[HN Gopher] How severe are Omicron Infections?
       ___________________________________________________________________
        
       How severe are Omicron Infections?
        
       Author : News-Dog
       Score  : 37 points
       Date   : 2021-12-19 20:52 UTC (2 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | parkingrift wrote:
       | Seems the evidence bar for bad news is quite low, but the bar for
       | good news is unbelievably high. Is there a good source for
       | variant circulation? As a layperson how can I find what
       | percentage of cases in a given area are from omicron vs delta?
        
         | epgui wrote:
         | The rationale for the bar being at different heights is:
         | 
         | 1) the "precautionary principle"
         | 
         | 2) the consequence asymmetry: if we're vigilant at a time when
         | we could relax, the consequence is small, but if we relax when
         | we should increase vigilance, the consequence is larger.
        
         | tehjoker wrote:
         | If good news happens, you don't need to do anything. If bad
         | things happen, you need to do something fast. I don't think
         | this is unreasonable.
        
           | hanoz wrote:
           | _> If good news happens, you don 't need to do anything._
           | 
           | There's plenty you need to stop doing.
        
             | Retric wrote:
             | Can stop doing rather than need to stop doing. Suppose the
             | crime rate drops dramatically, you could be less cautious
             | or keep doing the same things.
        
           | TheGigaChad wrote:
           | Idiot.
        
           | scns wrote:
           | If you want to read good news, you proactively look for them
           | eg here https://www.goodnewsnetwork.org/
        
           | redisman wrote:
           | That's what the news business would like you to think. How
           | much action are you taking from the 100+ bad news stories
           | bombarding you every day?
        
             | epgui wrote:
             | Well I'm a scientist with 12 years of post secondary
             | education in life science (and no conflict of interest),
             | and that's exactly what I'd like you to think too.
             | 
             | Be reasonable.
        
             | culi wrote:
             | Sure, that's generally true. But in the case of a global
             | pandemic, I think the comment is valid
        
         | adam_arthur wrote:
         | Fear and despair sells better.
         | 
         | But if Omicron happens to be benign enough, it almost acts as a
         | natural vaccine. This would be a very positive development for
         | covid, not negative.
         | 
         | For some reason the focus still seems to be largely on case
         | counts instead of actual outcomes.
         | 
         | Economic impact of lockdowns was mitigated somewhat by mass
         | money printing and fiscal spending. If we lockdown again, will
         | be disastrous for global economy as most monetary and fiscal
         | firepower has been exhausted. Very troubling to see nations
         | moving towards this again
        
           | epgui wrote:
           | This is an editorial in the world's top scientific journal--
           | they don't need to "sell" anything, and they need neither
           | clicks nor views.
        
           | weaksauce wrote:
           | > But if Omicron happens to be benign enough
           | 
           | Here's my speculation on the reason that the virus is seeming
           | benignish so far... omicron requires fewer ACE2 receptors to
           | bind to in order for it to infect a host(because of the
           | incredible reproduction rate over delta once it takes hold).
           | The younger are generally not taking as many precautions as
           | the elderly did(elderly have more ACE2 receptors but have
           | mostly been vaccinated or died already). so as the pool of
           | eligible candidates for infection trend younger (fewer ACE2
           | required moves the bar of easy infection down younger) you
           | have younger people generally having a better time with the
           | infection because their immune system is slightly more
           | robust. and that tracks with younger people (generally)
           | during the delta wave and original variant; younger people
           | tended to have fewer really bad outcomes.
        
             | Traster wrote:
             | This is the exact problem - there are a hundred different
             | explanations for why news might be good or bad. High case
             | right? Good sometimes!
             | 
             | You need a fully formed view to come to a conclusion based
             | on details and those most qualified to do so are the least
             | willing to do so.
        
           | matthewmacleod wrote:
           | _For some reason the focus still seems to be largely on case
           | counts instead of actual outcomes._
           | 
           | The reason seems obvious - it's been only 25 days since the
           | discovery of the first case. There haven't _been_ many
           | outcomes yet to focus on - as far as I remember, the average
           | time between symptom onset and hospitalisation is something
           | like 10 days, depending on the age group.
        
