Maybe No Omicron Boosters?

Remember how we were told that one of the reasons mRNA vaccines were so snazzy that it would be a snap to roll out new versions to tackle Covid variants…even if getting them approved, manufactured and distributed might lead to delays.

Even though Pfizer and then other vaccine-makers said they could have a booster targeting Omicron out in three months or so, the Administration is talking down the possibility of one. That seems odd in that:

2 vaccine doses barely create a dent against Omicron, and previous infection, according to initial Imperial College data didn’t either (although some other studies suggest prior infection could blunt severity; the jury is still out on many important Omicron questions)

There is good evidence that a booster of the current vaccines reduces the odds of severe outcomes, but not to the same degree as against earlier variants. However, it’s not as clear even against the original variants whether a booster produces as long-lived immunity as the first shots did; it may be shorter, even before you get to how it behaves against Omicron. Israel is launching its fourth round of booster shots only five months after offering boosters to the highest-risk populations. In other words, given that some, perhaps many, members of the public won’t be happy about a more than twice a year vaccination regime, if one is to stay current, another reason to back an Omicron-specific booster is it might last longer against Omicron than the current vaccines, which were developed against the wild type virus.

Now one might reasonably say that the vaccine-makers didn’t rouse themselves to create a Delta version. One reason was that Delta overlapped with the older variants a bit before becoming dominant. Second is that the performance of the original vaccines didn’t fall as much in reducing risk of hospitalizations and death as it appears to when boosted for Omicron. Sadly the vaccines did do more to reduce contagion of the wild type virus than Delta, but that change doesn’t get much mention.

But as far as I can tell, the idea of developing a new vaccine targeting Delta wasn’t even seriously entertained. Our GM described an additional issue which I never saw mentioned in the press: the Delta variations were orthogonal to some other variants. So while the original vaccine was pretty effective against wild type and Delta and the “orthogonal” variants, one aimed at Delta would not do much to combat the orthogonal variants. So it made sense to stick with the original vaccine as a reasonable “good enough for all current seasons” compromise.

But as we know, Omicron is fabulously different. So it’s disconcerting to see what sure looks like official reducing of expectations regarding getting an Omicron booster around March, as Pfizer and now others have indicated. From Top regulator says need for Omicron vaccine depends on staying power of variant in STAT:

Whether Americans will need additional vaccines specifically tailored to the rapidly spreading Omicron variant of the coronavirus may depend on how long it circulates in the United States, a top regulator told STAT in an interview Wednesday.

“If it turns out that Omicron is the new variant that actually things settle into, well then of course we will probably need an Omicron-specific vaccine,” said Peter Marks, the Food and Drug Administration’s top vaccine regulator. “On the other hand, if this is just a variant that’s passing through and we get [a new variant] in a month or two, we won’t need that.”

Marks added that Omicron is “a very, very fast-moving virus” that “could pass across this country within a matter of a few weeks,” and that he does not know for sure whether Omicron-specific jabs will be needed….

All three manufacturers with vaccines authorized in the United States — Pfizer, Moderna, and Johnson & Johnson — are currently readying Omicron-specific vaccines. Pfizer has said it could begin delivering its Omicron-specific vaccine by March, pending FDA approval.

Huh? Unless you assume Omicron will be displaced by yet another variant, even those who were boosted will need a new shot in 5-6 months. And even assuming perfect compliance, 75% odds of not getting a serious infection falls to 42% if you play that game three times, as in go 15-18 months under an Omicron regime. While if an Omicron booster lowers the odds of serious infection by 90%, the risk of getting a bod case over the same time period with perfect compliance is 73%. And to the degree the risk reduction is higher than 90%, the better the long-term odds.

And you don’t have to go far into the article to see that our suspicion, that this messaging reflected an Administration preference, looks correct, particularly when contrasted with the fact that the vaccine-makers are moving ahead with Omicron products:

The Biden administration has signaled that it plans to fight the spread of Omicron through existing booster shots, which were not formulated specifically for Omicron. Early data suggest that the booster shots from Moderna and Pfizer significantly enhance protection against the Omicron variant…

Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases and the chief medical adviser of the Biden Covid-19 response, has expressed doubts about the need for Omicron-specific shots.

Even if you wonder about the wisdom of having to get repeatedly jabbed with Covid vaccines, the risk/return tradeoff is clearly better, all other things being equal, with a more effective vaccine. So if you are going to use mRNA vaccines to combat Omicron, that argues for a sure-to-be-more-potent Omicron booster against Omicron rather than a less ooomphy one designed to beat the wild type variant.

GM confirmed our downbeat take:

Two possibilities here, not mutually exclusive, in fact they may well be part of the same scenario

1. They are expecting it to just burn through the population in the next 3 months so there is no point developing a new vaccine

2. The next variant will not be derived from Omicron. Which is highly likely given the experience so far — no dominant variant has come from the previous dominant variant so far, it has all been going back to B.1. This has to change at some point — there will not be surviving ghost B.1 lineages forever — but given how long it apparently takes for a variant to be cooked up, I would expect the next one, if it is not a B.1.X again, to derive from Alpha, Beta, Gamma, P.1, or some of the others. And it will be different from both Delta and Omicron. So they be waiting for the next one which they expect to be something entirely different again.

That does not make epidemiological sense — you want people to develop as broad immunity as possible so if you give them an Omicron vaccine, that will prepare them better for future variants than another WT booster.

But it makes sense from a corporate point of view — there is not going to be demand for Omicron vaccines once Omicron has passed.

And it makes sense from narrative control point of view — the moment they start giving variant-specific vaccines, the expectation will be that the same will be done for future variants too. And we are only now going to be seeing real diversification. Then you have three problems:

First, you need to actually deliver on that expectation, which will be logistically impossible if you have to revaccinate every 3-4 months.

Second, this exposes the insanity and complete bankruptcy of the whole vaccines-only approach. So you must not go there unless you absolutely have to.

Third, a key goal has been to get people accustomed to the idea that they will be endlessly reinfect and if you condition them to expect variant-specific vaccines, then you move away from accomplishing it. The long-term objective is for people to be happy with their annual “natural booster” whether vaccinated or not.

But at some point there will be no choice.

Note that the SARS-2 vaccine does not work at all on SARS-1, not even for severe disease (this has been tested in mouse models and the vaccinated mice die just as quickly and as often as the unvaccinated ones upon SARS-CoV-1 challenge). The antigenic distance between the Wuhan WT and Omicron is a third of that between Wuhan WT and SARS-CoV-1, and there is much more divergent stuff out there (e.g. SHC014). So plenty of room for further escape and evolution.

P.S. I forgot to mention another cross-protection measurement — a SARS-1 vaccine does not work tall on WIV-1, another one of those SARS-type coronaviruses that people were studying in the pre-pandemic days

We’ve backed ourselves into a collective corner with the “vax vax vax” approach and little to no focus on treatments and non-pharmaceutical interventions or eradication. And the fact that US life expectancy fell by 1.8 years in 2020 due to Covid ought to be treated as an outrage and a call to (much better) action. Instead, the collective reaction seems to be a shrug.

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  1. Roger Blakely

    At the moment Federal OSHA is saying that the courts have cleared it to implement its new vaxx-or-test mandate for employers with more than 100 employees. On Friday a 3-judge panel in the 6th Circuit ended the stay imposed by the 5th Circuit. Who knew? There has been a news blackout regarding this important development. Federal OSHA is saying that it will start enforcing its new regulation next month. It seems disingenuous to me for Federal OSHA not to mention that the plaintiffs will be taking the issue to the Supreme Court. The Biden Administration is Bogarting employers and employees into getting vaccinated with its less-than-honest announcement.

    1. ChrisFromGeorgia

      Well, the SCOTUS agreed to hear the case (and the CMS mandate one, I think) on an expedited basis. Another stay pending that hearing (Jan 7) would block OSHA yet again, and could drop anytime over the next week or so.

      Meanwhile most major corporations are in “holiday mode” with the HR dept. gone until Jan 3.

      OSHA is playing with matches and sharp objects, while the grownups are gone.

    2. chuck roast

      Wait…OSHA enforcement? OSHA doesn’t enforce, they hand-wave. There were 4,764 fatal work injuries in the US last year. I don’t believe that OSHA has the enforcement staff to even investigate these deaths. But that’s how the pols work…pass laws to protect the health and welfare of the general populace and defund enforcement efforts. Hey, it’s a win-win!

  2. ArkansasAngie

    If I may, would you … could you please give a couple of references that you get these numbers from? Thank you.

    “Huh? Unless you assume Omicron will be displaced by yet another variant, even those who were boosted will need a new shot in 5-6 months. And even assuming perfect compliance, 75% odds of not getting a serious infection falls to 42% if you play that game three times, as in go 15-18 months under an Omicron regime. While if an Omicron booster lowers the odds of serious infection by 90%, the risk of getting a bod case over the same time period with perfect compliance is 73%. And to the degree the risk reduction is higher than 90%, the better the long-term odds.”

    1. Yves Smith Post author

      We have written about it virtually daily for months when the data came out of Israel showing efficacy v. serious infection had waned as of July, which is when Israel started rolling boosters out (first group July 12, second group July 31). The vaccines weren’t not generally available till Jan 2021 and Israel was organized about vaxxing, so most got their shots in Jan and Feb. Further confirmation of waning vaccine efficacy from many other sources, such as a big VA study:

      This issue has been extremely well covered here and elsewhere, to the degree that it amounts to common knowledge. Why do you think people were being exhorted to get boosters even before Omicron?

      If you mean the computation, this is simple cumulative probability. I don’t need a reference for that. 75% odds of something not happening 3 x = 42.2% cumulative probability. The best estimate I have seen of efficacy of the current vaccines v. the boosters (see my comment lower down in the thread, I desperately need to turn in) is 70% to 75%, so using 75% is generous.

      This is why GM is correct in banging on about the dangerous casualness about getting Covid, given that immunity lasts only 5-8 months and that there are serious morbidity risks, such as a surprisingly high incidence of long Covid even in asymptomatic cases.

      1. GM

        This is why GM is correct in banging on about the dangerous casualness about getting Covid, given that immunity lasts only 5-8 months and that there are serious morbidity risks, such as a surprisingly high incidence of long Covid even in asymptomatic cases.

        Symbolically, the first confirmed Omicron death in the US was a reinfection…

        1. kl

          If you mean the man in TX, a reporter called the county health dept. (assuming this recording is real) and the dept. said the man had underlying conditions and a positive test but they can’t yet confirm what he died from as it needs to be investigated. Here’s the call:

          And another Omicron death story was found to really be linked to Delta:

          Media really wants Omicron deaths!

          Happy holiday all

    1. Yves Smith Post author

      Yes, but this is pre-Omicron. Estimates of efficacy of existing boosters v. Omicron is lower than for Delta and wild type. There’s a very big error band around the estimate of 70% to 75%: Pfizer of course has a very much higher estimate, based on their own study of a tiny number of people, which our brain trust pooh poohed.

      And efficacy will be even lower in old people who have weaker immune systems.

      1. IM Doc

        In the 1980s when I was a student, in the middle of the worst part of AIDS, I had the privilege of being on a service with an ancient Infectious Disease attending.

        He waxed poetic all day, and I learned a tremendous amount.

        He spoke a lot about pandemics. He wanted to make sure we all knew that he was certain we would see a pandemic in our lifetimes that was airborne and respiratory. “You cannot run from history”.

        And I will never forget what he added at the end – “It will almost assuredly be a coronavirus.”

