know?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666355/#:~:text=4.1%20Personal%20network%20size%20estimates,in%20presented%20in%20Figure%205.
On another note, my research (googling) introduced me to the concept of Dunbar's Number. Which is based on the theory that our brains are only capeable of maintaining relationships with a maximum of 150 people.
https://theconversation.com/dunbars-number-why-my-theory-that-humans-can-only-maintain-150-friendships-has-withstood-30-years-of-scrutiny-160676
Anyway, if I were a grad student who wanted to crunch all this data, my stated reason objective would to help public health officials and politicians better understand the disconnect between the public and concern about COVID.
Additionally, I think a visual model of the age distribution and potentially racial and gender mix of a persons social network would be useful in all sorts of other public policy areas.
And damn, I must be bored to write and research all this.
For the simplest model we can just use a binomial distribution with the COVID-19 death rate 1/500 as the trial chance, with the Dunbar's number 150 as the number of trials and calculate the cumulative chance of at least 1 death.
This simplest model is almost definitely wrong as it assumes the deaths to be distributed evenly in the population but in reality vaccinated population and unvaccinated population would have different chances of death.
With that in mind, the chance of knowing at least 1 person who died from COVID-19 is 0.26.
We can vary the chance of death to simulate the influence of vaccines.
In a population with a chance of death of 0.01, the chance of knowing at least 1 person who died from COVID-19 is 0.78.
In a population with a chance of death of 0.0005, the chance of knowing at least 1 person who died from COVID-19 is 0.07.
That part is easy. It's adding in the age homophily of social networks and the distribution of deaths that makes it hard.
i.e. The median American of age 40, knows a whole lot of people between the ages of 30 and 50, Then is increasingly less likely to have people in their social network 29 and under (low risk) and 51 and older (high risk).
I am just going to make up numbers.
Lets say 100 out of 150 social network are between 30 - 50. 45K total Covid Deaths.
25 people 29 and under (5,100 deaths)
25 people 51 and over (720K ish)
I am sure you can break these age groups down even more, like the dude will know more people closer to 50 than to 80.
(totally made up numbers here)
Lets say odd of knowing someone who died of Covid for 29 under is 1 in 100K. For 30-50 is 1 in 80 K. For 50 over its 1 in 200.
You now have to combine all these odds for to figure out the real chances this 40 year old knows someone who died of COVID. Probably very unlikely.
If you did the same thing for someone who was 60 years old. Then the odds are probably very likely.
All I know is that the 1 in 500 number is misleading. And most people have not had someone in their social network die of COVID.
Doesn't matter, facts aren't going to change the narrative.
you're doing good work :) always like to see sources cited. I saw a propagnda sticker on a lamppost the other day saying "imagine a pandemic so deadly it stops existing when you turn off your phone", which is quite persuasive rhetoric given the disjoint you describe.
Just to be clear. I am not a COVID conspiracist. Or an anti-vaxer. Get vaccinated. Get boosted.
Covid is like playing Russian Roulette with a 1000 round revolver.
Getting Vaccinated is like playing Russian Roulette with a million round revolver.
I know which one I would do.
But... I also get frustrated at the disconnect between real life and media/public health people.
There are other small things I notice. The media almost never shows personal stories of people who died, even though the number is large. I suspect its because the vast majority of people are older, and they just aren't as big of a media story.
Think back to the media stories on victims. Always young fathers, or a young nurse, or a some other person who is a good media story, who adds to the narrative, but who are statistically outliers.
Once again... Covid is bad. Get vaccinated. Follow precautions. Don't be that 1 in a 1000. Not worth the risk. However do keep things in perspective.
Another factor is that I and literally everyone I care about has been fully vaccinated since before delta. Deaths remain heavily concentrated in the unvaccinated, I don't really need to worry. Thus far just getting two jabs has been the uberprecation and I am skeptical that will change
Absolutely true. Vaccinated people will probably be more likely to have a social network that was vaccinated due to the homophily effects I mention above.