         | downWidOutaFite wrote:
         | I don't think that's right, we all heard the tentative good
         | news as soon as it was available. I think the bias is that
         | there is a massive thirst for certainty and definitive
         | conclusions for each new pandemic development, but science does
         | not work that fast. There's also a bias towards wanting your
         | political side to be proven correct, but the virus doesn't care
         | and has proven all predictions and conclusions wrong at one
         | point or another.
        
           | parkingrift wrote:
           | Perhaps so. I'm just on the lookout for good news, and it
           | seems the good news is always wrapped up in caution tape.
           | Maybe I'm just bitter.
        
         | throwhauser wrote:
         | > Seems the evidence bar for bad news is quite low, but the bar
         | for good news is unbelievably high.
         | 
         | It seems safer to believe bad news, and remain wary, than to
         | believe good news and drop your guard.
        
         | sega_sai wrote:
         | I disagree with your statement, but here are the results for
         | the whole UK
         | https://www.gov.uk/government/publications/covid-19-variants...
         | 
         | and here's the plot for London
         | https://twitter.com/theosanderson/status/1471907339397738502
        
           | parkingrift wrote:
           | Interesting. Thanks for the link. Do you happen to know of
           | equivalent data for NYC? I'm apparently not adept at finding
           | this information.
        
           | the-dude wrote:
           | Why is the delta graph blocky and the omicron one smooth?
        
             | matthewmacleod wrote:
             | This looks like the weekend reporting artefact - you can
             | see that Delta cases are lower at the weekend. You can
             | actually see the same effect show itself as a small
             | slowdown in the growth of the Omicron series, but since
             | it's a rapidly climbing figure it's a bit harder to make
             | out.
        
         | mint2 wrote:
         | This article summarized the studies and the results are mixed.
         | Not really sure what good news there is yet, aside that it does
         | not appear worse.
         | 
         | Unvaccinated who haven't had the virus should be very worried
         | due to the transmission. For people with some immunity, the
         | jury is out but personally I am not looking forward to probable
         | mild Covid, until recently I thought I had a good chance of
         | simply not catching it due to being vaccinated. that seems to
         | be no longer the case.
        
         | ineedasername wrote:
         | In this case, it's neither good nor bad news because there is
         | insufficient data. Per the article:
         | 
         |  _So far, the data are scarce and incomplete_
         | 
         | The rest of the article consists of anecdotes that could point
         | in either direction. If you want good news, check out the piece
         | from WaPo from a few days ago [0]
         | 
         | Just keep in mind the _scarce and incomplete_ factor. Give it
         | another 2-3 weeks and we 'll know more. Meanwhile it's probably
         | not a good time to stop whatever precautions you have already
         | been taking.
         | 
         | [0] https://www.washingtonpost.com/world/2021/12/14/south-
         | africa...
        
           | Retric wrote:
           | Many people take longer to die of COVID than has elapsed
           | since the first Omicron variant was discovered. We simply
           | don't know at this point, and won't for probably 2 months.
           | 
           | Extrapolating from hospitalization rates and limited sample
           | sizes is mostly just guesswork. It's probably not much worse,
           | but beyond that is up in the air.
        
         | MaxMoney wrote:
         | News is a conflict of interest. The business model relies on
         | viewership numbers to sell advertisements. The more the news
         | can drive up viewership, the more they can make selling ads.
         | The best way to get viewership up has little to do with actual,
         | factual news.
        
       | somewhereoutth wrote:
       | Hospital data from London:
       | 
       | https://coronavirus.data.gov.uk/details/healthcare?areaType=...
       | 
       | Admissions are rising markedly, compared to flat for the rest of
       | the UK. Omicron is surging in London, again (as yet) flat
       | elsewhere.
        
         | NicoJuicy wrote:
         | This is not Omicron. As far as I'm aware, main infections in
         | the UK are currently from Delta.
         | 
         | Edit: @downvoters. How do you know hospital cases are currently
         | Omicron? As far as i know there is a delay between new cases
         | and hospitalized cases of multiple days. And the difference
         | isn't shown in the article.
         | 
         | A hospitalized case of delta is averaged at ~ 8,5 days of
         | hospitalization. So we have to wait at least another week.
        
