Omicron Happy Talk in the US v. Toughening Restrictions in UK, Israel

It’s distressing to see optimistic pronouncements on Omicron when we are still far from knowing enough to make firm assessments, save its Delta-trouncing transmission rate. As we stressed in our first post, when the variant hadn’t yet been named (save as B.1.1.529), we warned that the precautionary principle meant that what might seem like an overreaction was the right response.

Instead, US officials and the press are downplaying Omicron, with some success since as of a few days ago most have not even heard of it:

Two messages have gotten widespread circulation in the US in the last couple of days, one that three doses of the Pfizer vaccine will provide protection versus Omicron and that Omicron is mild. We’ll address them in order. The first tidbit comes from Pfizer and needs to be taken with a fistful of salt. The second is at best dangerously premature and is based on anecdotal reports on a skewed sample.

GM helpfully kneecapped the Pfizer spin-meistering yesterday morning:

Regarding “VAX VAX VAX”, Pfizer just gave a press conference an hour ago where they loudly proclaimed that three doses of the wild type vaccine protect you against Omicron.

This despite a third preprint from yesterday showing the exact opposite — most people with three doses of Pfizer were below the detection limit within 3 months.

It looks like this has been immediately picked up by the media and is blasted from all directions…

Yesterday four different neutralization studies came out, and we are going to only pay attention to and believe the most optimistic one that also happens to be the only one where there is a giant conflict of interest?

And somehow the press has managed to memory-wipe the warning from Moderna’s CEO, that he didn’t expect the current vaccines to be terribly effective against Omicron. We pointed out that Moderna has been the most honest reported on the science front, not just among vaccine-makers but also including public health officials.

While the plural of anecdote is not data, recall that Israel’s first three cases were in vaxxed individuals. Recall also that Israel is a Pfizer monoculture. The story on Israel’s first case shows that three Pfizer shots did not prevent infection or contagion. And the patient got a moderate, not a mild, case even with that. From the Jerusalem Post:

[Dr. Elad] Maor tested positive for COVID-19 on November 28 and was diagnosed as having the variant a few days later. He was fully vaccinated with three shots of the Pfizer coronavirus vaccine.

The variant hit Maor harder than he expected, causing a fever for 48 hours and extreme fatigue for 72 hours. He said he had muscle aches, too. And even now [ten days later], Maor said he is not feeling back to himself.

The article reports that Maor spread Omicron to another person who was “also fully jabbed” which in context means three shots.

Some early data from Denmark:

The fact that infections are proportional to the vaccination level in the population means, in broad terms, the existing vaccines provide no protection against contracting Omicron.

GM provided some additional intelligence, across several e-mails:

As obvious from what is happening in Gauteng — most of those hospitalizations are reinfections, it’s just that the first infection was never recorded.

Also, they still have at least 20% vaccinated in hospital and the vaccinated there are mostly not just vaccinated, they are vaccinated on top of an unrecorded previous infection. So I would not be placing too much hope on the ability of “hybrid immunity” and 3 doses to prevent a catastrophic situation — sure it won’t be as bad as it would have been in an entirely naive population, but some reduction of a horrifically large number leaves you with another still horrifically large number….

When vaccine effectiveness waned to zero against infection after 25 weeks post-second dose here:

Vaccine effectiveness against severe disease went down to 71% but with a very wide interval

So this is the absolute upper limit for Omicron.

But it will likely be quite a bit worse because one mechanism behind that 71% VE with the original vaccine is memory B cells waking up and preventing runaway replication in the lower lung. But with Omicron we don’t have those B cells as Omicron’s spike is very different and we don’t have many memory B cells against it…

In any case, nobody will be able to give three doses to everyone on time – the thing is doubling every 3-4 days even in highly vaxxed populations. And there are already at least a million infections worldwide. At that rate most of humanity will have been infected well within the 100 days it will take to have an Omicron vaccine (let alone distribute it), and also at most 10-15% of people will get whatever benefit the third doses provide given how fast third doses are being given now outside Israel and a few other places. So it’s either lockdown or everyone catches it.

Now to the “oh but it’s not that bad” meme. First, that was propagated on what amounts to no evidence, a doctor in South Africa who was falsely presented as having “discovered” Omicron (no, that was Dr. Thomas Peacock of Imperial College, who posted his find on GitHub) and whose remarks were cherry-picked:

A lot of cheer has also been takes from remarks which the doctors admit are really clinical impressions based on the first two weeks of admitted patients in Tshwane Precinct (n=166). They are only guessing as to which are Delta versus Omicron since they cannot screen for the S-gene. However, hospital admissions have shifted towards the young (>50 year used to account for 80%, it’s now 19% 0-9 and 28% for 30-39) , and the proportion getting pneumonia has fallen, along with the average hospital stay.

The authors caution that this is the first two weeks only, and the profile could shift. They also note the province has a high vax rate for RSA, 57% in the over 50 and 34% in 18-49 cohort, versus 26% overall for all of RSA.

The concern I have is that no one has good enough data to draw good inferences. The big question here is why are there so few older patients? And remember that RSA has on the order of 70% to 80% seropositivity, meaning most people have already had Covid. That means most cases were asymptomatic. And RSA never saw Covid hospitalizations among the 0-9 cohort before.

Thus the analysis that would provide more insight is:

1. Age stratified hospitalization results. Young people are way more robust. If you were to compare current hospitalization results (days in hospital, % needing supplemental oxygen) by age cohort versus cases under Delta, the outcomes might not be terribly different.

2. Proportion fo symptomatic v. asymptomatic cases for Delta v. Omicron. This is something we can’t get but would need to make sense of what is happening. Are those (so far on average) not so bad seeming Omicron correctly compared to symptomatic Delta cases? But if a higher proportion of the infected become symptomatic with Omicron than under Delta, the “not so bad” is illusory, since a higher percentage are becoming sick (as in “mild” symptoms are worse than “no symptoms” and brute number of mild infection in the place of prior lack of symptoms could mask an average increase in severity).

Deepti Gurdasani offers a measured but duly concerned reaction. I strongly urge you to read the entire tweetstorm. Some key bits:

In the UK, Boris Johnson has gone contrary to normal Tory form and is putting a damper on Christmas and fourth quarter profits by imposing new restrictions starting next Monday. From the Financial Times:

Boris Johnson on Wednesday unveiled sweeping new coronavirus restrictions to combat the rapid spread of the Omicron variant as he apologised “unreservedly” for a leaked video that showed his aides joking about Christmas parties during lockdown.

The new restrictions for England include guidance to work from home from Monday, while masks will be mandatory for all indoor venues from Friday except for pubs and restaurants.

Covid-19 passports will be introduced for large indoor and outdoor gatherings, while Johnson also flirted with the idea of greater compulsion for vaccines to avoid an endless cycle of restrictions….

Justifying the new restrictions, which he described as “proportionate and responsible”, Johnson said: “We know the remorseless logic of exponential growth could lead to a big rise in hospitalisations, and therefore sadly in deaths.”

Allowing people to carry on in pubs and restaurants seems silly, but perhaps the other curbs will lower attendance levels. But I am surprised the UK is not imposing restrictions like those in Michigan in the first wave, of requiring patrons to stay masked until their food and drink arrived. That would somewhat curtail contagion time.

Israel took a less dramatic move, of extending the quarantine for Omicron cases from the former 10 days to 14.

As I keep saying, it would be better if I were wrong, but now is not the time to abandon caution. IM Doc reports two patients in his hospital that it refused to determine whether they had Omicron, but both vaxxed and boosted, both in generally good health, both sick enough to warrant Doing Something and both got zero benefit from Regeneron. Recall that it was predicted from the get-go that monoclonal antibodies would fail on Omicron. So the early watchers so far are being proven correct.

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    1. Yves Smith Post author

      I neglected to mention morbidity, above all long Covid, which Topol includes. We’ve stressed that morbidity is a bigger concern for the great unwashed public in reasonably good health than the death rate, since a higher percent of the infected suffer various afflictions, not just long Covid but some more specific, such as brain inflammation or ground glass lungs, and it’s not clear how much of that is permanent. But many long Covid victims report having at least one symptom linger longer than a year.

      And long Covid often occurs not just in mild cases but even asymptomatic cases.

      1. Mikel

        I have a co-worker, in her 30s. She has reported having covid twice. The last time a few months ago when she did some travelling.

        We are work from home and during a Zoom meet this week we were informed by another person in her department.
        This other co-worker said it wasn’t Covid, but some other virus and wasn’t serious.
        All I could think was it was serious enough for her to miss a Zoom that she doesn’t have to turn her camera on for.

        But what it had me wondering about was what constant battles with Covid may do to the body. And yes, I wondered about long Covid even though the claim was this time it wasn’t Covid. It was still someone exhibiting flu-like symptoms.

        1. Mikel

          And in thinking of this sickly co-worker, I just thought of another in the same line of work (sales) as her.

          This co-worker has done alot of travelling this past year – including the Carribean and Africa (Tanzania) just recently. She hasn’t reported having Covid. She is a heavy believer in wearing the mask. The other co-worker I also assume wears masks out in public.

          So what’s the big difference that I can think of? They aren’t that far apart in age. However, the co-worker that has been repeatedly afflicted with one thing or another has a pre-schooler.

      2. Basil Pesto

        for the record, I found this GM post from January while searching the site for “herd immunity”:

        That this is a SARS epidemic was known from the very beginning.

        That SARS causes lifelong disability was well known long before SARS-2 came — up to half (depending on the cohort) of the people who survived the first SARS epidemic in 2003 never recovered and remained disabled more than a decade later. Those “long COVID” cases that are still showing no improvement 10 months later but are presented as somehow just waiting for their recovery? Well, they will keep waiting forever, there will be no recovery for a lot of them.

        That there is no lasting immunity to coronaviruses was also well known long before COVID.

        1. Jason Boxman

          Although unlike SARS, the death rate just isn’t high enough (politically), so whatever initial steps were taken in the west, which were always insufficient, have been rapidly withdrawn and demonized. So we have no defense in depth at all, particularly in the United States.

          But perhaps as this evolves, we get to a place as bad as SARS in a different way. Substantial lifelong disability for a not insignificant slice of the population. That’s my fear, and so far I’m not seeing any evidence this is an unreasonable assumption to make about the future.

          I wonder how long a vaccination only strategy can endure (politically) if we have significant escape coupled with enhanced transmissibility? But in the United States, eternal denialism of reality is enduring, so this state of affairs might persist long past any point that seems plausible.

          Stay safe out there!

        2. Lee

          I’ve had ME/CFS since 2006, which is generally assumed to be a post-viral infection sequalae. I’m a patient at the CFS clinic at Stanford where they prescribe various off-label medications that mitigate but have not completely cured the condition in my case. The Stanford CFS clinic has recently expanded their practice to treat Long Covid patients.

        3. Skunk

          This is all true, Basil. I also shook my head in disbelief at the recent accounts of SARS-CoV-2 infecting someone in a quarantine hotel across a corridor. Again, it has been known since SARS-CoV-1 that these types of infections occur.

        4. BeliTsari

          Allegheny Health Network said vaccination might alleviate chronic PASC. Which we’d both noticed, at first. But, auto-immune & SCARY inflammatory issues persist 20 months later. We’re still trying Quercetin, bromelin, NRPT & phyto-polyphenol isoflavonoid rich SIRT-type diets; walking everywhere is intigral to life in NYC, just now. But brightly colored, greens, tart-dark berry juices, real ale, dark chocolate & red wine ain’t easy to find, or affordable to those most indentured by ER, ICU & drug debt?

          (Kinda gave up on nitric oxide precursors, but still using probiotics, for the very first time?)

      3. Lee

        COVID-19 survivors have an increased risk of death 12 months post infection (Medical News Today)

        “For people younger than 65 who were hospitalized with COVID-19, the risk of death in the 12 months after the infection was 233% higher than it was for people who did not have the disease, results published in the journal Frontiers in Medicine have shown.

        Nearly 80% of all deaths of people in the study who had recovered from COVID-19 in the past 12 months were not due to cardiovascular or respiratory causes, suggesting that the impact of the virus is significant and wide-ranging, even after the initial infection has been fought off.”

        1. saywhat?

          Sounds like selection bias to me. In other words, those who are hospitalized by Covid are less healthy to begin with.

    2. Brooklin Bridge

      Toward the end, Mr. Topol writes,

      “A key point here is that high transmissibility, which we are clearly seeing, will get a lot more people infected. Even if a smaller fraction don’t get severe illness, that’s still a lot more people very sick.”

      Should that not read,

      “A key point here is that high transmissibility, which we are clearly seeing, will get a lot more people infected. Even if a smaller fraction (don’t) get severe illness, that’s still a lot more people very sick.”?

      The latter would be bad news for hospitals and the population at large, but good news for those who would have gotten more sick via Delta?

  1. vlade

    Re the UK – there will be likely some noises that UK’s “Plan B” is a dead cat given Johnson’s problem with last year’s Xmas parties at No 10. I can see how it’d be so, but to get the plan B into action is not a spur of the moment thing. I’ve also heard that the tube drivers were told to expect reduced days already last week..

  2. Roop Dogg

    Some anecdata:

    I just tested positive (LFT) for Covid in London. Yesterday I came home from work early feeling awful (body aches, flu like dizziness, headache). I tested negative yesterday morning, positive today. Watching Dr John Campbell’s latest, quite upbeat, YT vid on Omicron symptoms it seems uncannily similar – aforementioned muscle aches and head ache, no cough or runny nose, slightly sore throat. And testing +ive 24 hours after serious symptoms developed.

    Review: Feeling already increasingly better today and much preferring the experience to the first time I got Covid in March 2020 – the early flu like onset then was similar but quickly changed to feeling irremediably cold and having weird breathing, which went on for more than week. Also, that time, the signature anosmia which developed into paranosmia, and still sometimes affects me today, so not sure if that is happening again yet. I also had ‘long Covid’ style tiredness going on for a long time – months and months. And possibly ‘brain fog’. Although that could just be age and lifestyle catching up with me! So far, it doesn’t feel like it is ripping through me in the same way.

    I was double jabbed (AstraZeneca) this year (second jab was in June). I’ve been taking crap loads of Vitamin D (unlike last time).

    I’m a 40 something male working in a school for children from some quite wealthy, international families, so reckon I’ve as good a chance as any of having been exposed to the exciting new Omicron strain if it’s ‘out’ here.

    1. outside observer

      I wish you a speedy recovery. Out of curiosity, have you tried anything on the flccc protocol aside from the vitamin d?

      1. Roop Dogg

        Thank you! I have not. When I told my doctor surgery here about my long haul symptoms, they just wanted to change my asthma inhaler, but did not offer the Iver!

    2. S.

      Another London anecdote. A colleague got Omicron (he was informed of this) and said it was very mild – runny nose and a headache for a few days and then he was fine. But we are back to having lots of friends report either being pinged or contacted by test and trace or getting Covid.

  3. Tomislav Ladika

    Regarding the “oh but it’s not that bad” point: I wish public health officials would provide a scientific explanation for why Omicron could be milder than Delta.

    Suppose that Omicron indeed developed from an initial COVID infection in 2020 of an immunocompromised person. That would mean the virus survived in the person for about a year without killing them. What if anything does that imply about the severity of this strain? Could it be that the virus was able to mutate so much inside the original infected person, because the conditions selected for mutations that cause milder disease?

    If not, what else could cause COVID to evolve toward milder symptoms at this stage?

    1. Mike

      I think it is because there is generally an inverse relationship between transmissibility and lethality, but that would be an assumption in this specific case. At least at this point there are no recorded omicron deaths, time will tell.

      1. vlade

        Measles has mortality of 0.2% (which is +/- covid) and R of 12.

        People tend to think that R and mortality have inverse relationship, but it’s not really true. The virus that spreads before the patient dies (as CV does) can have quite a high mortality with high R.

        If anything, the evolution would favour a virus that would have spread peak just before the onset of any symptoms.

      2. Yves Smith Post author

        You can have a very lethal disease and have it be highly transmissible. Ebola has a higher R0 than the seasonal flu, fer Chrissakes.

        In addition, there isn’t any reason to have a tradeoff when the death takes place well after peak contagiousness, as in the case with Covid.

        1. eg

          Yeah, this notion that the product of transmissibility and lethality must somehow equal 1 is its own special sort of nonsense. Wherever does this come from?

    2. Grebo

      Dr. Campbell yesterday noted a paper saying that omicron has acquired a gene from a common cold coronavirus. This kind of thing happens when someone is infected with both at the same time. Whole genes get transferred, wereas mutations are generally just small changes within genes.

      So one can imagine a scenario in which such recombination in an immunocompromised individual (giving more opportunities) results in a virus which gains infectiousness but loses deadliness so has plenty of time to spread to other people.

      1. Roop Dogg

        I loved that bit. If the common cold kills the ‘rona, won’t it be essentially the same plot line as War of the Worlds?

      2. Yves Smith Post author

        Please stop citing Dr. Campbell. He’s not qualified to opine and should not be trusted. As GM said,

        Campbell has been uncritically drinking various flavors of hopium from the start.

        For example, there is a very long series of videos over 2020 where he talks about reinfections as something impossible

        What he does is that he takes the mainstream view and propagates it without doing his own research. I don’t think he does it intentionally but he just does not go to the right sources to get accurate information and he is not an expert on the subject already

        Then he corrects himself eventually, but that is often many months later.

        In South Africa there is tremendous pressure to downplay the situation because of the travel bans. A lot of the economy depends on tourism, and the tourist season there is right now — winter in the northern hemisphere, summer there, so you usually get hundreds of thousands of wealthy tourists the northern hemisphere heading south for holidays. But there was no tourism last year because of B.1.351, and they are absolutely desperate to not let that happen again. Also, they are letting it rip internally so that is also a major reason to downplay it.

        One has to interpret any anecdotal statements coming from South Africa with that information in mind.

    3. Tom Bradford

      If not, what else could cause COVID to evolve toward milder symptoms at this stage?

      A highly transmissable, milder symptom virus would be more ‘successful’ in Darwinian terms than an equally transmissable virus causing more severe symptoms or even death as the latter puts more limits on the opportunities for transmission than the former – sick animals circulate less and are actively shunned – and if the former is even more transmissable its Darwinian advantages increase. Thus an evolution towards higher transmissability with milder symptoms is in the virus’ favour and in a real sense inevitable, driven by the fundamentals of evolution.

      1. Raymond Sim

        Thus an evolution towards higher transmissability with milder symptoms is in the virus’ favour and in a real sense inevitable, driven by the fundamentals of evolution.

        Incorrect. The fundamentals of evolution do not preclude mutual extinction, nor do they require ‘optimal’ outcomes of any kind, in fact the process, being path-dependent, is likely to preclude various kinds of optimization.

        For example rabies is quite successful as it is, but a path towards higher transmission via milder symptoms is difficult to perceive.

        Is there a path towards greater success along which SARS-CoV-2 loses the superantigen, or otherwise grows a ‘milder’ RBD that doesn’t also involve a scarcity of humans to prey on? I doubt it. Waiting for the virus to grow milder amounts to waiting for it to kill enough people.

        1. R

          It is not necessarily that a virus grows milder.

          A host population grows hardier – because the susceptible are culled….

          1. Raymond Sim

            ‘Hardier’?. Like populations with sickle cell trait?

            We shouldn’t count our eugenic eggs before they’re hatched.

      2. eg

        This nonsense brought to you by the same sort of thinking that gave us orthodox economics’ assumptions about equilibrium …

      3. Yves Smith Post author

        No, that is absolutely false. Viral shedding for Covid takes place in a tight time frame, 2-3 days around symptom onset (for symptomatic cases, presumably roughly the same amount of time after contracting Covid for asymptomatic cases; average symptom onset is ~5 days after exposure).

        Death occurs AFTER viral pneumonia sets in. That happens >5 days or more after symptom onset, so way after transmission, and it generally takes 2-3 weeks to kill. Death has zero impact on Covid transmission. Does not constrain it one iota.

    4. Skunk

      It implies nothing about the severity of the strain. For example, the Ebola virus can hide in the testes for years after a patient has been cured of any obvious symptoms of the disease. The virus has also been detected in eye fluid long after patients have been cured of any obvious symptoms. Also, these are not just inactive fragments of genetic material. In at least one case, a large outbreak of Ebola was traced back to an apparently “cured” patient who had unwittingly passed active virus to other people.

  4. Basil Pesto

    heads up: link in first paragraph goes to WordPress login

    (also, more pettily, there’s a “were are” typo in the same paragraph)

  5. Robert Hahl

    If omicron reduces the ratio of asymptomatic to mild symptomatic cases, and it spreads faster than delta even with warning symptoms, that is another bad sign.

  6. vlade

    Somewhere, don’t know where I read that omicron seemed to be recombined with a cold-causing coronavirus (which would support the hypothesis of originating in an immunodeficient person). Any thoughts on that (assuming it’s true)?

  7. The Rev Kev

    Whatever the effects of Omicron – both short term & long term – there will unfortunately be plenty of cases soon that will let us get a handle on this new variant. As I type this, Omicron has already spread to 57 countries and I suspect that it will be present in most countries by the end of the month thanks to trade and international travel. And since countries are renouncing the idea of closed borders and lockdowns, there will be nothing to stop it. And this is especially true as our leaders are still treating Coronavirus as something that is spread by droplets and fomite transmission as admitting that it is spread by aerosols would mean reconfiguring our economy and society which our leaders are loath to do. Better to do droplet theater and accept the body-count as it is cheaper that way. Hate to be the Gloomy Gus here but Omicron is heading our way everywhere and that is just a fact.

    1. eg

      Our PMC/leaders/betters in denial with respect to the HVAC implications of aerosol transmission are the equivalent of Victorian era grandees who harrumphed at the “unnecessary” expenditure on public sanitation to address cholera and its fellow travellers …

  8. Joe Well

    The pandemic keeps revealing basic failures in logical reasoning ability among the general public and the intelligentsia.

    Even if Omicron somehow did produce less severe symptoms than Delta, the fact that it is more transmissible would negate that. So if symptoms were 1/2 as severe but transmissibility is 4X…it’s 2X the morbidity and deaths and 2X the strain on hospitals that are already close to capacity, so good-bye non-emergency healthcare.

    How is that not obvious to anyone?

    1. Jason Boxman

      What’s for Christmas this year?

      Why, death for capitalism, of course! (And certainly not “of” capitalism.)

    2. Brooklin Bridge

      While I can’t speak for the intelligentsia, I think the public at large is still very much in the dark about Omicron generally and haven’t had much if any exposure to the possibility that it will or might -even if less severe- drastically overwhelm the ability of health care systems to handle other critical care needs (to mention just one negative outcome).

      As to our political leaders, other than their remarkable sensitivity to the proximity of lucre, it remains a mystery that they know enough to take their next breath, never mind weigh hefty matters of the public weal, severity, health care capacity, and multiplication tables.

    3. NotThePilot

      Hmm, I can actually see a weird, theoretical argument if you recombine Marx with Veblen (covid can do it, why can’t I?)

      In late-stage capitalism, with almost all increase in profit coming from intensive developments, perhaps a habit-of-thought has planted itself in our elites’ heads. Maybe they’re genuinely incapable of seeing the denominator anymore, only the ratio, and unlike wealth, those habits then trickle down.

      That said, I still prefer the simpler explanation that we’re led by decadent morons, but if you go looking enough, there may actually be reasons.

  9. Howard

    I might be too cynical but I believe the happy Omicron talk will start to change once the Christmas shopping season is over. We mustn’t scare consumers at this economically critical time.

    1. Jeff

      I’m a deeply religious cynic as well, but with so many shopping online, holiday shopping ain’t what it used to be.

      1. Basil Pesto

        That’s true, but it depends what’s being bought. If lockdowns or similar restrictions become necessary again to stanch the metaphorical bleeding, socialising might be ruled out – boom, clothes sales, especially formal and designer clothes, take a hit, to take one example. Certain industries, on the other hand (consumer electronics), would barely feel the hit if at all. Unless, of course, people start saving because what happens if Omicron threatens their job security somehow? Especially if payments to the proles are no longer on the agenda.

    2. haywood

      Aren’t yearly Wall St bonuses tied to end of year performance? That might be a lot of what’s behind this “mild” propaganda, no?

  10. Mikel

    It also appears they don’t want to delve into the implications of Omicron’s franken-spike proteins. Whatever people want to believe about the mildness of sypmtoms or not – franken-spikes have the scientists worried.

    It is a virus that is still “becoming” and all the wishful thinking in the world doesn’t make up the fact that nobody knows – especially bankers and economists – what it is becoming.

      1. Basil Pesto

        they’re weirdly vague about it though, “possibly one targeting omicron”. