The world reported more than 9.5 million cases last week, which is a 71% increase compared to the previous week. Although the greatest increase is still in the Americas (+100%), every region in the world now has increasing case trends. (Notice the y-axis is different for each region in the figure below).
Maryland hospitals passed their breaking point between Xmas and New Year’s and started shifting into crisis standards of care. No decoupling here other than the vaccinated have a dramatically lower hospitalization rate. Everyone else is being hit hard like before.
Something that I am interested in seeing is that Massachusetts intends to start splitting out their hospitalization data into “hospitalized with covid” and “hospitalized from covid”.
I think it will be revealing from a data perspective to see how much of the covid hospitalization rate in my state is due to covid symptoms vs incidental (tested positive while there for something else). The ludicrous transmissibility of omicron would surely increase the incidental rate, but it’s really hard to say by how much.
This will definitely be interesting. However, I read an article this week (perhaps in The Atlantic) that said the decoupling isn't quite as clean as you might think since COVID can exacerbate conditions people already have. So people come into the hospital FOR something else, but may have been able to avoid the hospital if it they hadn't been infected WITH COVID.
i agree. in addition, it matters what type of question we’re asking. do we care about hospital capacity or severity of disease? if the former, then it doesn’t really matter about for or with.
And recall that an incidental COVID diagnosis after in-hospital test still adds to the hospital stress/load because these folks now have to be isolated, staff contacts who might have sustained unmasked, or sustained content may be ill, and all contacts will likely be tested.
Is it possible we would see more decoupling if we had an accounting for the at home tests and their results? Just last week I knew 3 cases and yesterday 2 more. I know of several others as well that tested positive on rapid tests and have done well in the course of their illness.
ahh that’s a really good point. maybe? but at home testing is much more prevalent and available in the UK compared to US, so if we are comparing these two countries, then it wouldn’t make much of a difference
...except that, in my understanding, in the UK there is a well-known central reporting mechanism for at-home results via the NIH. There is no such mechanism here in the US. In fact, in my city, whose officials have taken the pandemic pretty seriously despite its existence in a denialist state, there is almost no communication with the public on whether to report home results. When you do find how to report them, you have to make a phone call. The number at the end of that phone call never answers and instead just plays an outgoing message of other numbers to call for various issues, none of which are "to report an at-home covid test result, please do the following..."
Positivity rate in local hospital lab was over 90% two weekends ago. At-home tests are so difficult to locate in the area that there is a facebook group dedicated to crowdsourcing pharmacy stock. The probability of grossly undercounting positives is extremely high. At this point, I would almost suggest that, in my area, if you don't want to be exposed to omicron, do use a p100 ventilator mask when you leave your dwelling.
I do not have a source that specifically indicates that they include rapid antigen test results in their official counts. I am assuming that they are included since they bother to collect them. See "What to do when you get your results" at https://www.gov.uk/guidance/covid-19-self-test-help
That section has a link to https://www.gov.uk/report-covid19-result which offers both online and telephone methods for reporting data. There is a link there that describes what the NHS does with your data, but it's mostly privacy-oriented rather than result-oriented.
NHS has a system to register your testing kit and subsequently submit your results (positive OR negative) for inclusion. While some states, and a few more health departments do have reporting system for at-home tests, we lack the depth to make this work.
I don't know if I have just been missing it in previous newsletters but today I noticed the offer of a version in Spanish. Thank you very much for providing this option (on top of all the terrific work you're already doing)!
Please note the damaging oped piece in the WSJ this AM entitled Omicron Makes Biden's Vaccine Mandate Obsolete. The authors cite a prepub article from Denmark that they say suggests that vaccines are ineffective against omicron. However the article ends with the following, ".......these findings highlight the need for a massive rollout of vaccine and booster vaccine."
I would not say they are ineffective, as they produce good reductions in cases, hospitalisations and deaths. The effect isn't sufficient to achieve control of the epidemic without a lockdown, but I wouldn't call that ineffective. I know the government is getting very good value from my vaccination because I'm significantly less likely to make use of the hospital system.
I haven't read the WSJ piece, but I wondered about this as well. The timing of the mandate vs. the onset of omicron wave seems like the mandate may end up being less useful. With a 2-round vaccine requiring an additional two weeks to reach efficacy, it seems that we might be on the backside of the omicron wave before vaccinations could start becoming relevant in the equation. Factor in the requirement to wait a certain period after covid infection prior to vaccination, and it makes things even more complicated.