           | leoedin wrote:
           | London is primarily Omicron at this point - it was 50% of
           | infections 4 days ago and spreading much quicker.
        
           | metafunctor wrote:
           | The latest data released on Friday by the U.K. Health
           | Security Agency indicates that 54% of positive tests in
           | England taken on Tuesday and Wednesday were of Omicron, and
           | more than 80% of cases in London.
        
           | sterlind wrote:
           | As of 12/17, Omicron seems to be around 50% of new cases in
           | UK, measured by proxy with S-gene target failure:
           | 
           | https://assets.publishing.service.gov.uk/government/uploads/.
           | ..
        
           | turnerc wrote:
           | Per [1] As of 18th December, a majority of cases testing with
           | the SGTF (indicator for Omicron) reached over 50% on the 14th
           | December. It's clearer to see in Figure 2.
           | 
           | [1] https://assets.publishing.service.gov.uk/government/uploa
           | ds/...
        
             | NicoJuicy wrote:
             | I have a strong feeling that current hospital cases are
             | mostly delta ( there is a delay between both normally,
             | since delta averages 8,5 days in hospitalization)
             | 
             | Even when new cases could be Omicron.
             | 
             | Either way, we will know soon.
        
           | drited wrote:
           | Things have changed fast. In London, 86.4% of COVID-19 cases
           | with known S-gene status have s-gene target failure[1] which
           | is a marker of Omicron (albeit with pending sequencing
           | confirmation for certainty[2])
           | 
           | [1] https://assets.publishing.service.gov.uk/government/uploa
           | ds/...
           | 
           | [2] https://www.who.int/news/item/26-11-2021-classification-
           | of-o...
        
             | NicoJuicy wrote:
             | Delta hospitalization is averaged at 8,5 days. You're
             | talking about new cases and not currently hospitalized
             | cases, which is what I'm interested in for Omicron.
             | 
             | To know the difference, we should at least wait another
             | week after Omicron takes over new cases in statistics.
        
         | parkingrift wrote:
         | I find the data presentation on that site to be quite
         | disappointing. The age brackets 0-5, 6-17, 65-84, 85+, ...and
         | 18-64.
        
           | contravariant wrote:
           | For the relative admission rates that's not a problem, but
           | for the absolute numbers... yeah a bar chart isn't a good
           | choice there.
        
         | turnerc wrote:
         | Please note the data above includes people admitted with an
         | incidental COVID infection and went to hospital for another
         | reason.
        
         | [deleted]
        
       | DantesKite wrote:
       | Someone made an interesting point that Omicron might become the
       | most virulent disease ever.
       | 
       | So I like how the bar has shifted, because everybody is so fed up
       | with the disruptions to their daily life. Understandably so. But
       | most virulent disease every is still pretty bad. Just from a
       | logistical standpoint.
       | 
       | For me, the real problem is what comes after Omicron.
       | 
       | HIV is a completely different disease with a different etiology
       | but it never went away. Treatments just got better with time.
       | 
       | I suspect the pandemic will force a lot of adaptations and
       | legislation. I'm most excited about rapid testing at home though.
       | I feel like that'll do a lot to stifle the pandemic.
        
         | adam_arthur wrote:
         | Ease of spread is only notable if it causes bad health
         | outcomes. Policy should only be made in response to actual
         | outcomes, not case counts or other inaccurate proxies.
         | 
         | Historians will look very poorly on the authoritarian type
         | policies being implemented that are, in fact, ignoring the
         | science (actual data, second order effects), not following it.
        
           | ineedasername wrote:
           | It's probably better to ratchet up precautions slightly for
           | the additional 2-3 weeks from now that it will take to get
           | more data.
           | 
           | I don't think history will look poorly on a scenario of "A
           | more infectious version of COVID emerged, so for the
           | following 6-8 weeks we asked people to increase social
           | distancing and mask wearing".
           | 
           | If the mandate was "Cancel Christmas and arrest people found
           | at holiday parties" then yes, "authoritarian" history would
           | look poorly on that. As it stands, I haven't seen any
           | governments take drastic steps towards more lockdowns due to
           | Omicron. It's all "urging more caution".
        
