Omicron: Fog of Information and Definitions

It’s a bit disconcerting to find we are a day further into a fast moving crisis yet I don’t have the sense anything both new and meaningful has emerged. But it still seems useful to try to clarify some of the claims floating about as well as a few new Omicron factoids that that have emerged but seem a lot less dispositive than the press enthusiasm would have you believe.

As usual we are very grateful for the help of our Covid Brain Trust and I am quoting more liberally from them than I did our also very valuable Brexit Brain Trust. The reason for hewing to our sources’ words more closely is I don’t want my interpretation to distort meaning.

And What Pray Tell Do You Mean By Severe?

Alarms appear to have gone off at WHO and the CDC after a spell of “initial signs are that Omicron isn’t that bad:

Oddly we have to go to Daily Mail rather than Twitter for a pointed recap of our CDC’s more downbeat outlook:

CDC issues grim forecast warning that weekly COVID cases will jump by 55% to 1.3 MILLION by Christmas Day and that deaths will surge by 73% to 15,600 a week as Omicron becomes dominant strain

And remember, even if Omicron is actually is less nasty on average, it’s so highly transmissive that hospitals will be overwhelmed:

And there is an offset that Thomas Peacock, the scientist first to post on B.1.1.529 before it was called even that, noticed immediately: that it probably evades monoclonal antibodies. Our GM was quite certain that would be the case, and our IM Doc now has pretty some pretty sick patients who are not responding at all to Regeneron, which has an EUA for use as a Covid treatment and is generally seen as effective. German researchers confirmed yesterday that Regeneron’s and Eli Lilly’s Covid treatments are not effective against Omicron. GlaxoSmithKline’s cocktail Xevudy still appears to work in vitro, but that may not translate as well in vivo.

The loss of some, perhaps all, monoclonal antibodies as Omicron remedies means that some patients that could otherwise have been treated outside a hospital will wind up being admitted. This is an offset to any average reduction in severity.

So it should not come as any surprise that, so far, deaths in Gauteng are tracking previous Covid waves:

Yet as our GM was correct to warn, the “mild” meme, as the hot take meant to preserve Christmas festivities and shopping, has become anchored. The press is pumping out even more articles to try to normalize Covid, such as the Atlantic’s Don’t Be Surprised When You Get Omicron. Gee, how about instead running a public service piece like “What You Need to Do to Not Get Omicron.”

GM reacted, quoting the article and then commenting:

One by one, the symptoms I knew so well on paper made their real-life debut: cough, fever, fatigue, and a loss of smell so severe, I couldn’t detect my dog’s habitually fishy breath.

Mild brain damage.

Once you know you’re infected, hang tight, limit your encounters with other people, and just take care of yourself.

As discussed earlier today, all the effective treatments need to be started early on. So what exactly is the advice to “just take care of yourself” on your own going to achieve?

And what are they going to do with the monoclonals and Omicron? There is only sotrovimab [GlaxoSmithKline] that actually still works and that is presumably in very short supply. But do they still refuse to give to the vaccinated (which are no longer actually vaccinated)?

IM Doc was even more disturbed:

This article is a sterling example of the vaccine only mantra.

“Stay home and take care of yourself.”

This is the terminal lunacy of VAX VAX VAX.

The problem is that many of these people are being told to stay home while they are turning blue and coughing up their lungs. And this week in my area 85% of the COVID outpatients are fully vaccinated with 30% of those boostered. It is as if the entire medical industrial complex has learned not a fucking thing in 2 years.

I cannot tell you how ashamed I am of where my profession is today.

The fact that our media is still putting out this kind of tripe to mislead the masses is yet another sign of the mass delusion.

IM Doc pointed out how the “mild” meme was doublespeak:

I think Americans think of “mild” as a head cold. I think the medical establishment thinks of “mild” as not being admitted. The non-admitted, however, can be violently ill, trust me.

GM wanted to understand exactly what “violently ill” meant. IM Doc again:

That is a medical intern phrase – it means very very sick – but not quite hospital level. And it is also very age dependent – younger people can handle this much better than older people.

I have 7 patients with COVID right now that my office and I are calling twice daily. They would all fall into this category.

By definition, they all have someone to watch them at home.

Some of the symptoms we are dealing with today – temps up to 103, severe shaking racking chills, sweating enough to soak the sheets 1-2 times daily, severe coughing, vomiting their guts up, severe myalgias.

These people are sicker than just a flu. However, not quite admission. Mind you, the criteria for admission has been higher lately, we have just not had the bed space – and people really do not want to be in the hospital.

This is most definitely not the average course of influenza….

We do not really have people deteriorating where they cannot get them to the hospital on time. WE KEEP A VERY TIGHT LEASH ON THEM. Unfortunately I do not think many Americans have a primary care practice that does this.

They also have very strict parameters to call us instantly.

And I call them twice a day. Most of the time there are 5-7 people. Some days upwards of 15. The highest has been 22 – but that is absolutely not the norm. It really gets quite crazy.

This is the large reason why I and my staff are so exhausted. To keep them out of the hospital and safe at home is just enormous amounts of work.

Unfortunately, I think myself and my practice are the extreme exception. I do not get the idea this level of care is being done by most practices. I just feel obligated to keep them at home as best we can.

IM Doc also underscored yesterday that even though he might have some Omicron cases (due to failure to respond to Regeneron) it was still too early in the course of a normal Covid case for any to be admitted.

Delta-Omicron Recombination Unlikely

Some readers were concerned by news reports of Moderna’s chief medical officer telling MPs that Delta and Omicron might recombine. GM was perplexed. His reaction was even if that happened, it would not appear to give the new variant any real advantage. But Delta and Omicron circulating at the same time (as opposed to Omicron pretty quickly becoming dominant) could still be very nasty. GM:

There isn’t much that Omicron can obviously gain from Delta and vice versa. Omicron has the immune escape, it has FCS enhancement, it has the N protein packaging improvement, it has the Nsp6 deletion, so what exactly is there in Delta that will make it fitter by recombination? And vice versa — Delta has those transmission enhancing features too. Some of the AYs have accumulated further ORF and Nsp mutations, so there might be some room for improvement there, but it will be marginal.

The bigger problem will be that you will have sick people in the same rooms in hospitals and they might become cross-infected, which should worsen the outcomes.

The Lack of Interest in Treatments

Biomedical professor KLG had said from the get-go that he expected the approach to Covid to come to depend heavily on treatments, as it has with HIV. The fact that we have instead gone all in with limited efficacy, comparatively short-lived vaccines is a big departure.

PlutoniumKun of our Brexit brain trust had found some hints in the Japanese press that Japanese doctors were prescribing Ivermectin and added:

From what I understand of the Japanese medical system, it wouldn’t surprise me at all if they are giving it to patients without telling them….Those who have lived in Japan will confirm I think that getting a straight answer from a Japanese doctor on any medical topic is nearly impossible.

Epidemiologist Ignacio noted:

One of the problems with Ivermectin, IMO, is the hospital-centric view that dominates medicine. It is well known that some approaches with medicines might work in early stages of infection (very early so as to be considered nearly preemptive) and only or mostly work if administered timely. This is, or can be the case of Ivermectin. When you go an do clinical trials the result is “It has no effect” and that might be the case if the design of the trial results in too late delivery to notice an effect. But in real life practice it might be the case that words have circulated among Japanese doctors in the sense that it indeed does something.

IM Doc described how the CDC has hung doctors out to dry:

When you have been doing this as long as I have, you have a memory of what happened before and with that comes certain expectations about what should be happening now. I think that is what separates the older than 55 crowd from the under 40 crowd.

We do not even have to go back to AIDS. I am thinking of the last 2 events in my career where there was exceptional involvement from the CDC. In 2018, we had the vaping crisis. In 2012 or thereabouts, we had the West Nile issue. Although that virus had been with us since 2001 here in the USA, it really exploded in the summer of 2012 in the Deep South in the USA. I will not include the 2014 Ebola problem. The CDC was very involved there but that never really had to be taken nationally, these other 2 examples did.

In both cases, there was frequent, at times weekly updating from the CDC about treatment options and guidelines. There was intense discussion of what seemed to be working and what did not. In both cases, these treatment options were obviously non-approved for these purposes by the FDA. There was a crisis, and this is what we have available, and this is how you should be using them. This is what works. This is what does not work. And this is our evidence why we feel the way we do. This was constant from the CDC in both cases.

That has simply not happened at all in COVID. Here we are 2 years into this. There is not a single shred of treatment advice from the CDC outside of the inpatient setting. Let’s face it – most antiviral efforts have to be done immediately. That would mean where I work in an outpatient setting is the golden hour. If we wait till the patients are in the hospital they are going to have much worse outcomes. The agencies are saying nothing about outpatient therapy and have put forth nothing. We have worldwide studies on fluvoxamine, ivermectin, HCQ, steroids, VIT D, VIT C, Zinc, and I am sure there are many others. We now have monoclonal AB. A question – have you ever heard Dr. Fauci discuss monoclonal AB in a positive way? If you have please show it to me.

There has been no guidance at all about any of these therapy options. There has been lots of censoring, hectoring, belittling, and confusion. It is unusual to find a physician willing to engage any of these therapies, despite some of them having overwhelming positive signals in early outpatient therapy.