But.... vaccinated people have a higher median age, therefore this will increase the chances of them knowing someone.
My gut feeling is the vaccination effect outweighs the age effect.
I also had this sort of.... I don't care feeling. I don't give a F about masks attitude.
Got to confess, this omicron thing making me reconsider a little bit.
Noah, if we take ~June 1st as the start of the Delta wave in the US, that's about a month after everyone in the US who wanted a vaccine could get one. I completed my second round by end of April and I wasn't in a priority group. So the vast majority of deaths from Delta were among the *voluntarily* unvaccinated. Quite frankly I'm not sure why we should grief for adults who've made a conscious decision to avoid a free vaccine.
Err, umm, US deaths attributed to Covid are fast approaching 800,000. Estimated total US Covid deaths, based on the increase in death rates during the pandemic relative to the prior period, are past 1 million. Delta was first spotted in the US in May and became the dominant variant by August. There have been more than 160,000 deaths attributed to Covid since the beginning of August, and there have been probably well over 200,000 more deaths than occurred in the same months of pre-pandemic years. By comparison, US fatalities in WWII were just over 400,000.
Okay but I and all my loved ones are vaccinated and boosted so who cares? What point are you trying to make here by listing these Delta numbers? Thousands of unvaccinated people died of the virus because they didn't want take the free vaccine. No skin off my back.
The point for "listing these Delta numbers" is because the first poster referred to the Covid-19 response heretofore as the "perpetual boy who called wolf".
To be clear, I don't consider covid itself to be a "boy who cried wolf" nothingburger, but rather the cycle of new variants that get hyped up and turn out to mean essentially nothing to the already vaccinated (original vaccines) population
Well you chose the wrong metaphor. The metaphor you want might be that you and all your family friends are in brick houses so why should you mind the wolves eating some of the neighbors? And I'm vaccinated too and I sympathize. But Delta was more than just a slayer of the stupid in developed countries, it also ravaged the poor in the rest of the world, and slowed recovery globally. It is true that early fears that Delta would evade vax immunity turned out to be wrong, but that's not "crying wolf" that's intelligent concern when a new variant is spreading like wildfire, and it's an intelligent concern again now with Omicron, until we find out for sure one way or the other.
Wait... you CARE about other people?
One barrier to the rapid expansion of booster shots, beyond production and distribution, is the growing wariness about day-after effects. I scheduled my booster on the day before a day when I had nothing scheduled. Sure enough, I spent that second day on my back (as I did with my second Moderna shot earlier this year). Anecdotally, I'm hearing more people who were eager vaccine takers earlier this year say they're putting off their boosters until they can plan a day off from work and family obligations. The problem here may not be limited just to those who had reactions to the first round of vaccines, since word-of-mouth accounts can drive more widespread concerns about those experiences -- or just give busy people people another reason to delay what they know they should do. I have not seen any data on how large that population who suffered these Day 2 effects is. And, although these effects are relatively minor, it they cause you to lose a day of work, that's significant. It seems to me that health authorities should be addressing this, not ignoring it. There are ways to overcome this problem, including working with employers to provide the boosters on a sequenced basis (employers may also become wary of incurring Day 2 absences from their staff if all are given boosters in the same week) and providing pay for those who miss work due to second day effects. But, not talking about it and not dealing with it is sure to slow down the needed uptake of boosters.
This. My sister (who got J&J last spring) scheduled her booster dose several weeks in the future so that she'd have a day off afterwards.
(And then, when she got there, the pharmacy was out of doses. She hasn't rescheduled yet.)
surely nobody's work is so important that they cannot take a day out however important they may think they are.
It's not about the importance of one's work but about the importance of one's paycheck, at least for lower income, front line workers. Those I know would welcome the day off but, depending on their employer's policies, they might not get paid for it.
Some people can take a day off work a lot easier than others. I wonder how much paid sick leave for everyone would increase vaccine uptake.