        What am I saying? – So much of this was known by experts for decades. They were often ignored and even laughed out of rooms. Even after SARS 1, coronavirus research was at best on the back bench.

        The people doing the laughing are now in charge. That gives me no comfort at all.

          1. IM Doc

            Look at the 1890s.

            Also the repeated coronavirus pandemics in veterinary medicine in the 20th century.

            It was just a matter of time.

        1. Geo

          Recently saw this c-span video of health experts (including Fauci) talking about this in 2019. At about the 6 minute mark they start discussing potential pandemics and the 8 minute mark has a quote (“Why don’t we blow the system up?”) that has been touted by anti-vax tinfoil hatters but it’s clear from the video the awareness was there. The fact that so little was/is being done systemically to address this is, to me, the depressing part.

  3. Lee

    FWIW, from Fauci, Universal Coronavirus Vaccines — An Urgent Need. NEJM

    I have no doubt that this has been thought of before but since the viruses that cause the common cold were not that much of a bother healthwise, there was little in the way of public interest or financial incentive. Now with the YIKES! meter turned up to 11, and squillions of dollars raining down on researchers and pharmaceutical companies, two questions arise. Is it doable? If so, in what time frame.

      1. GM

        As crazy as that might sound, the best thing that could happen right now is for the virus to make a quantum leap towards something at SARS and MERS levels of mortality.

        That will twist the hands of governments into controlling transmission and while it will kill a lot of people in the short term, it will save orders of magnitude more in the long run.

        There is a reason why SARS-1 killed less than 1000 people while the SARS-2 death toll will cross 20 million in the coming months — SARS-2 was benign enough to allow the propaganda campaign to brainwash people into accepting uncontrolled transmission to succeed.

        I still harbor a hope that the population has not been turned into complete sheep yet and that if someone tries to force people to live with a SARS-1-like pathogen, the result will be what should have happened in the summer of 2020 the latest — i.e. politicians and corporate CEOs hanging from lampposts and trees.

        1. notbored

          There may be no final solution to Covid apart from fundamental economic reform. For example, even as late as Newton’s time, 1665-1666AD, many people could retreat to their family farms in the countryside to wait out an epidemic. How many can do that now?

          Interesting times …

        2. MT_Wild

          Given enough time this is inevitable, right?

          I’m assuming the massive jump in contagiousness could have just as easily been a jump in severity. And with a few billion cases a year, plenty of opportunity for new more lethal variants that could compete locally and take hold.

        3. Joe Well

          I thought the reason SARS-1 was more transmissible was that the high death rate/short incubation period was a natural brake on transmission?

          1. Yves Smith Post author

            No, no one knows why SARS suddenly stopped.

            Patients are contagious as soon as they are symptomatic. Peak infectiousness in the second week. They typically die around day 21, so death has no impact on contagiousness. And in any event 85% don’t die.

            1. GM

              No, no one knows why SARS suddenly stopped.

              It did not stop suddenly, it was aggressively contained.

              Had it been left on its own it would have infected the whole world the way SARS-2 did, just a bit slower

              1. PlutoniumKun

                In 2003 at the height of SARS a recent arrival from China who couldn’t speak much English presented herself with respiratory symptoms at a hospital in Dublin. She was given some general drugs and told to go home by a duty nurse. All hell broke loose shortly afterwards when someone realised she had SARS symptoms.

                The nurse who treated her was sent out with police to see if they could find her. She was spotted on Dublins main street, O’Connell Street. You can imagine the scene when a hazmat clad nurse and two burly policemen dragged a screaming, panic stricken Chinese woman into the police car and roared off. Turns out she only had a cold.

        4. ChrisRUEcon

          Sadly, and scarily … I concur here.

          I’ve said it to others and whispered it quietly on my own – COVID-19, despite all its horrible destruction, is simply not deadly enough. It’s exactly as you said, it “was benign enough to allow the propaganda campaign to brainwash people into accepting uncontrolled transmission to succeed.”

          What’s more horrible is that the terrible response by the west is now going to be the default playbook, so that even if something more SARS-1/MERS-y comes around, you can bet they’ll let a lot more people die while they figure out how much money to give banks and corporations first, before they do anything meaningful. Lampposts and piano-wire, indeed.

        5. LAS

          Whoa … a bridge too far that I never expected from you. As if various gov agencies were not already trying to control transmission. They are. You seem to think population slaughter is going to teach people a lesson. Don’t we already see that it does not. You are no longer helpful when you get this burnt out and frustrated in your communications.

          The fact that mistakes and miscommunications are made sometimes from public figures does not exonerate you to regress in your statements, too.

          1. Scylla

            We are not seeing “mistakes and miscommunications”. We are seeing very deliberate policy actions from people who actually have a great deal of information. Their actions are considered and deliberate.
            The thing you need to come to grips with, is that their goals might very well be quite different than what you appear to assume.

      2. Lee

        But the given the cases were relatively few compared to present circumstances the market signal for the private sector was was weak, no? As for the public sector, I can think of no morally defensible excuse. Hence my hanging out here with other free market discontents.

        1. Yves Smith Post author

          “Relatively few”? SARS was a huge deal at the time, a lot concern then that it would get out beyond Asia. No one knows why it died out. China worked very aggressively to contain it.

          There have been even fewer cases of humans getting avian flu, yet every time there’s an outbreak among humans, it’s an international news item due to worry it might have become more transmissible among humans. See the CDC feeling compelled to have a page about it:

          And you are presupposing the answer is vaccines. Plenty of not-common diseases/ailments are treated with existing meds. My father was diagnosed with a rare disease and once it was diagnosed, the MD had treatments which helped for a few years. It’s usually fatal within a year.

          1. Lee

            I hold no brief against off-label use of existing medications. I take several for ME/CFS and associated chronic back pain with good effect. I was speculating about financial incentives as a cause for inaction in the private sector—more your field than mine. As for action or lack thereof in the public sector, it’s something I feel I should know more about but don’t. Time to read more.