Pragmatically--and without having read the WSJ piece--they may be right.
However, lots of things aren't 100% effective from a pragmatic perspective, yet we still do them as a society, e.g., laws against drunk driving. There is a "messaging" aspect of a mandate that would still seem useful even if, pragmatically, it won't yield all the benefits.
The other problem is that this also ignores the reality that delta does still exist, and it's not clear that having omicron confers any real protection against delta...but vaccines definitely do.
So, overall, I think there's still value in the mandate, just as much against omicron.
You need to stop saying things like “vaccine preventable disease”. It’s patently false at this point. Even the cdc has come out to say it doesn’t prevent. It makes everything else you say impossible to listen to,
The disease is COVID-19 (that's what the "D" stands for). An infection with SARS-CoV-2 may or may not cause disease in the infectee. To a large extent (not 100%, but to a large extent), the vaccines prevent COVID-19, particularly the more severe manifestations.
There is no vaccine of which I am aware that prevents 100% disease in 100% of the recipients. The COVID-19 vaccines are no different in that regard.
"Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur."
To the extent China (or Taiwan, or New Zealand, etc) was able to repeatedly achieve zero cases of community spread subsequent to reimportation of cases, is proof I'd accept that this was a 100% preventable disease. NPI tools of prevention include masking, hand-washing, distancing, and other individual risk mitigations; formal isolation of infected, quarantine of exposed; reduction of crowding, structured and regular testing and surveillance, contact tracing, etc...and ALSO there is vaccination, as the pharmacologic arm of prevention. Prevention isn't just jabs in arms.
But together each country had options and tools to successfully prevent this 100% preventable disease, had they summoned the coordinated will and efforts of the population and the government. A big ask you say? What's the price of a million lives? What's the cost of a 10-20 point IQ drop in a large part of the long covid cohort? What's the cost of the burden of care for a lifetime for this fraction?
But yes, any country that could not agree on purpose or method or objective to prevent death and disease, was surely going to fail, e.g., the US.
Here's an article from JAMA published today that reports a 93% reduction in infection in Israeli HCWs during a median of 39 days of follow-up after having received a booster of the Pfizer vaccine. https://jamanetwork.com/journals/jama/fullarticle/2788104
Note that this was a reduction in infection (including asymptomatic infection), not just COVID-19. Granted, that reduction is not a 100% reduction in infection, but it is significant in having prevented a large percentage of infections during the study period.
In one, very limited sense, you're correct. It remains possible to be infected by the virus and contract COVID-19. People who are vaccinated tend to have much milder cases, fewer require hospitalization and even fewer, most often those with compromised immune systems and multiple other medical problems, known as comorbiditites, die. On the other hand, the unvaccinated are at higher risk for more serious disease, hospitalization and death. This was already understood when delta was the prominent variant, and little has changed with omicron.
The original stated purpose of the vaccines was to reduce the incidence of serious illness and death. Sterilizing or fully neutralizing immunity was not involved in the intent of the developers because the chance of achieving sterilizing immunity is very small, approaching zero for a rapidly changing virus such as SARS-CoV-2 (or any of the coronaviruses).
Finally, vaccination reduces the likelihood of significant variant creation in an individual. Consensus is that virtually all the successful variants evolved in an unvaccinated individual. Vaccination allows the body's own defenses to more rapidly clear the viral infection by creating antibodies, but also by initiating the cellular immune system's response to the virus, and to infected cells.
Current CDC guidance is that everyone who is eligible for vaccination should be fully vaccinated, and all who are eligible for boosters be boosted.
Repairing the damage done to CDC will take years. The exodus of experienced scientists starting in 2017, ahead of, and concomitant with budget cuts, and placing Redfield in charge, was a damning indictment of the direction the place was headed. Walensky has had her share of messaging gaffes. Some of the decisions (e.g., reduction in quarantine/isolation periods) failed to disclose what, if any science was involved, and missed its mark with regard to testing: It had more the appearance of trying to keep people going to work in the face of illness than protecting the public.
That said, I was reminded that, overall, CDC does better talking to medical and public health professionals or once did, at least, than to the public.
You are entitled to your opinion. I will stick to the fact that I can get a lot of information from what CDC has published, perhaps because I'm familiar with the material already, and speak their language.
" In this scenario, Omicron would lead to a peak of 17,700 daily hospital admissions and 1,700 deaths per day." So, ten percent of #omicron hospitalizations will result in death? Where did this data come from? My searches a failing to come up with any significant number of deaths that are confirmed #omicron.
