Last week the World Health Organization reported more than 15 million cases of COVID19, which is so high that they had to change the y-axis scale of their epi curve. During the WHO press conference, one advisor said, “
Jan 18, 2022·edited Jan 18, 2022Liked by Katelyn Jetelina
From an epidemiological standpoint, this information is fascinating. From a nursing standpoint, it is moderately terrifying. Here, in Virginia, our new governor has removed mask mandates for K-12 public schools, flaunting CDC recommendations, and opposes vaccine mandates for healthcare workers. I'd be interested in policy change impacts on our state but am not confident in his newly appointed cabinet members overseeing VHHS and VDH to adequately report. Time will tell.
I love your optimism about Omicron peaking, but with our vaunted federalist fragmented approach, the many unvaccinated libertarians, and the Supreme Court taking the virus's side it seems reasonable that the Omicron surge will continue by spreading into the remaining vulnerable areas of the US.
You state: "there will be the same number of new infections on the way down as there were on the way up." That would be true is the curve were symmetric, yet since the "down side" of South Africa's curve is fatter and taking longer (5+ weeks vs 3 for up), wouldn't there be *more* infections on the way down?
Also, when you state "African deaths are still increasing" - do you mean the *rate* of death is increasing (terrifying) or the *number* of deaths is increasing (which is sort of obvious, which is why I'm wondering if you mean *rate*)?
Again, thanks so much for helping all of us understand and know what to keep our eyes on.
Would you be willing to accept $50 contributions so that the likes of the New York Times, Fox News, Bloomberg News, the Wall Street Journal, and Breitbart News can receive your emails?
I would love to see "absolute risk" of hospitalization expressed on a *per case* basis, with reasonable assumptions for true case counts. I loved your post last week on "denominator thinking" but the most important denominator - # of cases - is almost always left out of statements of risk. A key metric for "ending" the pandemic is when the risk of getting sick / dying is low assuming you catch the virus, instead of the risk assuming we're taking population-level steps (masks, isolation) to avoid it. In fact, expressions of absolute risk that implicitly include mitigation measures give people a false sense of security and lead to risky behavior / taking the pandemic too lightly.
Great summary - I agree that Omicron has torn through the US and collectively is on the decline but has laid waste on many health care systems ( and still is). Unequivocally this is a different disease ( for most) and the lack of anosmia and aguesia are telling re tissue tropism and diminished lower respiratory targeting as well.
THE REAL issue now is whether this massive wave of omicron ( primary and especially breakthrough) will be attended by Long COVID ({PASC) at a similar or hopefully diminished incidence as previous waves ( especially Delta) . No data as of yet because its too soon. IF ( a big IF) we knew that Omicron had a far less impacts chronically the justification of a'conservative' ( progressive?) proposed strategy of not taking vigorous NP efforts to risk mitigate ( no booster for all- Israel like program ... in young and low risk segments of the population ie not elderly or immunocompromised!) would be somewhat sensible. Since it can not be stopped
I think the unvaccinated are less likely to be tested because they generally don't think that covid is severe and they are less likely to interact with the health system. This can result in some strange results for example page 13 of https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1018416/Vaccine_surveillance_report_-_week_37_v2.pdf (may need to download, Safari doesn't like the mix of portrait and landscape) where for older ages the vaccinated have higher rates of covid. For hospitalisations and deaths everything makes sense because these are difficult to avoid.
Seems to me that we need to know fairly precisely the relationship between infectiousness and symptoms, particularly by immunity status (vaxxed, boosted, recovered, etc.) so that we can know how to proceed once this wave is down.
As I think about the "omicron wave" and people getting ready for "the next variant," I find myself thinking that the way omicron pushed out delta (and delta pushed out whatever was before delta) was by being more transmissible. Given the R(0) of omicron, the "next variant" would have to be REALLY, REALLY transmissible to push out omicron. Thus I see two scenarios: one where omicron and minor mutational variations becomes the ongoing, endemic variant for years to come; and another scarier one where a variant comes along that is even MORE transmissible and thus creates even more havoc in our civilization and society. Am I missing something?
Thank you for this update. When our local supermarket has to close 2 hours early for the last three weeks in highly boosted Ireland, Omicron is a lot more serious than I was hoping. The previous variants set the bar so low (with such serious illness) that the scale of what is happening now is beginning to sink in. It is sobering to read your and other trustworthy, data driven assessments.