          2. sharron

            I lived in Singapore during the SARS infections. The country reacted surprisingly fast and shut the country down for 2 weeks with temperature monitoring at the entry of EVERY building.

            Again, they are handling COVID much better than the US. They were sending self administered tests home to everyone in the country at least 6 weeks ago. These tests were to be taken every Monday and reported to the Ministry of Health and of course self quarantining, monitored by the government.

            Singapore is a very capitalistic country, but believes in preserving the health of their citizens.

          3. Barry

            I worked at a hospital in Beijing in 2001-2011. The hospital serviced Expats and wealthy Chinese. We were all afraid of the unknown virus and from what the governments response was. At the time Beijing was probably city wide a population of close to 17 million. Many were from all over China workers building all the new apartment blocks and in the hospitality sectors. It was very close to Chinese New Years and people loaded on trains to all over China for the holidays against the public health departments advice. We never saw a SARS patient and I think after several months there were hardly any cases or deaths in all of China. A few expat colleagues returned home because they were afraid but my wife a GP and myself an Acupuncturist stayed with most of our colleagues. I have seen this play out before and I suspect since we didn’t test with PCR and had more strict definition what a case was and people had to be symptomatic to be called a case there was not as much panic. We also in rounds discussed what treatments were and could be used both drugs and Chinese medicine. I live in Australia now and I work with my wife at a small clinic am flabbergasted at the heavy handed, myopic and irrational response to this disease.

    1. Larry Y

      There were earlier links to a multi-coronavirus vaccine developed by the US Army that just passed phase 1 testing. Targeted viruses include SARS-COVID-1.

      It uses a spike ferritin nano-something to deliver multiple proteins.

      1. Hayek's Heelbiter

        The Virustatic Shield (actually a snood that makes me resemble a holdup outlaw from a Western) uses some sort of embedded metallic antiviral compound. I thought at one time I read that it was ferritin, but now I can’t find the reference.

      2. Yves Smith Post author

        GM is not all that excited about it. It is not as groundbreaking as the press hype would have you believe and no magic bullet:

        Pan-coronavirus vaccine using chimeric nanoparticles

        There have been half a dozen of these published

        Should work.

        Question is how do you displace Pfizer?

        It will still wane in 6-12 months though

        Even if the vaccine gets all the way through clinical trials, the Army would need to team up with a drug co for manufacture and distribution.

        So I would put this in the category of an improvement as opposed to revolutionary, despite the tech being novel.

        What we need is a nasal vaccine. That would be close to sterilizing and a game-changer.

        1. Brunches with Cats

          > Question is how do you displace Pfizer?
          Maybe you don’t have to? Walter Reed re-opened its Pilot Bioproduction Facility in May after extensive renovation and expansion. Its purpose is to produce small batches of new vaccines for testing, so theoretically anything Walter Reed’s research team developed could get through the testing phases faster, including vaccines for the latest variant, while Big Pharma assesses whether it will be around long enough to be profitable. Looks like they’re also renting it out to the private sector:

          Being a military organization, Walter Reed also has instant access to the vast database of active-duty military and veteran medical records, plus tens of thousands of guinea pigs volunteers (not that the private sector doesn’t — Moderna made extensive use of VA medical centers to test its vaccine). Once they’d done all the initial R&D and testing, do you think it would be that hard to find a manufacturer and distributor? Keep in mind that they have a lot of collaborators, many of them well-connected. For all we know, a deal’s already been made.

          1. Oh

            The vaccine and its rights will be given away for free to the Pharma companies who’ll exploit it by charges big time prices to the consumers. That’s how US brand of capitalism works.

          2. Yves Smith Post author

            *Sigh* Big Pharma is profitable enough to recruit clinical trial participants. That’s not a barrier.

            And you missed that the issue is manufacturing, to pharmaceutical grade standards, and distribution, where you not only have to get the drugs out, but have to be able to track literally where every package went.

            The military is not set up to do that.

    2. Basil Pesto

      arghgjgh this is so frustrating:

      People who have been naturally infected with SARS-CoV-2 can also be naturally reinfected, as has been shown with endemic coronaviruses, influenza viruses, respiratory syncytial virus (RSV), and many other respiratory viruses. Moreover, immunity following natural infection with SARS-CoV-2, combined with vaccine-induced immunity, has so far not prevented the emergence and rapid spread of viral variants such as the highly transmissible delta (B.1.617.2) variant and the recently identified omicron (B.1.1.529) “variant of concern,” which as of the end of November, appeared to be highly transmissible. It remains unknown whether and how permanent protective immunity can be achieved, and whether it can prevent emergence of immune escape variants of SARS-CoV-2.

      These sobering facts suggest that SARS-CoV-2 is unlikely to be eliminated, let alone eradicated; it will probably continue to circulate indefinitely in periodic outbreaks and endemics. Meanwhile, an unknown number of animal coronaviruses, of unknown transmissibility and lethality, may well emerge in the foreseeable future. We must therefore greatly accelerate our efforts in coronavirus vaccinology.

      The second paragraph almost qualifies as a non-sequitur it’s so inane: “because the one serious attempt we’ve made at eliminating the virus based on a vax vax vax strategy has been a failure both on theoretical and practical grounds (which we were warned about in the first place and duly ignored), the virus can therefore not be eliminated.”

      Am I losing my mind? Am I actually just really stupid and missing something completely? The questions are very simple, it seems to me: how is the virus supposed to survive with community-wide N95+ masking (which can be implemented at small scales as proof-of-concept and scaled up) blocking access to mucosa? What is the virus supposed to do at that point? Even if eradication doesn’t follow, the problem would be so much more manageable. Are these masks not, in fact, functionally superior to vaccines in reducing transmission of the virus in all settings across all durations of time? Why haven’t they been distributed for free, population-wide? Why look for a complex theoretical technical solution when a completely viable, plausible solution is staring us in the face?