Speaking of the UK and Denmark, are you going to talk about the vaccine’s negative efficacy there? (As well as Iceland and Canada, where they are also seeing higher cases among the vaccinated vs unvaccinated)
https://www.rte.ie/radio/podcasts/22048573-newspaper-panel/ especially about 15 minutes in. We're getting cases in Ireland but it's very much not as bad as last year. 95% of eligible population vaccinated and counting. The UK has huge vaccination numbers, and millions boosted, and very few restrictions, so Omicron is breaking through when it can. But other than soccer games being put off, they are relatively happy to continue as they are. I think Iceland and Denmark also have very high vaccination numbers, come to think about it. I still don't want to spread the virus, but vaccines have given us hope that we are actually getting back to normal.
As many families, mine is currently dealing with COVID running through the house. I would love for you to address a post on the aftermath of Omicron for a family. What does it mean we should/could/should not do now? We are all vaccinated (and adults are boosted) and now we've even had omicron (we assume it's this variant given the prevalence in our area). We've been SUPER careful (N95 masks, only going out for essentials), but the (vaccinated) kids brought it back from school anyway. After we recover, can we be less careful? Can we get it again? socialize and travel more?
My son, an ID specialist, takes issue with your last report "There is a flaw in her analysis of the relative lack of decoupling. We have vastly undercounted the cases in the US omicron surge. People already knew that omicron is mild at the start of our surge, so many aren’t testing. We have many more home tests, none of which are counted. I addition, it is estimated that 50-70% of Covid hospitalizations are for reasons other than Covid." Best wishes, james R Oster, MD jroslo@cox.net
Decoupling can ONLY be judged based on reported statistics. In essence, your son is likely correct in one sense. Cases are underreported for a variety of reasons, not the least of which is, 2 years into this, we still have no valid testing and reporting strategies. However, there was some significant concern with reporting and actual hospitalizations reported in South Africa, and initial numbers from the UK were, at best, equivocal on disease severity. Looking at similar populations , the UK looked like a better match for the US than S. Africa did.
I'll note that incidental COVID-19 cases in the hospitalized population still require handling as if that were the primary diagnosis because of the high transmissiblity. Relatively mild symptoms have prevailed in the vaccinated population, but not in the unvaccinated population, although even that bit of relatively good news wasn't obvious in the first weeks of this surge.
Given the increasing evidence of long term impact on children even after mild cases, such as the increase in diabetes, are you concerned the the officials are calling to keep schools open no matter what. Why no urging testing or circuit breakers briefly virtual? My city of Virginia Beach (not a small town-school division has 65,000 students) is far from alone falling that guidance to keep schools open with almost no access to testing even for those sick and with symptoms, definitely no regular testing, falling down cloth masks (while we're "lucky" enough to require them), contact tracing has been suspended due to rates too high, and in most cases no improved ventilation from before the pandemic (a few classrooms got filters but not most). Our community rates are 44% positivity and we are around 1000 per 100,000. Hospitals have stopped non-emergency surgeries. 25-40% of students and staff are absent, so little to no learning is occurring.
I understand babysitting is needed for the economy, but it is devastating the health of so many staff and students and a profession (education) that already sorely was lacking staff is and will to hemorrhage people at an even higher rate because of how people are being treated. We are destroying our education system in addition to health and it breaks my heart. Thank goodness, I already resigned after how poorly we were treated last year but I feel for all my friends and colleagues still suffering, both as parents and staff members. Even those who are vaccinated have been getting quite ill, having other family members get more seriously ill (because they're still bringing it home to immunocompromised or unvaccinated family), not to mention the sometimes devastating and sometimes more minor long term impacts to their health that we are seeing in large numbers.
I know you can't answer every question but thought I'd ask since I have not been able to find any articles on my question (below). I am an MD with an MPH so know just enough to get obsessed with the data but don't have the analytical skills or advanced epi training to distill the information myself. I have been SO GRATEFUL for your scholarly and accessible newsletter which I read first thing every morning. Sorry it has taken me so long to pay for a subscription given how much time and effort you put it!
Here's my question: If a health young person (28 yo male) is due for their mRNA booster but tests positive for Covid (presumably Omicron given the timing but not confirmed) should he delay his booster? And if so by how long? Or go ahead and get it now as planned once he is out of the quarantine period?