There is not ONE single bullet. By now, 2 years into this we should be throwing all kinds of things at these patients – anti-virals, anti-clotting agents, anti-inflammatory agents. But we are doing nothing.

Again, our CDC has done nothing to help with this at all. NOTHING. Not only the CDC. In previous events, there was treatment advice flowing from medical schools around the country. CRICKETS.

We have gone all in on the vaccine approach and have done so from the beginning.

Now, the bill is due. My office is literally flooding with vaxxed and boosted patients that are very ill. We are in a precarious situation with the hospitals of America. They are in much worse shape employee-wise than many Americans would dare dream.

I feel all alone. I feel it is my sworn job to keep as many of these people safe and out of the hospital as possible. But there is literally no help from the CDC at all VAX VAX VAX. Here is the problem – about 85% of these patients in my practice that are now positive and getting sicker by the day are already VAXED Many of them boostered. We are in the middle of a crisis with the hospitals – and we simply cannot fill them up the way we have.

Hyping of Way Too Preliminary Report of Omicron Bronchial Replication

This finding is being hyped in the mainstream media, such as Reuters, as if Omicron won’t take hold in the lungs and will nicely and courteously stay up in your bronchial passages:

Help me. It typically takes five to seven days from symptom onset for Covid to produce viral pneumonia, in cases where it advances that far. The NHS indicates that the most rapid onset of garden variety pneumonia is 24 to 48 hours, with several days more common, strongly implying that 24 hours is bleeding edge.

Thus concluding anything about possible disease evolution at 24 hours for pathogen that normally takes well over a week after exposure to get really ugly (recall symptom onset averages 5 days after exposure) is quite a stretch.

GM was also skeptical and pointed out that Delta was hard to make behave in vitro and that may be true of Omicron, further complicating reaching early conclusions:

They found greatly increased replication in bronchus cells but reduced replication in lower lung tissue.

And now the narrative is that it is becoming an URT [upper respiratory tract] infection.

But this makes no sense — in the same plot they have Delta showing the same pattern, and Delta was more severe than WT [wild type], not less, and this is what every study finds, so it’s not even controversial.

And they tested this only up to 48 hours, but that is not how this works in actual human bodies — it starts as an URT infection then moves further down. So if you have 70 times more virus in the middle lung, you should be seeding a lot more of it in the lower lung, even if it replicates a bit less there, and the net effect is negative…

Everyone is in a mad rush to put out results as quickly as possible and as a result they are not even thinking how damaging putting out incomplete data with premature conclusions can be…

But there is more to this story.

Another factoid, from Vineet Menachery:

“A bit inside virology, but #omicron grows very poorly and causes very little CPE. This makes interpretation of replication data difficult since most measures are dependent on CPE based measures. Doesn’t mean that data is wrong, but magnitudes maybe a bit fuzzy.”

Menachery is someone who studied coronaviruses before the pandemic, i.e. one of the few OG coronavirus scientists and someone who knows this stuff inside out

But apparently Delta is not that easy to grow either. Yet both are hypertransmissible. So there is some major poorly understood difference between in vivo and in vitro…

Then this preprint came out too:

Which is mostly yet another neutralization study, but the supplement is interesting:

Figure S2.

Here, they grew it up to 96 hours in VeroE6 cells.

And you see a curious thing — Delta shoots up real fast, but even WT [wild type] grows much better than Omicron, which initially goes down at from 0 to 48 and only then ramps up.

Yet it is hypertransmissible like nothing seen before…

I have no explanation nor can I square any of this (or any putative reduced virulence) with the mutations in the virus.

It’s a wait and see for the fog to disperse…


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  1. Michael

    “”And remember, even if Delta is actually is less nasty on average, it’s so highly transmissive that hospitals will be overwhelmed:””

    Should this be Omicron?

    Thank you for this recap.

    Share widely today!!

  2. cocomaan

    The simultaneous downplaying of severity and the upbeat attitude towards vaccines speaks loudly: the captured federal agencies are trying to push as much money toward the pharmaceutical company winners as possible.

    With an early intervention therapeutic, you only treat the 1% infected at any one time. With a vaccine, everyone needs to be injected. Way more money to be made with the second than the first.

    These aren’t trustworthy agencies. It seems like a trite comparison, but these are the same public health organizations saying that recreational drugs like marijuana or psilocybin are both highly dangerous and have no medical use. They’ve been repeating that mantra for decades with no sign of stopping anytime soon, despite widespread use in the population, medical trials showing efficacy, and so on.

    If you use those recreational drugs as a yardstick for how long these federal agencies will stick to stupid narratives that hurt more people than they save, you get an idea of how long they’ll stick to Vax Vax Vax, by which I mean “as long as they are making their friends $$$.”

    1. Cocomaan

      Also want to ask the brain trust to what extent the “mild” narrative comes from countries with lower median age. South African doctors and public health officials have talked about mild omicron cases but the fact is that they have a younger population than in the west.

      Obesity is a major risk factor and one unaddressed by the vax crowd, and that may factor in since western countries are overweight as a rule.

      1. Yves Smith Post author

        It was worse than that. The “mild” narrative started before you’d see hospitalizations in the normal course of events, so it would inevitably look “mild” because too early!

        And then the early part of Covid waves tend to start with lower hospitalizations because the young get it first, as happened in Gauteng (the outbreak was concentrated at a university and Cornell. The young get way more infections proportionately at first because they are out and about much more than the elderly and working stiffs.

        And yes, on top of that RSA is young. Average age 27 v. over 37 for the US and over 40 for the UK.

    2. PlutoniumKun

      I can stand corrected on this, but I think the ‘mild’ narrative was pushed from SA initially as they were worried about their own tourist season and travel. But it was immediately jumped on by politicians, media and public health authorities who didn’t want to have to make a quick decision in the run up to Christmas. In other words, they used an easy excuse to duck their responsibilities.

      I’m still astonished by the failure to learn the mistakes of the very recent past. I’m watching here a re-run exactly of last year, just with what looks very likely to be something far worse than delta. I passed a shop today at lunchtime and in the window there was a TV showing an interview with one of those experts who has been consistently wrong with every call he has made since early 2020. I didn’t have to see what he was saying, there is no reason to think this particular professor has learned a thing, apart from how to get his face on TV. Honestly, if there had been a brick handy I would have thrown it through the window. I just despair.

  3. Tom67

    Hi Yves
    Thanks a lot for your covid updates. One line from IM doc realle resonated with me:
    “There has been no guidance at all about any of these therapy options. There has been lots of censoring, hectoring, belittling, and confusion. It is unusual to find a physician willing to engage any of these therapies, despite some of them having overwhelming positive signals in early outpatient therapy.”
    I am German and live in Germany. Here it is exactly the same. My own case might be instructive: as my wife´s cousin died one week after getting the second Astra Seneca shot we decided no way we´d get inoculated. Just in case you wondered: he was 47, no known health issues and after his death he was examined and found to be full of trombose.
    I have three kids 14,16 and 18 and despite all pressure they have not been jabbed either. So I got ready to get Covid and tough it out. I read the Front line doctor advice and decided to get Ivermectin. They recommend to take it as soon as you get Covid. But you can´t get Ivemectin in Germany for humans. Luckily another relative had researched Ivermectin and pointed me to an adress in the Netherlands where I can get the stuff for horses. He had also researched exactly which amount to take which is really quite hard as the dosage for horses is completely different. So I ordered Ivermectin for me and my family.

    Last month it happened. First my 16 year old daugher got it and then all her friends and my other two kids.
    The kids had the sniffles, a headache and that was it. As soon as I felt under the water I took Ivermectin. I felt bad for 5 days but that was it. No fever no loss of small. Now I am completely restored.
    The mother of a family which is also not inoculated is in danger of losing her job because she doesn´t want the jab. So she didn´t take Ivermectin. In Germany if you are “recovered” they then leave you alone for 6 month. So to keep her job she felt she had to get sick. And sick she did get. She is a healthy sporty woman of 49 years. She was really sick for one week and her sense of smell hasn´t come back yet. What world do we live in if people are desperate to get sick?
    Unfortunately we don´t know any IM docs here. We are totally on our own. One thing I might add for readers from the US: we used to laugh at the US and how you called yourself “land of the free”. In fact your country is now the freest in the so called West. At least as regards Covid and your federal structure is a huge advantage. Your very diversity seems to guarantee that no insanity will ever engulf the whole country. There are always some outliers who do things differently. Me and my family have to contend with the following:
    – no more sports for the kids
    – no pubs, no concerts, no cinemas no shopping except for food
    – no public transport-
    Believe me we hope and pray that the US will lead the way out of this mess. For our country we only see increased repression and ultimately an inoculation mandate.

    1. Michael Fiorillo

      Wow, and not to be flippant, but if you’re looking to the US for guidance on anything, then Dog help us all…

      1. BeliTsari

        All the US authorities learned, was how to better hide the bodies? Just THINK of what pragmatic grown-ups could be learning from coronavirus hijacking millions of victims’ immune systems? Quite aside from only an exceedingly small, well isolated cluster of rich, connected, complicit churls pontificating, “vax, vax, VAX!” Victims, their equities & kleptocrats 1099’d out of any health insurance, sick-leave, child-care means (since MANY of us were fed to COVID and had wild, scary side-effects, with only very cursory diagnostics/ imaging). In NYC at least, sneering petit bourgeois beneficiaries will NOT allow any media source, blog or social networking to even ask what any subsequent waves will be like, with us uppity essentials & death o’ disparity deplorables doubting or disbelieving everything we’re being told we believe, by smug, senile zombie kleptocrats?