      If the only rebuttal to this is “well, masking’s hard in America bc freedom” then, well, perhaps it’s time you (Fauci et al) got your shit together, and the rest of the public health establishment stopped paying mere lip service to the airborne nature of the problem. And you still haven’t tried free mask/respirator supply as you now are with RATs and as you have been with vaccines – free respirators delivered to your door with information leaflets, only the most ridiculously intransigent couold turn their nose up at that. And it’s not like the vaccines are any less fraught of an issue, and future vaccines surely will be too. Surely a freely supplied (in a way that won’t raise suspicion of being on the hook for secret medical costs) non-pharmaceutical intervention that can actually dramatically slow down transmission is going to be more successful?

      1. Tom Stone

        My Dear basil Pesto, $30,000,000,000.00 in profits the first year for one beloved donor.
        “Because Markets, Go die”.

        1. KLG

          Eli Lilly collected about $300M, adjusted for inflation using the BLS Inflation Calculator, during the first year of comprehensive vaccination against polio with the Salk vaccine (from Charlotte DeCroes Jacobs’s biography of Jonas Salk, 2017), less than 1/100th of Pfizer’s revenue in 2021 for a vaccine that is really only just a “shot” or two or three or four ad infinitum (Financial Times, WSJ, CNN, take your pick).

      2. Keith Newman

        Re Basil @8:30am.
        I feel the same frustration re masks. We are almost two years into the pandemic. Why aren’t N95s being distributed free everywhere? Why isn’t there a big publicly funded research effort underway to make them more effective and more comfortable?
        To quote Garfield: “Arghhhh”!

        1. juanholio

          Because free N95s would run counter to the freedom, 99.9% survival rate, it’s just a cold, wash your hands propaganda that has been so effective at getting people back out feeding the economy.

      3. Bryan

        If the only rebuttal to this is “well, masking’s hard in America bc freedom” then, well, perhaps it’s time you (Fauci et al) got your shit together, and the rest of the public health establishment stopped paying mere lip service to the airborne nature of the problem.

        100%. The signal feature of this and other public health campaigns for “vaccination uber alles” is the failure of the public health establishment to understand and accept the loss in confidence felt toward it by large segments of the society. The specific reasons for that matter, and there are very good and very ridiculous ones, but the failure of those in charge to respond appropriately to that situation is the biggest reason we are where we are. It’s a variant (pardon the pun) of Upton Sinclair’s observation about the difficulty of getting someone to understand something their salary depends on their not understanding it. Their standing and self-regard depends on their not accepting what is evident, which produces articles like this that completely ignore the externalities of resorting to purely control-based governing strategies:

      4. Medbh

        I don’t understand why there isn’t more emphasize on cleaning the air. It seems like it’d be the one area that neither the left nor right would complain about, and has historical precedent too. We learned to clean the water to prevent disease, now we need to clean the air. Prioritize the buildings (maybe start with schools), and start upgrading them. Covid is a polarizing topic, but it’s hard to argue against clean air, especially when you can remind people it will help prevent flu and colds too.

        1. Basil Pesto

          “how are we going to pay for it?”

          50 years of ever-miserly austerity isn’t going to go down without a fight. Hence the propaganda effort to convince the people that government spending is what’s causing current price inflation. There’s no such thing as free clean air, as an economist probably once said.

      5. John Zelnicker

        Basil Pesto – No, you aren’t stupid, but you did leave out something: Profits! uber alles.

        But, I suspect you knew that all along.

        If we were to substantially reduce transmission with widespread N95 masking the justification for vaccines would drop off significantly.

        Can’t have anything get in the way of Pharma profits, now can we? /s

        Edit – looks like others made my points while I was typing this.

        1. Basil Pesto

          I get the profits argument but how far does it actually get us? 3M is a huge company that would surely stand to benefit massively from distributed N95s. Some of the biggest multinationals going sell air purifiers (eg Philips, Samsung). Is it really just the case that one industry’s profit-making ability and incentive trumps all others? Like, one way or another, if the pandemic is to be “solved”, several entities are going to have to make a profit. Is it really just that pharma’s lobby’s that much more powerful that that’s where we focus all our attention when looking for answers?

      6. AJB

        Call me cynical but widespread N95’s and their effect might impact on certain mRNA vaccine manufacturer profits into the future. Those who are making a fortune out of the ‘vax, vax, vax’ policy will make sure that the ongoing policy remains ‘vax, vax, vax’. The same people that own shares in Pfizer & Moderna also own a lot of shares in big tech and big media…

      7. Hana M

        >>how is the virus supposed to survive with community-wide N95+ masking (which can be implemented at small scales as proof-of-concept and scaled up) blocking access to mucosa? What is the virus supposed to do at that point? Even if eradication doesn’t follow, the problem would be so much more manageable.

        The virus will survive as all viruses do during their ‘off season’ (which remains something of a mystery). With Sars Cov2 we have now identified multiple animal reservoirs that readily interact with humans (deer, mustileds like mink,,cats, and now with Omicron due to changes in the S protein, likely mice and rats). Sars Cov2 has also now been demonstrated to remain active for months in immune-compromised patients,mutating all the while. In a global world, it’s always winter somewhere and even Australia and NZ couldn’t wall themselves off forever.

        Masks, of even the highest quality are not 100% effective. At this point the only hope is therapeutics,,vastly improved ventilation and perhaps vaccines based on something other than the highly mutable spike protein. Oh, and of course, the national physical fitness program that Biden (following in JFK’s footsteps) announced at his inauguration….oops….I guess I misheard when he mumbled……

  4. ambrit

    Please correct me if I am wrong, but, this looks awfully like a “Jackpot” scenario.
    No Grand Conspiracy Theory needed. Simple hubris and stupidity will supply the needed dysfunctionality.
    We are being led by a bunch of actual Snake Oil Salesmen.