Are there any valid concerns about too many vaccines too close together or on the heels of an infection? I have read some unsubstantiated comments about "over stimulating" the immune system if folks stack their vaccines closer than recommended but not sure if this is true or how a breakthrough infection fits into this picture. I have not seen any data on this particular scenario or in the CDC guidelines (such as they are) yet so would appreciate your input -especially if other folks have the same question.
Thanks again for your dedication. Tell your little ones their mom is a hero. :)
Here's a question that I've been searching for an answer to and can't find anywhere.
Prior to Omicron, the science seemed to indicate that the risk of transmission outdoors was slim to none (unless you're in a large crowd of people). Kids' playdates, gatherings outside, etc. should be safe (even unmasked) because of unrestricted airflow.
Now that we have a far more transmissible variant, does that guidance change? If we can become infected with a much lower amount of exposure, then is outside still the magic bullet, transmission-wise?
In my suburban community, we rarely mask outdoors (but always, ALWAYS indoors). However, I've been wondering if it's wise to be masked outside with other people around. Do you have any thoughts, links, or information on whether the risk is different for Omicron outside than it was for previous strains?
As always, thank you so much for your efforts and insights. I appreciate your work so much.
Thank you for your amazingness and distilling this for us! I am wondering if you will be covering the nasal v. oral v. both debate that is currently happening for at home testing?
Thank you for continuing to give us the data! As frightening as it is reality helps us all make sound personal decisions.
Maryland hospitals passed their breaking point between Xmas and New Year’s and started shifting into crisis standards of care. No decoupling here other than the vaccinated have a dramatically lower hospitalization rate. Everyone else is being hit hard like before.
Something that I am interested in seeing is that Massachusetts intends to start splitting out their hospitalization data into “hospitalized with covid” and “hospitalized from covid”.
I think it will be revealing from a data perspective to see how much of the covid hospitalization rate in my state is due to covid symptoms vs incidental (tested positive while there for something else). The ludicrous transmissibility of omicron would surely increase the incidental rate, but it’s really hard to say by how much.
This will definitely be interesting. However, I read an article this week (perhaps in The Atlantic) that said the decoupling isn't quite as clean as you might think since COVID can exacerbate conditions people already have. So people come into the hospital FOR something else, but may have been able to avoid the hospital if it they hadn't been infected WITH COVID.
i agree. in addition, it matters what type of question we’re asking. do we care about hospital capacity or severity of disease? if the former, then it doesn’t really matter about for or with.
And recall that an incidental COVID diagnosis after in-hospital test still adds to the hospital stress/load because these folks now have to be isolated, staff contacts who might have sustained unmasked, or sustained content may be ill, and all contacts will likely be tested.
Correction: they will be starting next week.
https://www.bostonglobe.com/2022/01/07/nation/heres-why-state-is-changing-way-it-reports-covid-hospitalization-data/
Is it possible we would see more decoupling if we had an accounting for the at home tests and their results? Just last week I knew 3 cases and yesterday 2 more. I know of several others as well that tested positive on rapid tests and have done well in the course of their illness.
ahh that’s a really good point. maybe? but at home testing is much more prevalent and available in the UK compared to US, so if we are comparing these two countries, then it wouldn’t make much of a difference
...except that, in my understanding, in the UK there is a well-known central reporting mechanism for at-home results via the NIH. There is no such mechanism here in the US. In fact, in my city, whose officials have taken the pandemic pretty seriously despite its existence in a denialist state, there is almost no communication with the public on whether to report home results. When you do find how to report them, you have to make a phone call. The number at the end of that phone call never answers and instead just plays an outgoing message of other numbers to call for various issues, none of which are "to report an at-home covid test result, please do the following..."
Positivity rate in local hospital lab was over 90% two weekends ago. At-home tests are so difficult to locate in the area that there is a facebook group dedicated to crowdsourcing pharmacy stock. The probability of grossly undercounting positives is extremely high. At this point, I would almost suggest that, in my area, if you don't want to be exposed to omicron, do use a p100 ventilator mask when you leave your dwelling.
do you have a source that explains UK includes rapid antigen tests in their official counts? i would love to read up on this.
https://www.nhs.uk/conditions/coronavirus-covid-19/testing/test-results/report-a-rapid-lateral-flow-test-result/
I found this while trying to organize a site to accept test results from home tests.