The difference to last year is still there: I have yet to hear of anyone I know going to hospital in an ambulance because of covid this January. It was such a sad time. This time last year, the first Pfizer vaccines were given to the nursing home residents and hospital staff. I still hope that American citizens will have another look at American vaccines, that have the power to improve life for everyone.
Another solid update, thank you. Given how clearly the data is presented and diverse sources from which it originates, how can so many people continue to rely on conspiracy theories and conjecture for their health decisions? The vaccines work, they're incredibly low-risk, and widely available. US vaccination rates continue marching steadily upward, but what can be done to break the stranglehold of misinformation-guided decisions by the anti-vax crowd?
Thank you for the update. With so many kids/teens getting Omicron, I'm wondering if there's any data/guidance on getting a booster shot after you've had Omicron and qualify for a booster? My 15 year old son was vaccinated the moment he was eligible, but then got Covid over winter break while visiting his father (a mere week before boosters were approved for his age group). I'm curious if I should get him his booster now, later, or hold off. Thoughts?
What is your opinion of the qcovid.org risk assessment tool? The NYT published a link to it this morning claiming that it's broadly applicable outside of the UK, but a local epidemiologist in MI told me that the data was too old and the UK's medical environment too different for that to be applicable here in the US where the case rates are much higher than their tool permits.
Question- do we know how many times Covid -19 can pass from 1 person to another? More specifically, if A gives it to B and B gives it to C…. Is there a limited number of reinfections that can occur which might account for waves?
Is this explained by the idea that hospitalizations/deaths lag cases by a small duration (2-3 weeks)?
Also, is it plausible that cases are actually dropping here given they haven't yet started dropping significantly nationwide, and also that west-coast overall isn't showing the same trend? In other words, could this be bad data, or a regional anomaly that indicates a true-drop in cases?
From an epidemiological standpoint, this information is fascinating. From a nursing standpoint, it is moderately terrifying. Here, in Virginia, our new governor has removed mask mandates for K-12 public schools, flaunting CDC recommendations, and opposes vaccine mandates for healthcare workers. I'd be interested in policy change impacts on our state but am not confident in his newly appointed cabinet members overseeing VHHS and VDH to adequately report. Time will tell.
The best summary in a while. If one reads this and still doesn't get it, he is reading in the wrong language!!
I love your optimism about Omicron peaking, but with our vaunted federalist fragmented approach, the many unvaccinated libertarians, and the Supreme Court taking the virus's side it seems reasonable that the Omicron surge will continue by spreading into the remaining vulnerable areas of the US.
Thanks for your excellent summaries.
You state: "there will be the same number of new infections on the way down as there were on the way up." That would be true is the curve were symmetric, yet since the "down side" of South Africa's curve is fatter and taking longer (5+ weeks vs 3 for up), wouldn't there be *more* infections on the way down?
Also, when you state "African deaths are still increasing" - do you mean the *rate* of death is increasing (terrifying) or the *number* of deaths is increasing (which is sort of obvious, which is why I'm wondering if you mean *rate*)?
Again, thanks so much for helping all of us understand and know what to keep our eyes on.
Dear Katelyn,
Would you be willing to accept $50 contributions so that the likes of the New York Times, Fox News, Bloomberg News, the Wall Street Journal, and Breitbart News can receive your emails?
I would love to see "absolute risk" of hospitalization expressed on a *per case* basis, with reasonable assumptions for true case counts. I loved your post last week on "denominator thinking" but the most important denominator - # of cases - is almost always left out of statements of risk. A key metric for "ending" the pandemic is when the risk of getting sick / dying is low assuming you catch the virus, instead of the risk assuming we're taking population-level steps (masks, isolation) to avoid it. In fact, expressions of absolute risk that implicitly include mitigation measures give people a false sense of security and lead to risky behavior / taking the pandemic too lightly.
THE QUESTION OF OMICRON AND PASC/Long COVID
Great summary - I agree that Omicron has torn through the US and collectively is on the decline but has laid waste on many health care systems ( and still is). Unequivocally this is a different disease ( for most) and the lack of anosmia and aguesia are telling re tissue tropism and diminished lower respiratory targeting as well.
