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.
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.
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.
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!
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.
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.
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.
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.
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.
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.
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.
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!
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.
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.
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.
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.
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.