      1. ambrit

        I get the point but personally adhere to The Alchemist’s Code: “As above, so below.”
        The Snake Oil Salesmen think that they control the situation. There’s the Hubris part.
        Be safe!

    1. Yves Smith Post author

      While we appreciate reader support, we do not play favorites based on donations.

      I suggest you read our site Policies, which explain moderation.

      They also say that complaining about moderation earns you troll points and does not get your comment approved any faster. We have thin resources and the mods get to comments as they have time….and this is right before a holiday too. Every MD’s office I have called this AM is closed, for instance.

      1. Arizona Slim

        Zim, don’t give up.

        I’ve had more than a few of my comments devoured by the Comment Eater. Thing must be really hungry because there are times when it doesn’t even burp a comment moderation notice at me.

        Hang in there.

        1. ambrit

          Ditto. As a certain Maven says: “The Internet is not a user friendly environment.”
          Ye Internet Dragons are equal opportunity in their diets.

        2. Pat

          Sometimes I thank the comment eating monster, but most times I curse. Doesn’t happen enough to drive me away, but the glitch that feeds it doesn’t like a hungry monster.

          1. juno mas

            . . . that is why the Hosts suggest you create a NC folder and copy any well-reasoned, lengthy comments to it, in case the Internet gods send it to the ether. Makes it easier to re-submit.

    2. Joe Well

      NC has swallowed up some of my completely benign comments and allowed through some I regretted.

      It’s just the realities of automated comment moderation.

      I have managed WordPress blogs before and the comment spam is incredible. Sometimes you just “select all” and delete (which I’m sure isn’t being done here, but it’s easy to lose comments amid so much spam).

      So much SEO depends on comment spam, it’s a huge industry. The people managing comments have a lot to keep up with.

      1. Yves Smith Post author

        Comments are NOT automated. We have tripwires and then human review of the moderation queue.

        But we also have a spam service. Gets 3000 comments a day. If you post the same comment or basically the same comment multiple time, rather than waiting for the mods to get to your comment and liberate it, you are teaching the service to see you as a spammer. We can’t whitelist anyone who gets themselves in this fix, nor do we even being to have the time to root in the spam folder, where the comments are not only many but often hellaciously long.

  5. Steven

    Can’t help but think that what’s at risk here is a social system based on money and power. Gods of Money help us if we impose a lockdown and have to feed people who can’t afford InstaCart rather than just let them starve. People might not show up for work at crappy jobs again or be sufficiently deferential if they do.

    1. Kevin Carhart

      A 1099-misclassification startup is not synonymous with food delivery. They bundle and conflate a use value with a vicious change in structuring of work. Somebody else made a business around the use value without the misclassification. Is everyone who eats breakfast immediately in terms of “Kellogg’s”?

      If it’s too trite and minor to be snarling at people for pumping trademarks into their language, well who the hell are Instacart and how and why did they become banal enough to be doing that offhandedly?
      Not because I think there is some “aha” flash but because it’s good to demystify them and have a look at the money. Gods of money as you said, including the ones who embed a subject matter and mix it with an attempt at doing more.

  6. Cocomaan

    This feels a lot like the “any mask will do” narrative being thrown around in summer 2020, when data showed that some masks were worse than nothing and n95s were the gold standard.

    Now it’s “any vax will do”.

    1. Basil Pesto

      This feels a lot like the “any mask will do” narrative being thrown around in summer 2020, when data showed that some masks were worse than nothing and n95s were the gold standard.

      If the Melbourne 2020 case study is anything to go by (and I can’t think of any confounding factors except the contemporaneous lockdown, but case numbers didn’t decline until the mask mandate was introduced on top of the lockdown) then “any mask will do” may well have been enough for wild type (or whatever variant was in play in Australia in August 2020 – memory’s sketchy on that). That’s partly why our 2021 lockdown failed – the mask guidance didn’t improve in the face of a more transmissible variant (and airborne transmission to this day remains inadequately explained, and ‘road out of the pandemic’ vaccines were coming so don’t even worry about masks).

  7. SomeGuyinAZ

    Thank you. This is just an old curmudgeonly complaint so if it’s counterproductive feel free to delete it, but man am I getting vaccine/booster burnout – physically speaking. Had to burn through the majority of my last PTO recovering from the effects of the first two doses and now sitting here cranking the heat over 80+F and still shivering uncontrollably (makes for some fun typing here lol) from the booster. My fault for not bunkering up til the new year before taking the booster, but meh. The route our ‘leaders’ seem to be taking of not pushing for eradication, but possibly multiple boosters every year is…tiring. I might be able to go through another year or two of booster whack-a-mole while dealing with repeated required booster doses and their side effects all the while burning PTO and being put on management reports for demerits from unscheduled/unpaid time off until finally fired, but it’s not a pleasant future to behold. I feel like a real [family-blogging] piece of trash for complaining like this when I’m one of the extremely lucky folks that can work from home for now until my management team decides enough is enough and the value they put on physical onsite ‘collaboration’ outweighs their aversion to employees dropping dead, but man, it just gets so mentally and physically tiring.

    Sorry, Thank You to NC and the brain trust here for the constant words of wisdom and sharing their experience, experiences, and ploughing through the ‘official’ misdirections all the while providing good options like badger seals, filtration updates, et cetera.

    Wow, that was much less productive than even I thought it would be.

    Stay safe everyone.

    1. tegnost

      I think the idea is that if you put all your money in pfizer stock you’ll never need to work again. I’m sure there will be plenty of government support to PFE et al for the cure for the cure for the cure that we’re currently testing for them, so endless flow of money! (/s)

      Thanks for the report and hope you feel better soon…

    2. marku52

      My Moderna #3 was much worse than #2. Woke up in the middle of the night with uncrontrollable teeth chattering chills.

      Going to be very skeptical about taking #4. Perhaps rely on Vit C D Z and I, and masking hermit-ing.