And being sick isn't pleasant.
This is normally a pro-vaccine argument: even if you are unlikely to die, you don't want to be sick. Being sick really sucks.
Quick work. Much appreciated.
Best case scenario is that omnicron has mild symptoms, low mortality, and infection creates a long lasting broad immunity especially if paired with vaccinations. Theoretically it could burn itself out with little consequence, even theoretically creating herd immunity against all Covid-19 variants.
Yeah… we can wish.
One thing that hasn’t been mentioned is this variant most likely came about in a vaccinated person. The number and type of mutations were evolved specifically to beat vaccination antibodies.
This does not mean that I am anti-vaccine. I already have my booster. Just that there is this assumption that vaccines alone can beat this thing. This is a naive assumption.
One question I haven’t seen answered is do natural immunity antibodies do better against this variant?
I am also curious whether there is a trade off between antibody escaping spike mutations and it’s danger to the human body.
Regardless, I have zero faith that our CDC and FDA will make smart quick decisions.
Vaccines can beat the kind of behavior you describe, but only if everyone is vaccinated. The problem occurs when you have a thriving infected population intermixing with a vaccinated one. The emergence of any variant that can penetrate the protection provided by the vaccine, affords itself a massive breeding ground.
Yes. First few mutations to vaccinated to non-vaccinated back to vaccinated, etc... Partial vaccination very likely contributed is one way, but then it would probably have a trail that connected it with other strains. This one is completely disconnected. One virologist suggested that it could of mostly evolved within a single vaccination person who carried for an extended period of time while it sort of mutated to survive. Perhaps someone with a compromised immune system that wasn't quite strong enough to beat into submisssion.
It's probably not that that matters a lot in this case.
Some viruses most probably can replicate in the tissues they first colonize, ie nasal epithel for Sars-Cov-2, and create a very large amount of viral particles - enpough to lead to very high viral shedding levels and to become a superspreader, when infected cells so to say burst without giving any symptoms and involving other organs in the process.
The four versions of Coronaviruses responsible for the common cold are in this category, for instance, as well as several other usually very mild upper repiratory viruses plus rotavirus and novovirus.
Many viruses, those we have produced sucessful vaccines against that give reasonably long lasting herd immunty if at least 1 - (1 / R0) fraction of people are inoculated with them, such as measles, mumps, polio and so on need to travel to target organs through lymph before they begin their replication.
Nasal epithel do usually not have high levels of certain types of antibodies that are useful for forcefully stop local infection and if I understand things correctly - this was brought to my attention just recently - this makes the viruses that replicate directly at their site of entry into the body able to replicate without much hindrance even in individuals that have a high degree of acquired immunity.
The viruses that have to travel through lymph to begin replication produces an immune response that quickly shuts down virus replication - whatever their target organ tissue might be - in inoculated indivduals and individuals that have acquired immunity through infection and thus these persons do not become contagious even if infected asymptomatically.
This is why we see so small differences, practically none, of virus levels in nasal epithel - from where it is spread by aerosol in the case of Sars-Cov-2 - in naive individuals and people who have acuired immunity.
Besides, coronaviruses are known to often produce reinfection, ie giving a immunity that wanes quickly even after immunity acuired by infection. Immunityy acuired by infection most probably lasts under 18 months and the Pfizer vaccine have a hard time keeping a 50 % level of effciency 3 months after Inoculation for Delta.
So it does not matters how many are vaccinated, unless we can get a vaccine that gives an efficiency so near 100 % to in practice be 100 % for at least seversal months - ie it cannot wane to 75 % at three months since very few will wanna get vaccinated every three months except probably or possibly those over roughly 65-70 years of age. It will need to stay above 85 % out to at least 4 moths to have any cvhance at all of getting compliance from the public.