    2. Gumnut

      I hear you.

      I am from Germany and based in Denmark now.

      Germany has lost the plot. My friends & family there are vax^3 pro and unvaxxed hating. Can’t talk to them without them regurgitating talking points and blanking at any holes in the official logic.

      Also resorted to that Dutch veterinary supplier for emergency stash of the Japanese soil wonder drug. So far, just sitting in the fridge. But also believe we had alpha early in 2020 before testing was available, who knows.

      The previous German health minister had a bank apprenticeship and friends in pharma as his highest credentials for the post.

      The current German health minister is a health economist (as a German I dare to say that no German should be let near evaluating life, death and health through a monetary lens) and excels at talkshow visits where until just days ago he utters nonsense like “we can’t end this while there are still unvaxxed mingling amongst our hospitals and schools”. One ends in despair listening to them.

      All that said, the German public broadcaster has swung from pushing mandate rumours and kid-vax propaganda to non-vax-pharma covid treatments in the last day.

      As you write about ‘what country is this where one hopes to get sick?’, what country is it where one hopes that the omikron wave is large enough to swamp the vax-mandate stupidity.

      Denmark is fairly calm, but restrictions coming. Today first time ever 10k daily cases, ca. 20% omikron. Interesting distribution differences in vax status vs. delta/omikron since 22Nov (1st omikron case in DK): 90% of omikron in vaccinated.

      Table 4:

      1. fajensen

        Denmark has bought the ticket and now we will get to enjoy the ride!

        Denmark were, In My Opinion, doing OK for a while and then they suddenly decided to do Chernobyl-style Pandemic Managent: “Lets pull all of those control rods all the way out and see what happens!”.

        I belive that in about March 2022, we will be in a lot more shit than we were in March 2021.

        Sure, there are lots of people who are fully vaccinated and they may get off easy, but, when *one let cases double every 2 g*ddam* days*, then, even with only small’ish numbers of breakthrough cases (and this is assuming!! all will be mostly well), one will still manage to crush the health services, and then we will get the American CFR-rates of 1-2% and those triage tents and refrigeration containers for dead people!

    3. ahimsa

      Hello Tom,

      Thanks for the report! Am also in Germany and ordered my Ivermectin from India in Summer. It got held up at customs in Frankfurt but thankfully still came through. I take it once a month or more if there is any sort of outbreak in my contacts.

      Also, my doctor here was very proactive about checking my Vit D level and ensuring I get it up higher for the winter season. And he is willing to prescribe Fluvoxamine for me after he saw it positively reviewed in a medical newsletter which he receives.

      Have also heard positive reports from friends (if taken early!) of Shufeng Jiedu a Chinese herbal preparation for upper respiratory/influenza symptoms. So I also have that on hand.

      I wear a KN95 mask at work and also regularly use a nasal spray as first defence. So far so good, despite several colleagues and many students that I teach having been diagnosed with Covid.

      1. YankeeFrank

        I know we’ve discussed betadine before, but thought I’d remind people again since McCullough described it in detail during his talk with Rogan:

        He suggested use of betadine with water in a nasal spray (something like two teaspoons in six ounces of water, but don’t quote me on that) every time you return home from somewhere you spend time with other people indoors. You spray it high into your nasal passages so that it comes down in the back of your mouth, and then you spit it out, then gargle with the leftover solution. He said the virus is fragile and easily killed. He also said you can use hydrogen peroxide instead of betadine but didn’t specify the solution strength.

        1. chuck roast

          I bought some Povidone-Iodine Swabsticks today. Worst case I can use them as nasal swabs. Having been trained by Economists, this is probably the absolutely wrong thing for me to do…consistency being the hob-goblin of small minds. But, at my age, what the hey.

        2. Skip Intro

          You can get convenient bottles of Saline Nasal Spray at your nearest pharmabehemoth. I made a solution with Providone Iodine (similarly sourced) of 0.7%. Saline is better for your membranes, I think. The bottle will be very handy as a reusable nose sprayer.

    4. elissa3

      Regarding our federalism, I mentioned this to a friend recently concerning the resistance/refusal of certain state governors to Biden’s vax “mandate”. Odd times when I find myself applauding the likes of De Santis in FL, whose overall political philosophy is pretty retrograde.

      1. johnf

        If you have been neither fully vaccinated nor already infected, at the very least, you can be refused travel unless you show a negative rapid antigen test from a recognized testing center within the last 24 hours. This is an intentional nuisance to goad people into voluntarily being vaccinated.

      2. Alphonse

        A few bits and pieces I’ve run across:

        Papers, please on a train:

        The man recognizes the inevitability of the situation and stands at the nearest toilet door, hands up. Nevertheless, he is thrown to the ground, the plastic handcuffs put on him and he is thrown from the train with a loud shouting. Then another group photo of the officers with their target. It is now clear what happened here. The man got on quickly, did not have a ticket, wanted to buy it from the conductor and could not provide proof of vaccination.

        Police chasing a man in a park not wearing a mask. (Though my German’s not good enough to confirm the claim.)

        Police measuring the distance between protesters to ensure social distancing outdoors.

    1. Yves Smith Post author

      That is the worst dog ate my homework I have ever seen, and I have quite a few. IM Doc noticed too:

      I am informed by a reliable source that the initial data was looking overwhelmingly amazing.

      I have been doing this for 30 years , a decade and a half on an IRB.

      I have to say I have never heard one time of a major medical study like this not being able to secure meds. It would be one thing if it was a difficult boutique hard to manufacture oncology drug.

      But a drug that is being given millions of times daily all over the world?

      1. Basil Pesto


        Because if that does turn out to be the case, how is that supposed to be communicated? can you imagine the attempted face saving? That the “anti-vaxxers” were actually right about something, even though painting the Ivermectin-curious as “anti-vaxxers” was a moronic false dichotomy from the beginning. I mean, to this day, WHO et al can’t even bring themselves to say the word “airborne”, so how’s the other thing going to go?

        on the topic, I thought this was interesting from PK:

        From what I understand of the Japanese medical system, it wouldn’t surprise me at all if they are giving it to patients without telling them….Those who have lived in Japan will confirm I think that getting a straight answer from a Japanese doctor on any medical topic is nearly impossible.

        because earlier today I recalled his comments about his Japanese friend who had no idea about the idea of IVM being used as Covid treatment. Presumably, though, the quoted bit above would refer to giving it to patients once admitted early to hospital, as opposed to at-home use? How could they hide the drug from the patient if it’s on a prescription/blister pack with drug info leaflet/bottle with the drug’s name on it?

        1. PlutoniumKun

          I think I should just clarify this – my friend didn’t know what iverm was when I mentioned it – I was joking about getting a supply from some sheep farmers we were visiting on a hike (iverm is used in vast quantities in sheep here to prevent parasites). She later said that she was curious and looked it up – she didn’t recognize the name as its pronounced very differently in Japanese (イベルメクチン), and may have other specific trade names. She told me she’d been looking it up on Japanese pages and said it was ‘interesting’… at the time I wasn’t paying much attention to the subject so I didn’t ask her what she found. She’s in Japan now, just out of quarantine, and I’ll ask her to tell me all when she gets a chance.

          My other comment was the result of a recent online chat with someone I know who lives in Japan and is a more reliable source of information than the usual expat gossip (one thing you quickly learn in Japan is not to pay any attention whatever to expat gossip). She seemed to think it likely that the low death rate was due to a focus by the health authorities on early treatment of older people, and its possible that sheep dip was part of this. But there is a long tradition in Japan of doctors simply not providing the sort of information to patients that would be normal elsewhere. Its still not unknown for doctors not to tell people they are being treated for cancer (Pico Iyers has an interesting anecdote about this in one of his recent books). That was the context of my comments, plus a few other things I’ve picked up from attempting to apply my very weak Japanese reading skills to the media there.

          Anyway, I’m trying to find more – please take my comments with a grain of salt, its really just me trying to tie a few threads together at the moment.

        2. fajensen

          How could they hide the drug from the patient if it’s on a prescription/blister pack with drug info leaflet/bottle with the drug’s name on it?

          The japanese doctors will give you a small paper bag with a bunch of loose tablets, or even powder, and instruct you to take so-and-so much, at this interval, for so long :).

          1. Basil Pesto

            Thanks, but what is your source for this claim? This paper would suggest that that’s an oversimplification at best.

            In Japanese law, the Pharmacists’ Act regulates pharmacists’ roles. This legislation states that “a pharmacist is to contribute to the improvement and promotion of public health by administering the dispensing of medicine, supply of medicine and other pharmaceutical health and sanitation services, thereby ensuring the healthy living of citizens”.24

            In Japan, only medical doctors, dentists, and veterinarians have prescribing rights; pharmacists and other health care practitioners are not allowed to prescribe. Furthermore, drugs cannot be refilled in pharmacies; instead, patients must consult medical doctors and receive a new prescription every time they need a medication. Long-term prescriptions can be obtained for all medications except narcotics, psychotropic drugs, and new drugs (those within 1 year of their launch).