        1. Hana M

          I’m starting to feel like Dumbledore in Voldemort’s cave as Harry says “Just one more Professor! One more will make it stop!” And they didn’t even get a real Horcrux.

  8. Expat2uruguay

    Yves, editorial comment regarding the beginning of the fourth paragraph:

    There is good evidence that a booster of the current vaccines reduces the odds of severe outcomes, but to the same degree as against earlier variants.

    Is there a missing negation? Should it read “but *not* to the same degree as against earlier variants.”?

  9. Eloined

    Thanks for this rundown. A couple of thoughts:

    Re: “US life expectancy fell by 1.8 years in 2020 due to Covid”. Perhaps you’ve already them to COVID, though let us not forget — as these pages have often noted — the 20k+ YoY jump in (recorded) drug overdose deaths in 2020, most among those aged 25-55.

    Re: “Early data suggest that the booster shots from Moderna and Pfizer significantly enhance protection against the Omicron variant” (from STAT). I keep seeing and hearing this, first weeks ago when Fauci during a presser held one hand down at his side to show that double-jab vaccination offered yay much protection, whereas a booster — represented by the other hand held near his head — offered “significantly” more. Maybe that was in the pre-early data supposition stage, but he displayed the utmost confident nonetheless.

    1. Yves Smith Post author

      Fauci picked the most optimistic of four studies available at the time, the one by Pfizer on no joke, a mere 12 people. It was a disgrace. There was no Moderna study then. Either right before or right after the Fauci remarks, the Moderna CEO told the Financial Times that the current vaccines would not be terribly effective v. Omicron.

      1. Eloined

        Thanks for the context. I am most alarmed that he projects virtually the same degree of confidence regardless of scientific certainty — going back to his HIV fomite-alarmist days. Sure, it’s a reasonably effective trait in someone responsible for nudging mass populations. But it’s one that I painfully associate with fast-rising institutional midwits and gloryhounds, to the point that on foily questions of ulterior (or, say, mixed) motives, my first thought when I hear him speak is never “ok” but always “why?” YMMV.

  10. curlydan

    With our arm jab vax only strategy, I can’t help but think every time of a “dog chasing its tail.”

    And people and Wall St are sometimes happy that Omicron is “not that bad”, not thinking that the next variant could be a lot worse.

    1. LaRuse

      Some people, my spouse among them (who has been waiting in his car since 0830 this morning for a PCR test after close contact last week), are telling people that Omi is going to be the last wave. He feels like we will all just get it and after we have all recovered from Omicron, we go back to the way things were.
      Someone help me…he thinks everything I read on NC is tin foil wrapped nonsense.
      January is going to be awful.

      1. jr

        I am feeling your pain. There are none so blind. The Wishful Thinking Fairy is going to be putting in overtime this holiday season. My partner had been really good about safety measures after some early, initial resistance but no one else I’ve told about gargling or nasal rinsing does so. Simple, inoffensive, every-day steps that could prevent a viral buckshot blast from turning your brain into forcemeat, amongst other horrors. But everyone is getting boosted! So it’s restaurants and parties etc. I no longer plead or argue or debate with anyone about it. I’ve told everyone I care about everything I know in terms of prevention. I update when applicable. The rest is all just free education at the School of Raw Experience…the courses are harsh but you are welcome to retake them as often as you like until you pass.

        As for scoffing at NC, I got a bit of that from my partner until she read Yve’s bio. Now I spy her sneaking looks at my screen in the morning to read what I’m going on about without admitting I’m right about anything…

      2. Joe Well

        >tin foil wrapped nonsense

        My doubting relatives were convinced after the pandemic actually led to lockdowns as I predicted the first week of March. Yours wasn’t convinced by that?

        1. LaRuse

          He was. Way back in March of 2020 when I started sewing masks while masks were still not necessary (but also not commercially available), he thought I looked like a hero. Now that he is simply over the pandemic, nothing I learn here is relevant anymore.
          I kid you not – he got a negative PCR test this morning and after we all breathed a sigh of relief, he announced he was taking our teenager to see the Spiderman movie in the theater…which is where they are right now. I really had tried to convince him and the Kidlet to take the brand new N95s I got this week but no. “We’re going to be eating popcorn anyway!”
          I have a healthy stash of cold and flu remedies, elderberry syrup and homemade fire cider, and we are all taking Vit. D and Zinc. I can only do what I can, but for the Vax Vax Vax crowd, there is no breaking through the confirmation bias anymore.

  11. Pat

    Please do not forget NYC’s vaccine mandate. It is the most severe I know of. And if you read about it from an outside source it is even more draconian (the first place I saw would lead one to believe that even if you worked alone any dealings with the public would require vaccination, which logically would include accepting deliveries.

    It is effective prior to De Blasio leaving office and Adams taking over which does lead to the question if Adams will let it stand and face this battle.

    1. Ellery O'Farrell

      NYC apartment dweller here: you’re right. Here’s an excerpt from the letter I received this morning from my management company:
      “All personal workers employed by residents, such as housekeepers, health care attendants, trainers,
      contractors for small or large repairs or alterations, even dog walkers who come to your apartments,
      will have to provide proper proof of vaccination to be allowed entry into the building. We are asking
      all residents for your understanding and cooperation as the building obtains proof of vaccination for
      any workers that you employ in any capacity that need entry to the building or to your unit. Our
      building staff will maintain logs, which must be made available for inspection by city agency
      inspectors, to record workers entering the building and document that proof of vaccination was
      obtained. Anyone you employ to do work in your apartment must have proof of vaccination upon
      entry to the building or access will be denied.
      “We note that there is an exemption from providing this proof for a worker who enters the building
      for a quick and limited purpose. Thus, if you meet the dog walker in the lobby for pick-up/drop off
      of your dog, or accept a delivery in the lobby, there will be no need to show proof of vaccination.
      “Please join us in supporting your building staff who are going to be charged with checking the
      vaccination status for workers, both coming in to do work on the building and in your apartment.”