And such a vaccine will probably never be discovered, due to how our immune system works and the fact that coronaviruses are almost notrious for giving quickly waning immunty (although I guess it's possible the fourth or fifth booster with a Delta-targeted and Omicron-targeted vaccine might reach that kind of efficieny - Note that now people have only ever gotten at msot two boosters as of today - althoug I would bet aginst it.
Add a very high mutuation rate and we have a situation comon to those with vaccines for the common cold, which have never successfully been achieved (Where four types of common cold are caused by viruses from the Corona family)
Sars-CoV-2 is one nasty virus that is very hard to handle.
PS. I stress to note that I am very pro-vaccination, everybody who is over 50 and doesn't get vaccinated are taking a completely unneccesary chance with their lifes and considering the existence of Long Covid - where vaccines probably lower the risk for Long Covid maybe 2,5-3 times compared to post-infection in non-vaccinated persons - people between 20 and 50 should get vaccinated as well. I also think you could make a case for vaccination on the IFR rate of COVID for those over 40 - you don't want to have to go through ICU care since that often gives cognitive deficits.
The only group I am strongly against vaccinting are children where I feel the vaccine hasn't been tested enough yet and people under rougly 10 years of age have a very different immune system compared to adults and rougly only when people leave the teens their immune systems functions the same as an adults, so I feel that vaccination for at least those under 15 is highly unethical when we know that vaccination does not lower the contagiousness of an infected individual and I have not seen data that vaccines are benefical for the children themselves as the NNT (number needed to treat) is so extremely high and the Pfizer vaccine at least has a unusally high level of side effects and also the possibility of negative long term effects - especially concerning for children - is completely unknown.
How would you know that it evolved specifically to beat vaccination antibodies rather than antibodies from prior infection or antibodies from monoclonal antibody treatments. Vaccination rates were extremely low in Africa when omicron was evolving.
The reason is the sheer number of mutations, and this variant isn't directly related to other variants. If mutated in a non-vaccinated population, there would be no evolutionary reason for this many mutations. Any mutation would be outcompeted by standard variants. Read this thread...
https://twitter.com/jbloom_lab/status/1464005711327686656?s=20
South Africa is 24% vaccinated, so seems more likely to have evolved in a previously infected person
Yes. The person that omicron evolved also likely didn't live in South Africa. Most African countries have almost no surveillance testing, so it could have been spreading around many countries before it made it to South Africa & Namibia. Most African countries are less than 10% vaccinated, which further reduces the chance that it evolved in a vaccinated person.
That's a good point. South Africa was just the first detection point.
Possible. Not sure whether natural immunity antibodies attack different proteins than vaccinated antibodies.
I don't see anything on that thread that suggests the omicron variant evolved in a vaccinated person. They say that selection of variants is driven more by antigenic selection. The selection of variants is different than the specific person it evolved in. Antigenic selection is about escaping antibodies which includes antibodies from prior infections, not just from vaccination.
True. But antibodies from natural infection are different than antibodies from vaccines. Vaccine antibodies attack a specific spike area. This variant mutated specifically in this spike and not others.
Neutralizing antibodies- whether from infection, monoclonal treatment, or vaccination- are only neutralizing if they bind to a protein that stops the virus from gaining access into a cell. If given an mRNA vaccine, you only create antibodies to the spike protein, as that's all that's presented to your b-cells. For an infection, you create antibodies to every novel protein your b-cells encounter, but the only ones that are neutralizing are the ones to the spike protein. Monoclonal antibodies are selected for their ability to be neutralizing, to bind to the spike protein. Basically, all three provide an evolutionary pressure to change the spike protein.
South Africa is reporting that this variant seems to be outcompeting the Delta variant, even though their population is only about 28% vaccinated. It could be this is more like Delta where some of the mutations just happen to help it spread faster.
The vaccines target spike, and most of the mutations here are on spike. Actually many of the variants seem to be mutating spike. Check out Dr. Geert Vanden Bossche.