            Pharmacists working in community pharmacies mainly perform drug dispensing and clinical pharmacy services (as described above). They also manage patients’ drug administration history, including information about adverse effects. The medical remuneration points system was revised in 2016 and now includes newly established personal pharmacist guidance fees.28

            The provision, by specialized pharmacists, of centralized drug management services for patients helps to prevent overprescription, duplication, and low patient adherence, thus contributing to drug safety, efficiency, and optimal medical expenses. It is also possible for patients to choose their own reliable pharmacists, called “primary care pharmacists”, who integrate and manage drug information and give appropriate advice and suggestions, if needed, at any time (24 h/day), even if the pharmacy is closed.

            1. fajensen

              Exchange students. One got some rash from somthing and they were given a bag of pills to take. That was some time before 2016 though.

  4. R

    Yves, the post appears to be truncated. It ends in an emboldened section heading, Hyping of Way Too Preliminary Report of Omicron Bronchial Replication.

    As an extra titbit, I just got off the ‘phone with my friend who is part of SAGE and has had two of the most depressing meetings in their life in the past week.

    Currently the world only has in vitro data for vaccine efficacy against omicron, which shows negligible neutralisation by AZ. However, the mantra has been: it is too early to tell whether this reduces protection against clinical disease, we need clinical data for this, T-cells may be made of sterner stuff. Chris Whitty just stated to Parliament we need 250 hospital cases to estimate when we have only 15 now.

    Well, apparently SAGE actually has a model for predicting efficacy against clinical disease (based on correlating neutralisation data and outcome data for past waves) and the model is predicting… zero.

    One source of hope, this does not take into account T-cell immunity, which may turn out to be must stronger (it may be at work in the South African hospitalisation figures, but these are now climbing….). However, this explains the emphasis on the UK booster campaign at least. I still see it as a massive displacement activity compared with imposing controls (FFP2 or FFP3 masking, ventilation, closure of spreading environments like theatres, pubs and nightclubs etc.). But it is a Hail Mary pass, that we can re-immunise the population before most of them get omicron, so they stay out of hospital.

    On the “positive” side, the absolutely wild estimate of doubling times under 2 days may not be reliable. There are some subtle things wrong with the headline maths and the fact that the SGTF marker of omicron is not either/or, there are also equivocal and unknown status results. However, even when all allowances for sources of error are made, the current doubling time is still 2-3 days. So not that positive.

    My friend believes that it is now baked in that UK hospital capacity will be overwhelmed. There were ten people in hospital when we locked down in late March 2020 with the original virus with a 5-7 day doubling time and the hospitals came very close to being overwhelmed in London and other centres. There are currently 15 in hospital with omicron already ascertained and likely multiples more and the doubling time is half. Even if BoJo had announced a lockdown last night, the die is cast, especially if the vaccines are as ineffective against severe disease as the model suggests.

    All very depressing. I’ve genuflected to Amazon and bought a home oxygen concentrator, just in case any of us needs oxygen support and the hospital is full….

    1. Yves Smith Post author

      Please refresh your browser or reopen in a new page. The full post is up, not sure why you are not seeing it.

      And relying on T-cell immunity is not a hot idea with a pathogen that one can get repeatedly. New T-cells are made by the thymus, as you probably know, and that’s pretty much done by adulthood. Doctors are already seeing T-cell derangement and exhaustion. We hoisted this from an e-mail by IM Doc in an earlier post:

      Another concerning thing I am beginning to hear from my oncology friends is the absolute explosion of soft tissue cancers [note that is old school nomenclature] that are happening. This is especially true of malignant melanoma and renal cell carcinoma. One of my oncology colleagues noted to me the other day that he found it very troubling that these two in particular were going parabolic – the two soft tissue cancers whose etiology most have to do with a disordered immune system. Lymph tumors like lymphoma and myeloma are also apparently going off the charts as well.

      And GM’s reply:

      This was predicted already last year when it became clear what the virus does to T cells.

      You go through a large T-cell exhaustion and derangement event and then you have fewer of them to monitor your own cells for malignancies. Thus one of the key mechanisms through which the body cleanses itself of tumors is diminished. An aged immune system is not so good with dealing with them, which is one reason (along with the sheer accumulation of mutations over time) why old people get cancer so much more frequently.

      Well, the virus directly causes derangement of cellular immunity so logically it should also cause an explosion in cancers. If what your are seeing is confirmed as a trend, and if it’s these two types specifically that are exploding that is quite solid supporting evidence, then that hypothesis will turn out to be have been correct.

      And that’s a slow ticking time bomb that is only now starting to go off…

      1. LawnDart

        And that’s a slow ticking time bomb that is only now starting to go off…

        Slow, in dog-years?

        Where I am today, the sun is breaking free and it will be unseasonably warm. For all else, Doc and GM remind me that it’s a good idea to get outside and enjoy some of the day.

        Don’t really know how to express my gratitude to them and to others in the medical field, except by trying my damdest not to add to their workload by becoming a patient, and by word of thanks.

        Thanks again for keeping us informed.

        1. Airgap

          Thank you Yves for this wonderful update and to IMDOC and GM.

          Is there even more to the slow ticking timebomb?

          Last night on the local news: , I was surprised to learn of a new sublineage of Omicron – they were calling it ‘stealth Omicron’.

          ‘With BA.1, the original sublineage of omicron, a widely used PCR test from Thermo Fisher Scientific offers a characteristic error message. That error message, called S gene dropout, has given researchers a leg up in their surveillance efforts by flagging likely omicron samples for the genetic sequencing necessary for confirmation.
          As a result, labs can confirm the presence of omicron two to three days after someone takes a nasal swab. By contrast, it takes two to three weeks to identify stealth Omicron’.
          That lag may have implications for public health officials who need to know when to make the switch to other treatments, said Dr. Davey Smith, head of infectious diseases at UC San Diego.

          I would normally be very suspect of any information vomited from the TV but the source is a reputable MD in infectious diseases at our local campus.

          So I am wondering if this has popped up on the radar elsewhere. I will be keeping my eyes peeled.

      2. JBird4049

        >>>You go through a large T-cell exhaustion and derangement event and then you have fewer of them to monitor your own cells for malignancies.

        So this is becoming sorta, kinda like HIV/AIDS where it is not the disease itself that kills you, but the destroyed immune system it leaves you that allows everything else to kill you? Nice

        On not getting advice from anyone this time, unlike the earlier epidemics, I am guessing there are several reasons for this. First is the lack of trust and therefor safety to say anything that might violate the THOU SHALT NOT BE WRONG commandment. Secondly, there is the THOU SHALT NOT EMBARRASS YOUR BOSS. Thirdly, there is not only more fear in the controlled, there is also more control being exerted by the powers that be, who also are more fearful.

        In a functional business, or society, or family, when the fecal matter hits, a meeting can be called with everyone given permission to say anything without the fear of punishment. People feel that they matter, that they have some safety, and there might even be a solution even from the oddball.

        Nobody is feeling the safety and for good reason.

        In the United States, they have been ratcheting up the fear for over twenty years, both for profit and for control; only those parts of the government and business that can use the fear and control being allowed to both avoid the gutting of everything else and to actually grow. Monopolies are not only good for profit, they are good for control. Those things that are good for the nation or community, like the CDC, no monopolies, or demilitarized police, are gutted because they don’t give more control or are profitable to the powers that be. Then there is the neo-Stalinist thought control being imposed by the various political agents. Add a lethal pandemic, which makes the costs of all this so much higher, and you get the silence. And the dysfunction as there are no extra resources to do anything different. There is only enough for more of the same even if it kills us all.

      3. Basil Pesto

        This was predicted already last year when it became clear what the virus does to T cells.

        You go through a large T-cell exhaustion and derangement event and then you have fewer of them to monitor your own cells for malignancies. Thus one of the key mechanisms through which the body cleanses itself of tumors is diminished. An aged immune system is not so good with dealing with them, which is one reason (along with the sheer accumulation of mutations over time) why old people get cancer so much more frequently.

        Well, the virus directly causes derangement of cellular immunity so logically it should also cause an explosion in cancers. If what your are seeing is confirmed as a trend, and if it’s these two types specifically that are exploding that is quite solid supporting evidence, then that hypothesis will turn out to be have been correct.

        Without wishing to come across ‘vax vax vax’ (which you all know I’m not!) do the vaccines attenuate this impact on T cells at all? or unknown?

  5. Arizona Slim

    Yesterday evening, I Zoomed into the FLCCC Weekly Update. Once again, the chat was full of stories of Americans and residents of other countries who have had to resort to ordering IVM from Indian pharmacies, only to have it confiscated by government authorities.

    Other FLCCC Zoom chatters noted lengthy delays between the time of their orders and when they actually received their IVM.

    However, there is a ray of hope here in Arizona. Legislation has just been introduced, and it would require pharmacists to fill IVM prescriptions. Link:

    1. Splashoil

      Ivermectin(a) is sold over the counter in Mexico farmacias. It is manufactured in Queretaro. No prescription required.

    2. Basil Pesto

      There have been reports of counterfeit Ivermectin being seized – I think here in Australia – after it was ordered online. Ordering such a thing online would seem to be a pretty fraught business, but then opportunistic counterfeiting is an obvious inevitability when a drug is driven so pointlessly underground.