      Not even a boilerplate wish for the holidays. On Christmas Eve morning, no less. (To be fair, they’ll probably email greetings and best wishes later today.)

      Lines down the block for testing even in this remote part of Manhattan, in this freezing weather with a dusting of snow. Mask compliance 100% indoors, as far as I can tell, and above 90% on my subway line (the A). Almost everyone wears a mask even on the sidewalk, but that may be due in part to their protection against the wind coming off the river.

    2. Yves Smith Post author

      Conventional wisdom is Adams won’t reverse it but he won’t enforce it either. He already made a pissy statement about de Blasio imposing new measures on his way out the door. Adams is pro business.

  12. Tom Stone

    Considering how fast Omicron is spreading three months to produce a vaccine targeted at it is likely to be more than a day late and a dollar short.
    And I’m seeing no acknowledgement that a skyrocketing number of cases will cause severe disruptions in supply chains and food production as well as completely overwhelming what’s left of the healthcare system.

    And this with a “Mild” variant.
    We have been very lucky,so far.
    More cases in a given period of time = more mutations in a given period of time = a greater likelihood of a more competitive variant in that same period of time.
    And whether that variant has a greater mortality rate is largely irrelevant to that variants success.

    A 10% mortality rate with similar morbidity to Delta…

  13. mistah charley, ph.d.

    from today’s Financial Times

    Oxford and AstraZeneca developing Omicron-targeted version of vaccine

    Douglas’s team put out a non-peer-reviewed paper on Tuesday highlighting the speed at which it would be possible to make a new adenovirus-vectored vaccine such as AstraZeneca’s at scale.

    Researchers believe their work could enable the vaccines to hit the 100-day development target, taking little more than three months from pathogen identification to mass production, potentially including the distribution of millions of doses from manufacturing sites globally.

  14. Samuel Conner

    I suppose the people who are pre-occupied with long-term solvency of Social Security are feeling a bit better these days.

  15. Pat

    Anybody else think that along with draconian vaccine mandates, even less recognition of side effects, and continued deliberate ignoring of the aerosol nature of the virus, we will be seeing more and more “adjustment” of testing and quarantine requirements, especially in schools and highly visible businesses. Some of it may be desperation to keep things open, with multiple reasons, but we are already seeing new get out of jail free criteria in sports and schools.

    And with so many getting Omicron over a period where business and schools slow or shut down, it is a win win. Open up again in January and be better positioned for the next variant.

    And March is probably too late for an Omicron based vaccine.

    1. Joe Well

      >>And March is probably too late for an Omicron based vaccine.

      The question is why, this late in the game, there isn’t much better vaccine making capacity.

  16. chris

    On a more practical note, does anyone know what we’re going to do for testing once the EUA for PCR testing of Sars-Cov-2 expires on 12/31/2021?

    I called to ask my local clinics if they know what they’re going to do and was told that they will get back to me. Anyone else know what we’re going to do once the test of record that has been written into many HR policies for COVID-19 protocols is no longer approved, and we won’t be able to get rapid antigen tests because of the shortage?

    I’d like to assume that this won’t be a problem and everything is already in hand for a smooth transition. But given where we are… I really don’t think assuming this is under control is a good idea.

  17. VT Digger

    Omikron and successors will blow through the populace and be replaced faster than profit can be made from targeted vax…nature’s planned obsolescence? Maybe the military’s new super vax will save us.

  18. Tom Collins' Moscow Mule

    “There is good evidence that a booster of the current vaccines reduces the odds of severe outcomes, but not to the same degree as against earlier variants.”

    Fulfilling specific agendas [political, health, economic, ect.,] through narrative/message control as a public relations exercise [“The conscious and intelligent manipulation of the organized habits and opinions of the masses is an important element in democratic society,”] defines and creates social realities along with consumer expectations [After all, the entire exercise is about restoring ‘consumer confidence’ and restoring ‘normal’ consumption patterns and supply chains for the global factory and its marketing department and that is especially so during the Christmas sales season. ], as long as the professional raconteurs/gatekeepers in the Ministry of Information retain their perceived legitimacy in the hearts and minds of the governed.

    Even as we are told that, “Blanket booster programs are likely to prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate,” WHO Director-General Tedros Adhanom Ghebreyesus said during a news briefing. . . . . No country can boost its way out of the pandemic, he said.”

    “WHO says Covid booster programs limit vaccine supply for poor countries, could prolong pandemic”

  19. Ram

    Army made vaccine is just the narrative which will get extreme right wing anti Vax folks to get in vaccine lines. Anything from army cannot be questioned

  20. KLG

    Yes, the key advance with mRNA vaccines is they are “rapidly tunable.”

    Yes, this is what is done in thousands of molecular biology laboratories across the world, every day. Do an experiment, figure out a new mutant to make, make the mutant, re-do the experiment within days (not long ago it was months and longer), said experiment involving production of the mutant protein and then studying it in a test tube or transfecting it into a cultured cell line and measuring something in these cells, e.g., adhesion, motility, structure, localization of the protein tagged with a fluorescent carrier protein. But not in a human being! Or an experimental animal unless you want and need to go through a long and involved Institutional Animal Care and Use Committee (IACUC) application to justify your research. These applications are not pro forma, btw! They are taken very seriously by everyone, the scientist, the institution, and the funding agency.

    Anyway, are we really ready to experiment further with a novel human therapeutic, every few months, on people? Without reasonably extensive trials for safety and efficacy for each shot? I’m not using “vaccine” anymore. Virologists have long known that coronavirus vaccines are “problematic,” to use a common euphemism for “lousy and short lived.” That very basic scientific knowledge has not filtered up to science administrators or politicians…

    Just askin’?

    Happy Holidays to all!

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