I think the spike tended to mutate a lot more than other parts of the virus long before we had vaccines.
that’s not as clear if you consider when vaccine trials kicked off
True, but the antibodies you create that don't bind to the spike protein aren't neutralizing antibodies. The spike protein is what gains access to a cell, so if there's an antibody bound to it- whether monoclonal antibody, vaccine induced antibody, or infection induced antibody- it can't bind to the ace2 receptor and can't enter the cell. While there are certainly other evolutionary pressures applied on the cell as well, it makes sense in all cases that the spike protein is under a lot of evolutionary pressure to mutate around neutralizing antibodies. I don't think this really tells us much
I don't understand urging a third shot of a vaccine developed a year ago immediately after acknowledging that our #1 concern is that Omicron's mutations make it highly likely to escape existing immunities and [said] vaccine.
Infections provide the opportunity for new variants of concern to arise. To reduce the risk of new variants of concern, we should have been reducing infections by vaccinating humanity as a whole.
South Africa has been pushing for a waiver of vaccine patents for a year (https://twitter.com/sarahlazare/status/1464468594339766272), and been spurned. Instead they got a new apartheid, vaccine apartheid, fueled by an "intellectual property" regime (https://soundcloud.com/citationsneeded/ep-129-vaccine-apartheid-us-medias-uncritical-adoption-of-racist-intellectual-property-dogma).
Time to waive the patents, kick technology transfer up a gear, and point out that when The Russians™ or Iranian Hackers® "steal" vaccine technology, that's Good Actually. The best time to vax the planet was a year ago. The second-best time is now. Vax the planet!
Total distraction. There are no magic manufacturers who were going to scale up mRNA production even if they got the technical know how for free.
That's hard to square with the freakouts over sneaky foreigners daring to "steal" vaccine technology, and hard to square with the recommendations of Human Rights Watch (https://www.hrw.org/news/2021/06/03/seven-reasons-eu-wrong-oppose-trips-waiver), Amnesty International (https://www.amnesty.org/en/latest/news/2021/10/covid-19-time-for-countries-blocking-trips-waiver-to-support-lifting-of-restrictions-2/), and the 64 WTO member countries that back a TRIPS waiver (https://reliefweb.int/report/world/time-runs-out-break-trips-waiver-stalemate-protesters-us-and-eu-embassies-south-africa).
In any event, even if what you said were true, it would weigh against the standard objection to junking "intellectual property" in this situation (that it would lead to the First World's big vaccine manufacturers losing business to other manufacturers; if there are no such "other manufacturers" then no business can be lost to them). And the moral course of action would be to scale up those manufacturers that were capable of mRNA production, not to merely scoff about "magic".
I do have a problem in that you start the article with the *alarming* statement, "it’s spreading fast, and taking over very quickly from the Delta variant." (Without reference I might add)
... then buried further down, a more off-hand comment of .. "That said, the more dramatic graphs you’ve seen about Omicron spreading like wildfire may overstate the speed of its spread"
Dr Scott Gottleib is <hopefully> likely more correct, here.
Overall, yes I'd agree.. and with CDC's notable <mostly> absence while the world is thrown into an anxiety ridden panic these past 4 days, the WH & CDC messaging needs to step it up 200%
Your call to ramp up vaccine manufacturing reminded me of the book "Destructive Creation" by Mark Wilson. Just as the US government financed, owned and even operated much/most of the war "machine" that was the foundation for winning WWII, we need the US government to finance and "own" vaccine manufacturing plants and have the private companies operate them. No rational company will build the capacity to quickly make all the vaccines needed just so billion dollar facilities will be idled in 2-3 years.
As the great-grandson of the man who ran that operation in WWII, the government did not "own" or "operate" most of the war machine. Rather, FDR hired the President of General Motors for $1 a year to figure out how to produce what was needed and then convince the manufacturers to retool to build what was needed. This started well before we entered the war. The government financed it by purchasing the tanks, planes, munitions, etc. that were produced. The government owned essentially nothing and the only operation it did was submitting orders for what was needed.