    3. Screwball

      Let me state right up front – I cannot prove this or know if it is true – because I saw it on Twitter. There was a letter from the FDA telling the USPS not to deliver drugs from other countries. It looked legit, but I have no way of proving. I also don’t remember if it was just the drug that cannot be named, or any foreign country package that looked like drugs.

      I am watching for my mailman, who I know good enough to ask – and I will.

      If this is true, along with all the other things we see on a daily basis, every “optional” treatment gets the rug pulled from under it in one way or another. Coincidence? I think not.

      Another brick in the wall of lost trust.

  6. Jason Boxman

    The Atlantic article is a very direct way of instructing Americans to go forth and die for capitalism. It’s insane, particular given what we already know about this variant. In all of this, I was overly pessimistic about how long it would take to develop a vaccine (which we weren’t particularly told was non-sterilizing) and underly pessimistic about virus evolution outcomes. Oops. What can I say? It’s my first serious global pandemic. But people in the Establishment ought to know better, but act the fool anyway.

    Stay safe!

    1. BeliTsari

      Yep! Instead of embarrassment over constantly repeating Panglossian falsehood, divisive agitprop and pretty nasty how to infect the help, “masks are SO for the schvartzes” imprecations… The Atlantic & their yuppie-oriented blog counterparts, ALL immediately dug-in on “living-with” Delta/ Omicron (or, for their chronic PASC victims: that which does not kill you, just mutates and tries again! (Other Creative Class™ churls AGREE: Let ‘er RIP!)

    2. chuck roast

      I like that the The Atlantic has dispensed with the cursive script on its header and now simply has a big “A” on the cover. This apparently is a bold announcement that the olde abolitionist, anti-imperialist rag of our great, great fore-bearers has well and truly been reduced to a single letter. “A“…now the official brand of the intellectually incurious everywhere.

  7. responseTwo

    Boston Globe article this morning calling Omicron variant’s spread ‘interesting’. Oligarchs subtle way of saying ‘let the bodies pile up’.

    ‘It’s going to be an interesting winter’: Mass. scientists report Omicron variant’s spread appears to be so fast it’s hard to track

  8. The Rev Kev

    Many thanks for this post as it was as informative as it was exasperating. Coupla times I felt like thumping my desk with my fist while reading this as I am seeing here in Oz all that line of BS how it is mild, how it won’t get into your lungs so won’t be bad to catch. I swear to god that here they want it to spread because I am seeing State cases spike (Delta? Omicron? Both?) while they are easing restrictions and opening up the flood gates not only between States but also people like overseas students as well. It’s like both the government and the appointed medical authorities are just sick and tired of the pandemic so they just want to forget about it, get their pre-2019 lives back again and learn to live with this virus. I would also like to send on my personal thanks to the Covid trust and especially people like IM Doc and GM who are able to put all these facts into some sort of context. Finally, this is all reminding me of a line from a novel where a heroine said that we do not live in the Age of Reason but in the Age of Ostensible Reason now.

    1. Aljay

      Hi Kev,

      I live in Sydney and am just as horrified as you are with current events. In one week we’ve gone from cases trending down, to record numbers – and if today is not a crack of the 2k for the state I would be very surprised.

      For other readers – in July when our state lockdown came in for Delta it was very obvious that the (Conservative) state government was being dragged kicking and screaming into mandating a lockdown. We have since replaced our premier (governor) – due to a corruption investigation – and the new one is a full-on god-botherer. There is zero chance he will announce any measures that would jeopardise Christmas.

      Some anecdata – I know of a large COMPULSORY corporate Christmas party that was held 10 Dec. Omicron very much in the state, as well as lots of Delta cases per day. ~400 odd people forced to attend in a smallish conference hall, 2 hours of speeches, no way there was distancing or ventilation. And apparently almost no-one wearing masks! In better news I know that one of Australia’s largest employers has this week cancelled all events/gatherings/flights, so as usual it appears that the government is deliberately doing nothing so that employers have to make the unpopular calls.

      My partner and I are bunkering down and cancelling most social events we had planned. Not seeing much evidence of that in the rest of our circle. My sister-in-law is an ED doctor and has been exhausted for two years now, with “low” case numbers. I am very very worried about what is going to happen in the next couple of months, for her and for our health system.

  9. Dave in Austin

    Above it says:

    “According to a new lab study, Omicron infects & multiplies ~70x faster than the Delta variant and the wild type SARS-CoV-2 in the human bronchus, but not in the lung.”

    Could this be related to mouth breathers vs nose breathers? I’ve previously posted on the “mouth breather vs Nose breather/loss of smell” issue.

    If for whatever reason Omicron multiplies rapidly above the lungs (in the bronchus and nasal passages), then is the infection and distruction rate of the nasal cells supporting the “hairs” that smell happening even faster than with the original and Delta?

    If so, then the “Test your sense of smell every morning with an alcohol swab” is even more critical because it allows a very early response using Ivermechtin for those at home with no other symptom… yet.

    And it might help on the “overwhelmed doctors/overwhelmed hospitals” cycle. Does the Brain Trust have any comments on this?

    1. Winston S

      This is an in vitro lab study with bronchi and lung tissue getting direct exposure to the virus in petri dishes, so I wouldn’t expect nose/mouth breather to be a factor in the results.

  10. Medbh

    Does anyone have an answer to Littlefinger’s question (from the Game of Thrones)?:

    “Sometimes when I try to understand a person’s motives, I play a little game. I assume the worst. What’s the worst reason they could possibly have for saying what they say and doing what they do? Then I ask myself, ‘How well does that reason explain what they say and what they do?'”

    One of the things I find most anxiety producing about this situation is I cannot figure out the motivation of people with political and professional power. Their actions seem crazy to me.

    Is this just a refusal to accept the financial costs of mitigating an airborne disease (i.e. dead people are cheaper than upgrading HVAC)? But wouldn’t the never ending financial repercussions of new variants and waves be more costly? What is gained by telling people that omnicron is mild if it’s not, especially if that bill comes due in weeks, if not days? If it’s just about money, why not pursue vaccines and treatments so you can get double the profit?

    I wish I understood what they were doing and why.

    1. The Rev Kev

      I am going with the idea that the reason we see what we are seeing is that it is an attempt to preserve the economy and political setup from before the pandemic started. The status quo worked so well for them that they feel that it must be preserved at any cost. Eventually they would like to be able to say that they gave you the vaccines so any bad outcomes are all on you. We have done our part.

      I’ll give an example here. When you ask what are the most lucrative business operations, they usually require people to concentrate themselves into relatively small areas. So think here concerts, sports audiences, bars, restaurants, Las vegas, business conferences, etc. But in a pandemic, you would need a major overhaul of ventilation, building construction, social customs and not just for this pandemic but for the ones coming down the track.

      So, faced with this major reconfiguring of or society, our leaders have instead opted for a quick fix (vaccines) so that they don’t have to do any of that. It is of course as lazy as it is lethal but it appeals to the professional managerial class as all you have to worry about is who is vaccinated and who is not.

      1. GM

        It’s a redistribution and philosophical problem.

        Redistribution because you cannot get rid of the virus without doing a downwards wealth transfer. Somebody has to pay people to stay home and not work, for the mass testing, etc., and the people who have to stay home have nothing, so you have to take it from the rich, Completely unacceptable, not even so much as a one-time event but as the precedent that it would set — it should never be even contemplated that wealth could move in any other direction than upwards.

        Philosophically getting rid of the virus means doing something for the common good. Which exposes the ideological bankruptcy of the libertarian ideology that has been used to brainwash the masses into accepting the status quo. So we must absolutely never do anything for the common good.

        Even in a crisis — COVID is a stress on the system, and one way the system could have absorbed it was by taking from the rich and giving to the poor and improving its resilience through strengthening the internal bonds between the individual elements. Or it could have been absorbed through mass death and suffering.

        They chose the latter.

        China can deal with it properly because despite all the market-oriented restructuring of the economy, they still have a communist party in power that apparently takes at least some aspects of the “communist” part of its name seriously. It also has the ability to redistribute and channel resources as needed. And the freedom to think and make decisions about these things long term.

        This is a taboo topic in the West but people should read on the principles on which Soviet healthcare was founded — key among them was the prevention of disease. Not the treatment — that was seen as secondary and tertiary line of defense. The USSR would have locked down just as hard as Wuhan and would have fully contained it just as efficiently, because it would have been unthinkable for them to allow a dangerous infection to just spread uncontrolled. In the modern West, however, healthcare is a transaction and the healthcare system is one of the major tools for rent extraction from the masses. And that’s how you get “flatten the curve”‘, “learn to live with it”, and other insanities of the sort.

        1. Medbh

          Everything you wrote makes sense to me, but I’m still lost with their end game. What do they think will happen if we continue to have endless waves of covid, or one evolves with no vaccine protection and a 25% fatality rate?

          At some point you run out of medical staff, supplies, and a functioning society, and it will affect the billionaires too. Maybe they just can’t imagine a society where their power no longer protects them.

          1. GM

            The end game is a return to Dickensian England.

            Which was not a bad time for the elites, and they think they will be able to insulate themselves in this case too.

            1. William Hunter Duncan

              Less rabble to pay out entitlements to.

              So when does all this ignoble lying reach it’s watershed moment? Methinks Omicron may be it….