           | michaelbrave wrote:
           | I'm not so sure, some countries that clamped down very
           | hard("Authoritarian type policies") like Singapore, Korea or
           | New Zealand have done quite well, while countries who did
           | half measures ("USA, Italy") or very little ("Brazil") seem
           | to be struggling.
        
           | weaksauce wrote:
           | > Policy should only be made in response to actual outcomes
           | 
           | the problem with that kind of lagging reaction to policy is
           | that if you wait for the results of the variant you may have
           | a situation where you are unable to contain or curtail the
           | virus enough to not overwhelm the hospital systems. deaths
           | and hospitalizations are a very lagging indicator of the
           | effects
        
             | phkahler wrote:
             | >> the problem with that kind of lagging reaction to
             | policy...
             | 
             | We know that vitamin D helps prevent this kind of thing. We
             | know that most (Americans) are deficient in the winter
             | months. There is evidence to support the idea that it is
             | protective against Covid-19. It is also very safe to take
             | even if you're not deficient.
             | 
             | I have yet to see a PSA or recommendation on this. That
             | could have been proactive rather than lagging.
             | 
             | What I have seen is newer research suggesting that vit D
             | doesnt help, but always with some caviotte like "in people
             | who are not deficient" or one where they administered high
             | doses to people already on ventilators.
        
               | ineedasername wrote:
               | Evidence on vitamin D is equivocal. [0][1] Experts
               | disagree on how to interpret the various studies that
               | have come out that do not all show the same results.
               | 
               | On the other hand, an official proclamation that people
               | should ensure their vitamin D levels are okay would cause
               | a rush on it with many people taking much more than they
               | should. We've seen this with other medications that have
               | not been systematically shown to help COVID but still
               | obtain meme-like status. Ivermectin for example also has
               | only equivocal evidence for its use, but has resulted in
               | overdoses [2] and a spike in calls to poison control
               | centers over its use [3]
               | 
               | Maybe there's a middle ground there on something like
               | vitamin D, which as you say is often deficient. But it's
               | a fine line to walk when the evidence is uncertain about
               | its impact on COVID.
               | 
               | [0] https://www.covid19treatmentguidelines.nih.gov/therap
               | ies/sup...
               | 
               | [1] https://www.mayoclinic.org/diseases-
               | conditions/coronavirus/e...
               | 
               | [2] https://www.newsweek.com/man-covid-overdoses-
               | ivermectin-doct...
               | 
               | [3] https://www.npr.org/sections/coronavirus-live-
               | updates/2021/0...
        
             | adam_arthur wrote:
             | It's been weeks since the variant started to spread. If
             | outcomes were noticeably worse than Delta, it would be
             | evident by now. It being milder or the same is better
             | supported by the evidence.
             | 
             | You can think of any hypothetical worst case and make
             | irrational policy on the basis. Maybe next year's flu
             | strain will cause any who catch it to die one year from
             | infection?
        
               | matthewmacleod wrote:
               | I don't think I've seen _any_ suggestion that outcomes
               | are worse, or policies made with that assumption.
               | 
               | At the moment, the evidence we have available suggests
               | that Omicron is much more transmissible than Delta, and
               | between 0-30% less likely to result in hospitalisation.
               | It certainly seems like policy is being made with that in
               | mind.
        
               | adam_arthur wrote:
               | Most evidence I see suggests it's many fewer
               | hospitalizations.
               | 
               | Stats from a recent Denmark study show 60% fewer
               | 
               | https://twitter.com/BallouxFrancois/status/14726914313367
               | 265...
               | 
               | But people don't want good news with covid. They want to
               | fearmonger as if we can eliminate 100% of cases through
               | authoritarian policy. Which think I don't need to state,
               | will never happen, regardless if 100% of society is
               | vaccinated with a booster and we perpetually lockdown.
               | 
               | It's an endemic disease, that's life.
               | 
               | Zero heed is paid to the extremely costly second order
               | effects of these extreme policies. One of which was a
               | massive increase in wealth inequality, by the way
        
               | wetpaws wrote:
               | False positive good news would be much worse than false
               | negative.
        