You have family lore, which is great. The author would disagree with you and suggest that your argument is the result of the Chamber of Commerce's successful marketing campaign. Try reading the book and challenge your preconceptions.
The political climate was a lot different then. Both D & R's did not like all the "blood money" millionaires that came out of WWI. So there were lots of laws, passed prior to the war that not only limited upfront the profit firms could make but that the contracts could be renegotiated if the government found that the profits ended up being greater than forecast.
Only the government had the ability to finance the construction of new plants and industries- it is not like Boeing in 1940 could go out and raise the money to build a plant for an unknown number of bombers for an unknown number of years based on unknown and changeable contracts with the government. New industries like synthetic rubber plants for all the tires needed in the war were started from scratch. Other industries like the the shipyards for cargo ships needed to be built and expanded way beyond any peace time requirements. In the middle of a depression only the government could own and build many of those plants.
I am not arguing that the government did it with it's own people, lots of private sector business men worked for the government for reduced salaries, brought their expertise and managed government owned plants or negotiated contracts for contractors to run plants. Or you had the Navy which built most of their ships in their own yards and repaired same in their own yards and the Army which had its own munition manufacturing and armories.
You absolutely are correct at how it developed over the course of the war. I took issue only with the terms "owned" and "operated". This isn't family lore though. I'd suggest reading Freedom's Forge, by Arthur Herman, which is an account of both my great grandfather's role and that of Henry Kaiser.
Well, they might do if the government agree to pay them a handsome price for each dose. Though I'm loathe to admit it, sometimes it is prudent for governments to overpay private companies for medications, so that they don't have to bear the initial burden of the R&D costs.
Small comment on your Delta chart: do we have data showing that southern US states wouldn't have a summer wave if Alpha remained as the prevalent strain? We're now seeing COVID establish a seasonal pattern with southern states getting hit first (hot outside, everyone stays inside) and northern states getting hit next (cold outside, everyone stays inside). Does modeling exist for what the summer wave was expected to be with the Alpha strain in place, given what we now know about real-world vaccination and masking rates?
There is also the possibility (and I would even say it's the most likely) that the existing vaccines will protect from hospitalization and death just as well as against delta, if that's the case then this whole pandemic is basically over and the world can move on (minus some dead anti-vaxxers). Omicron looks like such a mutant monster that I can't imagine something worse coming along.
It seems way too early to get worked up about this if we have no mortality data.
A variant that is twice as infectious is *far* more dangerous than an infection that is twice as deadly. If it’s twice as infectious and only half as deadly it will end up killing far more people, because infectiousness is exponential while deadliness is only linear (it doesn’t matter how deadly a virus is if you never get it, and infectiousness determines how many will get it).
A variant that is much more infectious but less deadly may crowd other variants out (and build natural immunity). Between being less deadly, availability of vaccines, and better treatments, the best-case scenario is that Omicron is "no worse than the flu".
Yeah, enough less deadly to make up for increased infectiousness turns it into a cheap and easy vaccine that anti-vaxxers are happy to get.
I disagree with that assessment of the math, at least if it's true that:
(1) The base level of infectiousness (i.e., before doubling) is already at the level at which approximately everyone can expect to be exposed to an infectious dose.
(2) There's some level of durable immunity after a first infection.
I submit that existing variants of SARS-CoV-2 already meet both conditions.
Yeah, I've got an assumption that either R is low enough that a significant fraction of the population would avoid it, or there's an ongoing vaccination process that will give a substantial fraction of the population protection from the worst outcomes if they get vaccinated before they get infected.
I think that was true early in the pandemic when most people had no immunity. However, delta is already infectious enough that everyone is going to get infected. Being more infectious means the last few people without immunity get infected faster.
We have no good data on infectiousness, so we are just speculating. Not particularly helpful from a policy perspective, or just to have a level-headed, non-alarmist approach to fighting Covid. If it turns out that this is less virulent, alarmism will undermine trust in public health.
Nicely done. My guess is that Omicron won't be as dangerous as we fear, but it's impossible to know, and we certainly need to be prepared. One hopes that CDC and FDA will finally get their act together.
> But another reason, which Topol acknowledges, is that some public health officials in the U.S. saw boosters as taking away vaccine doses from developing countries.
This is incorrect. The FDA was very explicit about why they did not recommend the booster for everyone. The reasons did not include concerns about the rest of the world (I think it’s pretty clear from the lack of urgency in expanding vaccine manufacturing that western agencies simply don’t care about the RoW, which is the context in which the WHO chief’s comments about booster should be read).
https://www.cnn.com/2021/09/17/health/fda-advisers-booster-five-things/index.html
Their concerns were (a) lack of data, (b) concerns about younger people, and (c) most ridiculously, “first shots are more important than boosters”. The primary problem, once again, was provinciality, where they were discounting studies and experiences from outside the US.
While you are right that expanding manufacturing should be the answer to not enough shots, in the absence of such an expansion in manufacturing, boosters taking up shots which could be sent abroad was a sound justification for denying boosters.
Heck, in this hypothetical world where western boosters were sent to other countries to be used as first shots, the vast majority of boosters would have actually gone to South African countries which could have potentially even prevented the development of Omicron until a few months later. Omicron reinforces the concept that getting the RoW first shots is more important than boosters.
Of course, I personally was still in favor of boosters for the simple reason that history showed that boosters would not, in fact, be redistributed to the RoW, but in fact would continue to be hoarded until they expired anyways.
- There is only one “South African country”.
- South Africa actually has enough jabs but is struggling to get them into enough arms.
Hoarded until they expired? Is it really that dark? If so would appreciate source.
The site does not appear to allow me to paste links, but you can Google it. There’s a flurry of articles from last month talking about the US hoarding approximately 500mm vaccines, which, it’s easy to do the math, is far greater than any possible need (especially considering that at this point US needs can almost certainly be met by a small proportion of US manufacturing capacity itself, not requiring a reserve at all).
Some of these articles might also mention that until early October approximately 15mm vaccine doses were discarded in the US because they expired, and considering the vaccines last about 6-7 months before expiring, that number is only going to rise keeping the 500mm doses the vast majority of which will go unused, in mind.
You're right. One group I trust is doctors without borders, and here's the numbers from them: "Even while factoring in third-dose boosters for high-risk groups, high-income countries are hoarding an estimated 870 million excess doses—nearly 500 million in the US alone. The rapid redistribution of these doses to low- and middle-income countries could save nearly one million lives by mid-2022."
Shit... What part of this is dumb, and what part pure scared selfishness?
I agree that the CDC and FDA *ought* to fast-track variant-specific boosters for coronavirus, but how confident are you that the CDC and FDA actually have changed enough so that variant-specific will indeed receive approval soon enough that we can avoid a repeat of March 2020?
Well, you're never supposed to assert a probability of 0, but I'm hard-pressed to come up with a reason not to in this case.
Good recap. Should the FDA literally do the boosters like an annual flu shot approval? Or is there some other fast protocol the FDA should use for Omicron?
Also, should Moderna and Pfizer start switching over their manufacturing lines as soon as they have a candidate, or should they wait for FDA approval? If we do want them to start the switch early, should the Administration compensate them for the risk with an advance purchase order, like they did with Warp Speed?
We need fast booster approval, and fast booster manufacturing, both. I'd love to read anything you can turn up about how to make those happen.
The FDA already said they would approve boosters like annual flu shots. They are testing the current vaccines against omicron to see how much efficacy is reduced. I think those results would determine how important it is to switch over production to the new omicron vaccines. We still have a couple months left in the current delta wave, so I don't know if we want to halt production of current vaccines just yet.
Very dated article showing how wrong the forecasts on omicron were. In the UK there was an unwillingness to accept RSA science and I suppose in the US also.