              1. megrim

                I agree with all of this, but I’m starting to also think that even if the mass death isn’t the actual goal, it’s got to be a nice bonus. Too many useless eaters, they are probably thinking.

            2. Noone from Nowheresville

              GM: But they don’t have to take it from the rich – they didn’t do that before or now. They just have to stop giving it to the rich, stop privileging them above the common good and stop them from dismantling the little common good that remains. Of course that would expose the lie.

              Return to Dickensian England: We need to get rid of 6 billion people then? I suspect the rest of the world might eventually have something to say about that. Plus getting rid of so many of your own population does leave one in a weakened state for others with more people and basically all of the West’s technology and manufacturing capability to take over. If that’s the plan, then maybe it’s for the best. Big maybe. Front row kids – the big A-holes.

              It’s kind of funny. Say what one will about Trump (and we do!), but initially he had more public-facing human inclinations than other politicians when the pandemic was first announced.

              But the semi-scripted reality political TV show written by children who think they are adults had to continue lest we realize how scripted it is and has been.

              And say what we will about the US CARES Act (and again we do although it’s mostly a distant memory which no one really analyzes because how could we without real data on where the leveraged money at the top went), politicians pulled that together in 7 days and there was no real opposition to it.

              7 days and not one politician stepped out of line. When something actually matters to them, politicians don’t screw around with the scripted games.

              1. Yves Smith Post author

                Oh, come on. This is astonishingly naive.

                How do you propose to live? Just stop paying rent or your mortgage and be homeless? Or eat? You’re going to stop paying the food middlemen who squeeze farmers and grocers for fun and profit? Not work so as not to let your employer take more of your increase to his productivity than he deserves? How are you going to avoid the medical industrial complex and its rentierism if you get sick or hit by a car?

        2. Andrew

          I had an argument with someone recently who couldn’t understand why I was praising the Chinese approach to dealing with Covid. He had that ‘we couldn’t possibly do that here because markets’ Western exceptionalism way of thinking. I think we in the West have given up on the idea of public health and doing things for the common good. It’s all about money. And the libertarian mindset of ‘freedom’. Admittedly, how the Chinese went about this isn’t for the weak but once they stopped trying to silence those who were raising the alarm they ‘got religion’. The West, in comparison, dropped the ball and we’ve been paying the price every since.

      2. Jason Boxman

        That’s been my thinking as well; It’s a more immediate form of what’s coming for climate change: preserve the status quo for as long as possible. I might live long enough to see how this all plays out, but honestly not sure I want to have front row seats to this.

      3. VietnamVet

        There is no doubt that today the Elite are desperately trying to keep the status quo going at all cost — to others not themselves. Except 2019 is no more. The price of the pandemic is so enormous in lives lost and wages gone that the cohesion of the 50 State Union is questionable.

        An example of this belief system was on display on NewsHour last night discussing the FED increasing interest rates in 2022:

        The powerful simply cannot admit that they are wrong. Their belief is that the current inflation is due to rising wages; not the loss of workers due to illness/fear and shortages from the collapse of just-in-time logistics. Charging interest on debt will kill all of the current voodoo businesses kept going by zero interest rates. The beliefs are so divorced from reality that a correction that works is impossible.

    2. DanB

      Speculating, I’d say that the response of governments and other “leaders” is structural or systemic, or what anthropologist Mary Douglas would term “institutional thinking”, where embedded patterns of perception and interpretation, that is, social constructions of reality, automatically lead people to make decisions that seems “rational” from their point of view. Accordingly, most decision makers are not really thinking, they are protecting their status quo, their bubble, their paradigm, their social construction of reality, etc. IOW, they are not thinking deeply or, in a genuine sense, thinking at all. The social construction of reality guiding their institutional thinking is neoliberalism, a concept difficult to define yet easily recognized -by some, and unrecognizable or befuddling to others- as the surreal social world we live in. As Lambert codified its rules, “1. Because markets; 2 Go die.”

      1. Alphonse

        I think this is right. People of all beliefs tend to think in certain ways. Part of that entails imagining that one’s enemies are deeply conscious of their actions.

        Here on NC, the argument is that the powers that be are advertising Omicron as mild because thy want to preserve the status quo.

        Among vax and mask mandate dissidents, the argument is exactly the opposite: the powers that be are suppressing the fact that Omicron is mild because they want to continue a Shock Doctrine-type reconfiguration of society.

        Although these positions are contradictory, their basic worldview is so similar that I can imagine someone who subscribes to one could easily have chosen the other instead. Both positions exhibit a collapse of trust for the authorities. And both see the authorities as acting intentionally as part of a larger plan.

        Consider vax mandates. I think there are excellent ethical reasons to oppose them even if they are effective. Yet mandate opponents overwhelmingly argue not only that the mandates don’t work: they also argue that the virus itself is a minor threat. I think they are doing what we all tend to do – making facts to fit their narrative. (Many also think the real purpose of the pandemic itself is to provide an excuse for dismantling democracy and instituting social credit.)

        Consistent facts make for a coherent narrative. The world makes sense. Both stories – a deadly virus ignored by status quo elites, and a mild virus hyped by revolutionary elites – would make excellent film plots. The signal feature of both is a belief that the “bad guys” are ideal villains – intelligent, deliberate, acting in concert.

        This applies equally to the powers that be. The denial that covid is airborne is a coherent story, believed by a group sharing common education experiences, with a history of success (or apparent success) to back it up. It also has individual incentives: pharma pays, ventilation doesn’t. And so it solidifies and institutionalizes.

        The powers that be are likely acting less as a conspiracy aiming to achieve overarching goals than as a mass seeking acting consistently with what for them is the revealed meaning of the pandemic – which, to a large extent, also aligns with their material interests.

        So I think your explanation is right, DanB. I think both narratives are possible: that the virus can be simultaneously played down and played up: it is mild enough that we can get back to work, but severe enough to justify the expansion of a covid surveillance and enforcement bureaucracy. That’s not a particularly coherent position – but the job of a narrative, or myth, is to reconcile contradictions.

        In the Origins of Totalitarianism, Hannah Arendt argues that the desire for consistency is what makes propaganda and ideology effective:

        The effectiveness of this kind of propaganda demonstrates one of the chief characteristics of modern masses. They do not believe in anything visible, in the reality of their own experience; they do not trust their eyes and ears but only their imaginations, which may be caught by anything that is at once universal and consistent in itself. What convinces masses are not facts, and not even invented facts, but only the consistency of the system of which they are presumably part. . . .

        What the masses refuse to recognize is the fortuitousness that pervades reality. They are predisposed to all ideologies because they explain facts as mere examples of laws and eliminate coincidences by inventing an all-embracing omnipotence which is supposed to be at the root of every accident. Totalitarian propaganda thrives on this escape from reality into fiction, from coincidence into consistency.

        But, she says, that story eventually collides with reality. When it fails, believers wake as from a dream.

    3. PlutoniumKun

      I’ve been wondering the same thing too. The twitter thread linked yesterday from the Spanish scientist (who’s name escapes me at the moment) has an interesting series of thoughts as to why the medical establishment has dug its heels so hard into failing to accept the airborne hypothesis. I think the least malign interpretation you can make is that many scientists and doctors are simply too ashamed to accept that they’ve been giving terrible advice for more than a year.

      But there is little doubt in my mind that there is an institutional resistance within governments worldwide to accept the consequences of adopting new ventilation standards. In my own little corner of the world I’ve been repeating at every opportunity that our office is not fit for purpose, but every time I get the same response – ‘it has been checked and everything is in accordance with the regulations’. I’ve asked Santa for a CO2 monitor for Christmas.

      The worst irony of it all is that the costs are pretty small beer compared to what omicron will cost every economy. In Ireland there was an estimate of 90 million euro to equip every classroom with a HEMA filter. This is chickenfeed compared to what is being handed out to keep other sectors of the economy going. Its absolutely insane.

    4. LilD

      Local benefits, near term. We are probably in a game theory nightmare, as actors with power can cause small ( or large…) costs to a huge number of people in exchange for some personal gain.

    5. William Hunter Duncan

      There are too many people for too little resources. Select elite are well aware, more than the people are.

    6. Objective Ace

      One of the things I find most anxiety producing about this situation is I cannot figure out the motivation of people with political and professional power. Their actions seem crazy to me.

      Worst possible motivation take: They’ve finally comprehended how bad global warming will be and that 90 percent of the population needs to go. Better to get ahead start on that so they can maintain much of their quality of life

  11. Jen

    In a meeting yesterday one of the department Chairs asked the following question about the configuration of space in her department, which is basically a cube farm for the peons with offices for the more deserving:

    “I’m wondering if this configuration will really be workable if Covid is going to be with us for the for-seeable future?”

    Public healthish researcher. Seems to see at least some of the writing on the wall.

    Most of my colleagues are traveling for the holidays. We’ll see how many of us are on the first check-in zoom of 2022.

  12. steve

    Occasionally you encounter a truth that is utterly unbelievable, that goes against all your internalized notions of what should be, that leaves you thinking you would have to be unhinged to believe, that you have saddled too close to the precipice and tipped over into madness to even consider.

    And even if you do finally move to think ok this is how it is, you wall it off to some out of sight corner and carry on. But can you?

    There’s a coordinated effort to thin the heard and remake the world. The Masters that be, the craven sociopaths they are, have seized the moment and making a Big Play, how gleeful they must be. Considering only that these are the same monsters that got us here, I don’t expect it will go well.