THE REAL issue now is whether this massive wave of omicron ( primary and especially breakthrough) will be attended by Long COVID ({PASC) at a similar or hopefully diminished incidence as previous waves ( especially Delta) . No data as of yet because its too soon. IF ( a big IF) we knew that Omicron had a far less impacts chronically the justification of a'conservative' ( progressive?) proposed strategy of not taking vigorous NP efforts to risk mitigate ( no booster for all- Israel like program ... in young and low risk segments of the population ie not elderly or immunocompromised!) would be somewhat sensible. Since it can not be stopped
Love collective thoughts on this
I think the unvaccinated are less likely to be tested because they generally don't think that covid is severe and they are less likely to interact with the health system. This can result in some strange results for example page 13 of https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1018416/Vaccine_surveillance_report_-_week_37_v2.pdf (may need to download, Safari doesn't like the mix of portrait and landscape) where for older ages the vaccinated have higher rates of covid. For hospitalisations and deaths everything makes sense because these are difficult to avoid.
So, what's next?
Seems to me that we need to know fairly precisely the relationship between infectiousness and symptoms, particularly by immunity status (vaxxed, boosted, recovered, etc.) so that we can know how to proceed once this wave is down.
https://twitter.com/ScottGottliebMD/status/1483445587446018048?s=20
For the non-naïve immune, can we use symptoms as starting point for mitigation or will we miss too much transmission and be stuck with another cycle?
Also, has anyone done any research into what Omicron reinfection cycle might look like?
And, has anyone done any estimates or modelling on how many immune naïve will be left after this wave?
As I think about the "omicron wave" and people getting ready for "the next variant," I find myself thinking that the way omicron pushed out delta (and delta pushed out whatever was before delta) was by being more transmissible. Given the R(0) of omicron, the "next variant" would have to be REALLY, REALLY transmissible to push out omicron. Thus I see two scenarios: one where omicron and minor mutational variations becomes the ongoing, endemic variant for years to come; and another scarier one where a variant comes along that is even MORE transmissible and thus creates even more havoc in our civilization and society. Am I missing something?
Thank you for this update. When our local supermarket has to close 2 hours early for the last three weeks in highly boosted Ireland, Omicron is a lot more serious than I was hoping. The previous variants set the bar so low (with such serious illness) that the scale of what is happening now is beginning to sink in. It is sobering to read your and other trustworthy, data driven assessments.
The difference to last year is still there: I have yet to hear of anyone I know going to hospital in an ambulance because of covid this January. It was such a sad time. This time last year, the first Pfizer vaccines were given to the nursing home residents and hospital staff. I still hope that American citizens will have another look at American vaccines, that have the power to improve life for everyone.
Another solid update, thank you. Given how clearly the data is presented and diverse sources from which it originates, how can so many people continue to rely on conspiracy theories and conjecture for their health decisions? The vaccines work, they're incredibly low-risk, and widely available. US vaccination rates continue marching steadily upward, but what can be done to break the stranglehold of misinformation-guided decisions by the anti-vax crowd?
Thank you for the update. With so many kids/teens getting Omicron, I'm wondering if there's any data/guidance on getting a booster shot after you've had Omicron and qualify for a booster? My 15 year old son was vaccinated the moment he was eligible, but then got Covid over winter break while visiting his father (a mere week before boosters were approved for his age group). I'm curious if I should get him his booster now, later, or hold off. Thoughts?
What is your opinion of the qcovid.org risk assessment tool? The NYT published a link to it this morning claiming that it's broadly applicable outside of the UK, but a local epidemiologist in MI told me that the data was too old and the UK's medical environment too different for that to be applicable here in the US where the case rates are much higher than their tool permits.
Question- do we know how many times Covid -19 can pass from 1 person to another? More specifically, if A gives it to B and B gives it to C…. Is there a limited number of reinfections that can occur which might account for waves?
King county (Seattle) is reporting a drop in cases, but hospitalizations and deaths are still going up.
https://kingcounty.gov/depts/health/covid-19/data/daily-summary.aspx.
Is this explained by the idea that hospitalizations/deaths lag cases by a small duration (2-3 weeks)?
Also, is it plausible that cases are actually dropping here given they haven't yet started dropping significantly nationwide, and also that west-coast overall isn't showing the same trend? In other words, could this be bad data, or a regional anomaly that indicates a true-drop in cases?