I do not have a source that specifically indicates that they include rapid antigen test results in their official counts. I am assuming that they are included since they bother to collect them. See "What to do when you get your results" at https://www.gov.uk/guidance/covid-19-self-test-help
That section has a link to https://www.gov.uk/report-covid19-result which offers both online and telephone methods for reporting data. There is a link there that describes what the NHS does with your data, but it's mostly privacy-oriented rather than result-oriented.
just found it: UK include antigens and PCRs in officially reporting. which has important implications. i’ll be sure to mention in next post.
federalism is good for some things, but data collection is not one of them.
NHS has a system to register your testing kit and subsequently submit your results (positive OR negative) for inclusion. While some states, and a few more health departments do have reporting system for at-home tests, we lack the depth to make this work.
I don't know if I have just been missing it in previous newsletters but today I noticed the offer of a version in Spanish. Thank you very much for providing this option (on top of all the terrific work you're already doing)!
this is a new feature! (you didn’t miss it). please share widely!
Aaaaaaand I think it just got me. Developed a 100 degree fever earlier today
On the other hand if Covid did get me, I can at least say that Wordle edged it out by one day and "infected" me first. WIN!!!!
Please note the damaging oped piece in the WSJ this AM entitled Omicron Makes Biden's Vaccine Mandate Obsolete. The authors cite a prepub article from Denmark that they say suggests that vaccines are ineffective against omicron. However the article ends with the following, ".......these findings highlight the need for a massive rollout of vaccine and booster vaccine."
I would not say they are ineffective, as they produce good reductions in cases, hospitalisations and deaths. The effect isn't sufficient to achieve control of the epidemic without a lockdown, but I wouldn't call that ineffective. I know the government is getting very good value from my vaccination because I'm significantly less likely to make use of the hospital system.
I haven't read the WSJ piece, but I wondered about this as well. The timing of the mandate vs. the onset of omicron wave seems like the mandate may end up being less useful. With a 2-round vaccine requiring an additional two weeks to reach efficacy, it seems that we might be on the backside of the omicron wave before vaccinations could start becoming relevant in the equation. Factor in the requirement to wait a certain period after covid infection prior to vaccination, and it makes things even more complicated.
Pragmatically--and without having read the WSJ piece--they may be right.
However, lots of things aren't 100% effective from a pragmatic perspective, yet we still do them as a society, e.g., laws against drunk driving. There is a "messaging" aspect of a mandate that would still seem useful even if, pragmatically, it won't yield all the benefits.
The other problem is that this also ignores the reality that delta does still exist, and it's not clear that having omicron confers any real protection against delta...but vaccines definitely do.
So, overall, I think there's still value in the mandate, just as much against omicron.
You need to stop saying things like “vaccine preventable disease”. It’s patently false at this point. Even the cdc has come out to say it doesn’t prevent. It makes everything else you say impossible to listen to,
The disease is COVID-19 (that's what the "D" stands for). An infection with SARS-CoV-2 may or may not cause disease in the infectee. To a large extent (not 100%, but to a large extent), the vaccines prevent COVID-19, particularly the more severe manifestations.
There is no vaccine of which I am aware that prevents 100% disease in 100% of the recipients. The COVID-19 vaccines are no different in that regard.
She continues to call it a fully preventable disease. That’s simply a false statement,
Primary prevention:
"Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur."
To the extent China (or Taiwan, or New Zealand, etc) was able to repeatedly achieve zero cases of community spread subsequent to reimportation of cases, is proof I'd accept that this was a 100% preventable disease. NPI tools of prevention include masking, hand-washing, distancing, and other individual risk mitigations; formal isolation of infected, quarantine of exposed; reduction of crowding, structured and regular testing and surveillance, contact tracing, etc...and ALSO there is vaccination, as the pharmacologic arm of prevention. Prevention isn't just jabs in arms.
But together each country had options and tools to successfully prevent this 100% preventable disease, had they summoned the coordinated will and efforts of the population and the government. A big ask you say? What's the price of a million lives? What's the cost of a 10-20 point IQ drop in a large part of the long covid cohort? What's the cost of the burden of care for a lifetime for this fraction?
But yes, any country that could not agree on purpose or method or objective to prevent death and disease, was surely going to fail, e.g., the US.
I've not seen that. What I've seen in this particular post is "...vaccine-preventable disease," not a "fully" preventable disease.
Where did you see where Dr. Jetelina described COVID-19 as "a FULLY [my emphasis] preventable disease?"