    On a lighter note, the honeybees are out and about. Didn’t see any all summer so it’s quite the treat for mid December. If they hang around a bit longer I have some Buttercups that will be in bloom soon.

  13. Tom Stone

    I’ll add my belated thanks to the brain trust.

    Omicron is going to cause a collapse of the Hospital system here in the USA unless I am happily mistaken.
    I don’t see how it can be avoided.
    I’ll also posit that the next few “Waves” of Covid will come closer together in time, simply because more people infected in a given period = more mutations in a given period of time.
    And there’s the cheerful possibility of a substantial increase in mortality from the next successful variant, I wonder if a 10% mortality rate would inhibit replication significantly…?
    20% ?

    Long Covid is going to be a very big problem unless sufferers start dying off in large numbers soon.
    A solution that has a few drawbacks.

    It’s going to be a rough time over the next year or so, one of the things making it tougher is a society crippled by corruption and incompetence.
    The transition from a high trust society to a low trust society seems nearly complete, but the costs are just beginning to show up.

    800 K Dead in the USA, with many more to come.

  14. mikeyoe

    Thank you for this post NC.
    The “Mild” mantra has spread faster than Omicron.
    Even Cornell’s President Pollack mentioned it in her letter

    Cornell Goes Code Red, Cancels Most Campus Activities During Covid Spike with “Very High Percentage” Omicron in Fully Vaxxed

    Here in the NYC area the local media has done little reporting on Omicron .
    The one change in reporting and on TV is that the frequent messages and commercials to vaccinate children between the ages of 5 – 12 y/o have stopped.

  15. Louis Fyne

    this is sad. The civic-trusting America is dead. Not rose-colored glasses, 25 years ago, while America was imperfect, IMO, there was social trust that American institutions were competent. No more.

    This were are living in a dystopia straight from a 70’s movie. All that is missing is Soylent Green. IMO, the 2022, 2024 elections will be wild as the fruits of all this latent, under-the-waves distrust and angry will bear fruit.

    1. flora

      Completely aside, not about medicine: this is a ~50 minute talk given by Scottish television presenter and author Neil Oliver. utube. ~50 minute speech. (Q & A follows speech) He talks about the deliberate destruction of important cultural guide stars, and how that loss affects a whole range of activities and outlooks. I think this fits in general with your comment about before-after wrt institutional competence and social trust.

      Neil Oliver: “The Attack on Our History & Culture”. The New Culture Forum’s 2021 Smith Lecture

      1. Louis Fyne

        As an another aside, Neil Oliver made some great history documentaries for the BBC, before the BBC became institutionally woke (IMO).

        IMO, since roughly 2009-onwards, America was completely broken down in terms of inter-generation transmission of values (and this is before considering that Americans can’t even agree upon what values are good anymore).

        And I also want to say that at some point in the past 10 years that the CDC has pivoted to wokeism, not public health competence. But opine that too loudly and one is labeled a partisan hack.

        1. juanholio

          Good job too. The US population, and their values, have been a blight on The Earth since WWII. It’s a shame those values weren’t put out to pasture sooner, before all the harm they did.

          1. Duke of Prunes

            So you must be an optimist… as there is no guarantee that whatever replaces the American values “blight” will be an improvement. In fact, IMO, chances are it will be worse.


    It’s been almost 2 years. I’ve taken lots of multi-layered precautions + I’m fortunate enough to be able to work from home so I’ve been able to avoid the virus. My question is w/Omicron being so much more transmissible and with the rest of society describing the pandemic in the past tense -> is it time to just accept that I’m going to catch this and go live my life?

    I’m at a point where I think isolating myself through this wave just won’t be enough and I’ll eventually pick this up getting a haircut or grocery shopping anyway. So I’m wondering if the whole “see you at Christmas next year” thing is pointless this time around.

    1. Jeremy Grimm

      Cut your own hair. Order groceries delivered to your door or for curb pickup. Get a P100 mask and continue to hunker down. The “go live my life” idea is an old dream that will not survive the Corona Plague … and remember the Corona Plague is only the first Plague to show up. It may not be the last.

    2. Objective Ace

      Sure you’ll get it–but will you get it 2 or 3 times or 10 or 20 times throughout your life? All these people saying its unavoidable–while accurate–are missing the bigger picture.

  17. Matthew G. Saroff

    What are the preliminary numbers on transmissibility of Omacron?

    From what I’ve been reading, it seems to be approaching Measles levels, which is scary as **familyblog**.

  18. Wukchumni

    In March of 2020 I was wrestling with going skiing with our over the hill group in Mammoth, I had read of the travails in Lombardi, and there was a group of 14 skiers from LA who had gone to Italy and a number of them had come home with Covid.

    On the Friday before we were to meet in Mammoth on Sunday, I e-mailed everybody and told them I felt it wouldn’t be a good idea, and I wasn’t going to make it, and everybody sent their regards and told me that they’d miss me, but they were all going anyhow.

    Turned out to be a moot point as Mammoth shut down that Sunday for the season.

    I feel much the same about our family xmas get together starting in a week from now, 5 members of the family will be flying in, which is an added danger in that Omicron spreads so easy.

    If we killed my 96 year old mom over this, it would be devastating.

  19. Peerke

    Something does not seem right with the high R of Omicron. I wonder if the apparent rapidly increasing cases of Omicron is due to the PCR spike dropout. Let’s say the PCR technicians are trained to expect a certain set of specifications for a Delta strain fail but what they were actually sampling was Omicron with spike dropout, then could they say the test was negative instead of positive? But now the spec has probably been brought up to date and they are recognizing Omicron correctly? Any PCR experts in the readership? Also, as far as antigen/lateral flow at home tests go, I saw in the Twitter anecdote that Lambert posted some people were asking if swabbing was done only in nose or also tonsils for negative tests. If Omicron happens to be more prevalent in tonsils than nose then we could see a similar false negative test issue for Omicron. I say all this because I am seeing my kids and wife getting heavy colds and being negative for PCR and antigen test. Seems strange to me that we can avoid Covid but not the common cold.

    1. Peerke

      Forgot to say that antigen test instructions I have used say to swab only the nostrils. In UK when I was there and used a NHS antigen test it included tonsils. Also here in Arizona any PCR swabbing I have seen has only been nostrils.

      1. Biologist

        In UK NHS has apparently changed it, I did a swab yesterday and it said (both) nostrils only.

        @Peerke: PCR S-gene dropouts in Omicron are not being mistaken for negative, as these assays measure two other target genes and those need to be positive (if they are all 3 negative, then it’s a negative result).

        This dropout is caused by S being so mutated, and has been discovered already one or two weeks ago (I think!), and it was in one of the UK’s Health Safety Agency technical reports. Further, this was already known (and used, and validated) for Alpha a year ago, so folks in PCR labs know what to look out for. Now, whether S-gene dropout rates are a good measure for overall Omicron rates depend on how many (and in which geographic location, etc) of the testing lab are using this 3-gene panel vs. some of the other PCR tests that are not able to pick this up (I think they only target one gene). As long as that ratio is known for a particular region and time, it’s a very accurate tool to estimate Omicron cases.

          1. R

            SAGE friend was making the point that the Taqpath PCR assay can give four answers: S gene target positive, S gene target negative, equivocal and unknown. SAGE friend was spending today running some numbers because there is a risk the doubling times are an artefact of various biases (sampling, ascertainment etc) and, essentially, the denominator is wrong (too small).

            However, the final point was that, even if you adjust everything, the expectation was still 3 day doubling – but that is better than under 2!

  20. Carolinian

    Thanks as always for bringing IM Doc’s real world advice to this blog. It’s a comment on how broken our society is at the moment that the establishment can’t even be straight on matters of life and death–at least when money is involved. We have a real “values” problem in the United States.

    This is why the censorship craze must be fought even if free speech allows those on the far right to spin their own “narratives.” It’s depressing that the current so called left doesn’t seem to realize how important this is.

    1. Arizona Slim

      What shocked me was IM Doc’s use of the f-bomb, right here on this family blog. Methinks that our doctor is in need of our moral support.

      IM Doc, how can we best support you during these times?

      And, IM Doc, it may not feel like it right now, but you’re sitting at the cool kids’ table. We’re glad you’re here.

      1. notbored

        But you’ll never hear IM Doc use “dog” except to refer to a species of canines. So cool table may be a stretch …

      2. elissa3

        Yes, I noticed that as well. Here is an individual who, while passionate in his recitals, has been pretty restrained verbally. On the other hand, the f word has rapidly become quite common in “polite” discourse over the past 5 years or so. Waiting for the NYT to give their stamp of approval.

    1. chuck roast

      I get only news-I-can-use at NC. The plan is to drive to PQ Sunday morning. I’ll tune in. Hope it still works. Thanks!

      1. chuck roast

        Here I am listening, and sure enough the buggah’ is speaking in an alien language. So, they are only bilingual in Alberta and Newfoundland?

    2. Paleobotanist

      Legault (premier) is an idiot businessman who is determined to protect the economy at all costs. Dubé (health minister) is about the same. Dawg help us. I do not see any sign that our masters understand that just maybe, just maybe, the world has changed.