               | freemint wrote:
               | fewer then what in what population?
        
               | adam_arthur wrote:
               | Why don't you read the link in the post?
        
               | matthewmacleod wrote:
               | I'm very happy to see more evidence that suggests the
               | severity may be lower, but it is still _very_ early days.
               | 
               | I honestly don't recognise your portrayal of
               | fearmongering or a desire for negative news. In fact I've
               | been particularly surprised by the response to this
               | variant in some circles, which is to hop right on to the
               | tiniest shred of potential positive evidence as a cast-
               | iron guarantee that it's no big deal. Everybody _really
               | wants this to go away_ , and there is _extensive_ debate
               | in every country about the second-order effects of
               | control measures.
        
               | adam_arthur wrote:
               | By and large the people advocating extreme caution with
               | covid are looking at policy from a single variable
               | perspective.
               | 
               | The population looks at multiple variables. IE their
               | quality of life, their financial situation, their desire
               | for social connection.
               | 
               | Any policy that looks at a single or small number or
               | variables, vs the holistic system is a policy that's not
               | "following the science".
               | 
               | If you drive through the south of the US, you'll find
               | that nobody masks and they live life as if covid never
               | existed. And their health outcomes are basically exactly
               | the same as NY or CA. So what effect do these policies
               | have? The science shows, basically nothing other than
               | harming quality of life
        
               | Retric wrote:
               | No, people often take over a month to die from COVID, we
               | simply haven't had enough time to collect data especially
               | when the first few cases represent a tiny sample.
               | 
               | This is one of those enough information ask again later
               | situations.
        
           | culi wrote:
           | health outcomes vary widely by location. South Africa seems
           | to be particularly less severe than in other places
           | (suggesting population and environmental factors may play a
           | big role). The fact is that in other countries death rates
           | are still rising so there's a lot of unknowns and the science
           | says this could be really bad
        
             | adam_arthur wrote:
             | The science says destroying the global economy with
             | lockdowns is bad too.
             | 
             | Do we make all policy on the basis of one variable, or do
             | we look at the multivariate system holistically? Majority
             | of countries are doing the former, which is not "following
             | the science" but cherry picking a subset of the science
             | that reinforces your view.
             | 
             | I can assure you everybody on earth catching covid would be
             | less severe and painful than the GFC was for global
             | population. Which is pretty easily borne out by the data
             | (the science).
             | 
             | A second global lockdown would have pretty similar results
             | to the GFC, given that ammo for stimulus is spent.
        
       | Gatsky wrote:
       | My take on this is that if you live in a country where there was
       | widespread use of less effective vaccines, where resources are
       | limited for booster doses, and there is very limited access to
       | treatments which we now know reduce disease severity after
       | infection (sotrovimab probably still works for Omicron infections
       | and paxlovid almost certainly does), then Omicron is going to be
       | bad.
       | 
       | Unfortunately a lot of the world which isn't Europe and North
       | America seems to fit into this category.
        
         | [deleted]
        
       | yung_steezy wrote:
       | The issue is transmissibility rather than severity. Say it was
       | 50% less severe but 25% more infectious that would cause hospital
       | infrastructure to fail because the absolute number of
       | hospitalisations go up as more people are infected.
        
         | [deleted]
        
         | culi wrote:
         | Also the fact that the severity of omicron varies from country
         | to country. In the US it is likely to be much more severe than
         | in South Africa
         | 
         | https://www.npr.org/sections/goatsandsoda/2021/12/17/1065315...
        
       | culi wrote:
       | It's important to note the severity of omicron seems to vary a
       | lot from country to country. Omicron in South Africa seems to be
       | much less severe than in other countries.
       | 
       | Also if you do wanna take the hot take of omicron spreading and
       | displacing other variants, then it's still very important to get
       | the booster shot. The vaccine has a much bigger effect on those
       | variants than on omicron. In Norway at a party of 120 fully
       | vaccinated people, 80 of them got infected with omicron. So no
       | matter what, it's still important to get your boosters!
        
         | chrismcb wrote:
         | Why do you say it is still important to get your boosters?
        
       ___________________________________________________________________
       (page generated 2021-12-19 23:01 UTC)