Here's an article from JAMA published today that reports a 93% reduction in infection in Israeli HCWs during a median of 39 days of follow-up after having received a booster of the Pfizer vaccine. https://jamanetwork.com/journals/jama/fullarticle/2788104
Note that this was a reduction in infection (including asymptomatic infection), not just COVID-19. Granted, that reduction is not a 100% reduction in infection, but it is significant in having prevented a large percentage of infections during the study period.
In one, very limited sense, you're correct. It remains possible to be infected by the virus and contract COVID-19. People who are vaccinated tend to have much milder cases, fewer require hospitalization and even fewer, most often those with compromised immune systems and multiple other medical problems, known as comorbiditites, die. On the other hand, the unvaccinated are at higher risk for more serious disease, hospitalization and death. This was already understood when delta was the prominent variant, and little has changed with omicron.
The original stated purpose of the vaccines was to reduce the incidence of serious illness and death. Sterilizing or fully neutralizing immunity was not involved in the intent of the developers because the chance of achieving sterilizing immunity is very small, approaching zero for a rapidly changing virus such as SARS-CoV-2 (or any of the coronaviruses).
Finally, vaccination reduces the likelihood of significant variant creation in an individual. Consensus is that virtually all the successful variants evolved in an unvaccinated individual. Vaccination allows the body's own defenses to more rapidly clear the viral infection by creating antibodies, but also by initiating the cellular immune system's response to the virus, and to infected cells.
Current CDC guidance is that everyone who is eligible for vaccination should be fully vaccinated, and all who are eligible for boosters be boosted.
The CDC has lost literally all credibility as everything is rapidly coming undone.
Repairing the damage done to CDC will take years. The exodus of experienced scientists starting in 2017, ahead of, and concomitant with budget cuts, and placing Redfield in charge, was a damning indictment of the direction the place was headed. Walensky has had her share of messaging gaffes. Some of the decisions (e.g., reduction in quarantine/isolation periods) failed to disclose what, if any science was involved, and missed its mark with regard to testing: It had more the appearance of trying to keep people going to work in the face of illness than protecting the public.
That said, I was reminded that, overall, CDC does better talking to medical and public health professionals or once did, at least, than to the public.
You are entitled to your opinion. I will stick to the fact that I can get a lot of information from what CDC has published, perhaps because I'm familiar with the material already, and speak their language.
" In this scenario, Omicron would lead to a peak of 17,700 daily hospital admissions and 1,700 deaths per day." So, ten percent of #omicron hospitalizations will result in death? Where did this data come from? My searches a failing to come up with any significant number of deaths that are confirmed #omicron.
yes that’s correct. 10% is about right. Here is a data source, but there are many more estimating about the same https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778237
This data says nothing about #omicron.
Speaking of the UK and Denmark, are you going to talk about the vaccine’s negative efficacy there? (As well as Iceland and Canada, where they are also seeing higher cases among the vaccinated vs unvaccinated)
And another by Reuters with some additional context.
https://www.reuters.com/article/factcheck-omicronvariant-breakthroughpro/fact-check-article-examining-the-probability-of-omicron-variant-breakthrough-cases-is-misinterpreted-online-idUSL1N2T81PO
Here's a discussion of that claim.
https://www.politifact.com/factchecks/2022/jan/04/facebook-posts/omicron-risk-claim-vaccinated-missing-key-context/
https://www.rte.ie/radio/podcasts/22048573-newspaper-panel/ especially about 15 minutes in. We're getting cases in Ireland but it's very much not as bad as last year. 95% of eligible population vaccinated and counting. The UK has huge vaccination numbers, and millions boosted, and very few restrictions, so Omicron is breaking through when it can. But other than soccer games being put off, they are relatively happy to continue as they are. I think Iceland and Denmark also have very high vaccination numbers, come to think about it. I still don't want to spread the virus, but vaccines have given us hope that we are actually getting back to normal.
As many families, mine is currently dealing with COVID running through the house. I would love for you to address a post on the aftermath of Omicron for a family. What does it mean we should/could/should not do now? We are all vaccinated (and adults are boosted) and now we've even had omicron (we assume it's this variant given the prevalence in our area). We've been SUPER careful (N95 masks, only going out for essentials), but the (vaccinated) kids brought it back from school anyway. After we recover, can we be less careful? Can we get it again? socialize and travel more?
My son, an ID specialist, takes issue with your last report "There is a flaw in her analysis of the relative lack of decoupling. We have vastly undercounted the cases in the US omicron surge. People already knew that omicron is mild at the start of our surge, so many aren’t testing. We have many more home tests, none of which are counted. I addition, it is estimated that 50-70% of Covid hospitalizations are for reasons other than Covid." Best wishes, james R Oster, MD jroslo@cox.net
Decoupling can ONLY be judged based on reported statistics. In essence, your son is likely correct in one sense. Cases are underreported for a variety of reasons, not the least of which is, 2 years into this, we still have no valid testing and reporting strategies. However, there was some significant concern with reporting and actual hospitalizations reported in South Africa, and initial numbers from the UK were, at best, equivocal on disease severity. Looking at similar populations , the UK looked like a better match for the US than S. Africa did.
I'll note that incidental COVID-19 cases in the hospitalized population still require handling as if that were the primary diagnosis because of the high transmissiblity. Relatively mild symptoms have prevailed in the vaccinated population, but not in the unvaccinated population, although even that bit of relatively good news wasn't obvious in the first weeks of this surge.
Take issue how?
Given the increasing evidence of long term impact on children even after mild cases, such as the increase in diabetes, are you concerned the the officials are calling to keep schools open no matter what. Why no urging testing or circuit breakers briefly virtual? My city of Virginia Beach (not a small town-school division has 65,000 students) is far from alone falling that guidance to keep schools open with almost no access to testing even for those sick and with symptoms, definitely no regular testing, falling down cloth masks (while we're "lucky" enough to require them), contact tracing has been suspended due to rates too high, and in most cases no improved ventilation from before the pandemic (a few classrooms got filters but not most). Our community rates are 44% positivity and we are around 1000 per 100,000. Hospitals have stopped non-emergency surgeries. 25-40% of students and staff are absent, so little to no learning is occurring.
I understand babysitting is needed for the economy, but it is devastating the health of so many staff and students and a profession (education) that already sorely was lacking staff is and will to hemorrhage people at an even higher rate because of how people are being treated. We are destroying our education system in addition to health and it breaks my heart. Thank goodness, I already resigned after how poorly we were treated last year but I feel for all my friends and colleagues still suffering, both as parents and staff members. Even those who are vaccinated have been getting quite ill, having other family members get more seriously ill (because they're still bringing it home to immunocompromised or unvaccinated family), not to mention the sometimes devastating and sometimes more minor long term impacts to their health that we are seeing in large numbers.
Dr. Jetlina,
I know you can't answer every question but thought I'd ask since I have not been able to find any articles on my question (below). I am an MD with an MPH so know just enough to get obsessed with the data but don't have the analytical skills or advanced epi training to distill the information myself. I have been SO GRATEFUL for your scholarly and accessible newsletter which I read first thing every morning. Sorry it has taken me so long to pay for a subscription given how much time and effort you put it!
Here's my question: If a health young person (28 yo male) is due for their mRNA booster but tests positive for Covid (presumably Omicron given the timing but not confirmed) should he delay his booster? And if so by how long? Or go ahead and get it now as planned once he is out of the quarantine period?
Are there any valid concerns about too many vaccines too close together or on the heels of an infection? I have read some unsubstantiated comments about "over stimulating" the immune system if folks stack their vaccines closer than recommended but not sure if this is true or how a breakthrough infection fits into this picture. I have not seen any data on this particular scenario or in the CDC guidelines (such as they are) yet so would appreciate your input -especially if other folks have the same question.
Thanks again for your dedication. Tell your little ones their mom is a hero. :)
Dr. Jetelina,
Here's a question that I've been searching for an answer to and can't find anywhere.
Prior to Omicron, the science seemed to indicate that the risk of transmission outdoors was slim to none (unless you're in a large crowd of people). Kids' playdates, gatherings outside, etc. should be safe (even unmasked) because of unrestricted airflow.
Now that we have a far more transmissible variant, does that guidance change? If we can become infected with a much lower amount of exposure, then is outside still the magic bullet, transmission-wise?
In my suburban community, we rarely mask outdoors (but always, ALWAYS indoors). However, I've been wondering if it's wise to be masked outside with other people around. Do you have any thoughts, links, or information on whether the risk is different for Omicron outside than it was for previous strains?
As always, thank you so much for your efforts and insights. I appreciate your work so much.
Thank you for your amazingness and distilling this for us! I am wondering if you will be covering the nasal v. oral v. both debate that is currently happening for at home testing?