      I and mine are preparing to hunker down in Montreal again. The large order of catfood arrived yesterday. Priorities. I’ll go Tuesday and get boosted with Moderna to try anything to protect a very ill spouse. I can stay home from work until Jan. 6 marking finals and writing papers. Montreal is quite bad casewise and getting worse. Our GP is probably back in the covid ward at Jewish General Hospital. I hope he doesn’t catch it. People not great about masking here, they don’t seem to understand that it’s in aerosols, but this is getting little play in the press. People seemed oblivious to the approaching storm today when I went out to have an abcessed tooth drained. I have N95’s now but I am very nervous about the metro and buses.
      I guess epidemics reveal what a person is really like.

      The washing machine part has not arrived after 3 months. I gave up. A new washer hopefully arrives Monday.

      1. Gabriel

        You might want an elastomeric respirator such as the 3M 7500 series with P100 cartridges. I know Montreal firefighters use something similar on first response medical calls.

    1. Kris Alman

      One of the concerns of these experts in India is antibody dependent enhancement. This article is a thorough review of that possibility.

      A review: Antibody-dependent enhancement in COVID-19: The not so friendly side of antibodies

      A light at the end of the ADE tunnel?: Repurposed rapamycin.
      Rapamycin: Drug Repurposing in SARS-CoV-2 Infection

      No doubt this drug, like ivermectin, will be confined to the waste heap, denigrated as veterinary medicine.

      After all, it’s all VAXX.

      1. Kris Alman

        Rapamycin aka Sirolimus
        Rapamune among others, is a macrolide compound that is used to coat coronary stents, prevent organ transplant rejection, treat a rare lung disease called lymphangioleiomyomatosis, and treat perivascular epithelioid cell tumor (PEComa).
        Has a generic version of Rapamune been approved?
        A generic version of Rapamune has been approved by the FDA. However, this does not mean that the product will necessarily be commercially available – possibly because of drug patents and/or drug exclusivity.

        And who owns the brand name drug Rapamune?

        1. R

          That study is a literature review so unless you find a doctor willing to prescribe it on the back of a scientific hunch, rapamycin is not going to be available. It’s a really interesting drug though. It can be dose adjusted very nicely to close the G1/S cell cycle checkpoint but not block others or provoke cell suicide. This means that entry into the reversible part of the fell cycle happens but progression into the irreversible part does not. Sadly, tumour cells are thugs and run stoplights so it never made it as a cancer drug but I was involved in repurposing it for Alzheimer’s diagnosis and treatment (in AD, the G1/S checkpoint appears faulty)….

  21. Petter

    Norway here. I caught Covid in the pulmonary unit at the regional hospital, Ahus, northeast of Oslo. Was admitted on the 23rd of November and discharged on the 26th. A planned discharge but they couldn’t hardly wait to get me out because that morning a doctor came in to inform that one of the nurses had tested positive. No surprise to me. I was admitted to see if I could benefit from oxygen (severe COPD and pulmonary hypertension), but as I was carted around for different tests I noted that the mask wearing was lax beyond belief. And on my unit the nursing staff would wear masks when interacting with us but take them off while hanging around the nursing station.
    My health had been heading south all fall, starting with severe, other level attacks of shortnesss of breath ( testing at the hospital revealed a very likely pulmonary thrombosis – am now on blood thinners – diuretics too, since I’m mentioning meds. Oh yes, Prednisone.
    Could go on – my wife got it too – bad cold symptoms – me – how to describe it??
    Our 1948 farm house is not designed for this. Bathroom and shower in the basement, bathroom and bath on the second floor. No bathroom on the main floor where I live, Hooked up to oxygen. Sleep on couch, sit in chair, bathroom is a porta potty.
    My GP has been terrific – calls every day, the municipality has been terrific, the follow up from the hospital has been terrific, my kids and wife have been terrific. I should have been in the hospital but did not want to go back there.
    So Norway what’s the situation?
    An old joke – guy calls his brother who he hasn’t talked to for a while. Asks his brother how dad is. Brother replies – dad’s dead. The brother replies back – why break it me like that? Why not say dad is on the roof, and when I call back say dad fell off the roof, and then dad is in the hospital and then finally dad is dead. You could have broken it to me gently. BTW, how’s mom?
    Brother replies- mom is on the roof.

      1. Petter

        The night of my discharge I read a notice in the local paper that the hospital had tightened up it’s protocols – masks for visitors, etc. Not enough, too many exceptions.
        No mention of the outbreak on the pulmonary unit.
        Ever tried..
        Ever failed.
        No matter.
        Try again.
        Fail again.
        Fail better.
        – Beckett

  22. Elizabeth

    Thanks to all the braintrust who actually give it to us straight about covid v. “public health experts.” I also noticed IM Doc’s frustration at being hung out to dry from the CDC – this is one of the major things that has puzzled me from the beginning – literally giving out false information and saying that covid is not an airborne disease. Also, why isn’t the focus on treatments being done. Cheap, re-purposed drugs are not to be mentioned – doctors are threatened with loss of license, ostracized by the medical community and ridiculed and censored. In my lifetime, I do not remember anything like this ever happening. Whatever happened to the doctor-patient relationship? Is it really greed? control? or both and why?

    I told a friend that I think the “experts” want to keep this pandemic going – too much money being made. It shocks me that this is allowed to happen and thousands/millions of people die needlessly. Dystopian doesn’t seem a strong enough description for me. Is the Hippocratic Oath still in effect? (IM Doc still believes in it).

    1. drumlin woodchuckles

      I agree with your assessment. I also believe that the elites ( whoever gives orders to the WHO, the CDC, etc. from deep behind the scenes, is trying to spread this pandemic on as-close-to-purpose as they can without several billion everyday people all over the world all coming to the same sudden conclusion together . . . . that the OverClass Elite-Lords are working to spread this pandemic on purpose.

      I have already suggested what I think their motive is.

  23. KLG

    Conversation this morning with a colleague, PhD in Biochemistry and Postdoctoral Fellowship from universities everyone in the world would recognize as at the top of the heap (heap: I use that word advisedly these days). Said colleague said that now it is up to everyone to get vaccinated, as many times as needed, and then just “Let ‘er rip!” and see what happens. To be fair, said colleague also allowed as how distancing, masks, avoiding crowded/poorly ventilated spaces are also to be recommended. But the main emphasis is on vaccines that barely work, now and forevermore. I changed the subject to administrivia we both deal with on a daily basis…I will continue to make the virus work hard to find me.

  24. chuck roast

    Today’s pink paper

    Two stories on the spread of Omicron and institutional responses (sic) to the spread of the new variant. Not a peep in either piece about commonplace breakthrough cases. All about vaxing; pharma catch-up; hospitals; yadda, yadda, yadda. Gotta maintain that PMC weltanschauung.

  25. skippy

    All these anagram institutions which might have once functioned with public good in mind have been white-anted or re-tasked, long list of government or civil organizations have been corrupted during the neoliberal era – per se Sierra Club for a civil example or IMF for government and tertiary education as a public/government one, where all that is required is to insert the right person at or near the top and before you know it all the past is forgotten and only the glorious future awaits the faithful.

    Those that facilitate this agenda are rewarded monetarily and with laurels as exemplars to the unwashed, I mean who can degenerate the successful in a everything is a market paradigm/paradise.

    The McCrazzypants part is it was not long ago that the ubermarket fundies were trotting out the suicide numbers of any quasi socialistic nations like northern Europe vs the U.S. or U.K. along with the U.S. having the worlds best medical system in the world, due to its market based approach, but now, 100s of thousands of dead and maimed humans is just the cost of doing business … same sorts that used to bang on about how everyone was a commodity that need to sell themselves in the market place or anything done to an individual that diminished their value was an act of violence/force and yet here we are now … complete 180 degree paradigm shift of let her rip and let the chips fall where they may …

    Its just exasperating to have watched the dialectal twist its self into Gordian knots without blinking an eye in an amazing feat of post hoc ergo propter hoc, but it is good to see the veil dropping with those like Thirdway Nancy Pelosi saying freemarkets freemarkets freemarkets before all else …

    Like giving covid runaway mutation opportunity … just wow … and only a few years into this event … not to mention the first thought in any pharma/health/insurance concern is how things will effect its share price .e.g. personal wealth and formulate policy from that perspective first and foremost.

  26. William Hunter Duncan

    Has anyone else listened to JHKunstler’s new podcast with Dr David E Martin?

    I felt like I crawled OUT of the rabbit hole….

    1. Yves Smith Post author

      This was foreseeable from the outset. GM certainly anticipated very rapid spread; other Twitter experts did too, or put it another way, “What about R0 way higher than Delta don’t you understand?” And NYC would be a prime hot spot again due to high pop density and winter temps.

      NYC probably has way better #s than the rest of the US due to having free testing kiosks, while home test kit results almost certainly are not being included.

      1. Basil Pesto

        I know this was uncertain last week but do we have a clearer idea now of why O is more transmissible? Inherently so or immune escape or both?

  27. Gabriel

    Question for the medically inclined, such as GM or IM Doc:

    Seeing as
    1-COVID is airborne, and infects by breathing in virions.
    2-Severity scales with viral load.

    Wouldn’t an infected person in a poorly ventilated room be breathing back in his own virions, spreading the infection in different parts of his respiratory system? In that case, wouldn’t having a HEPA air purifier in said room lead to better outcomes?

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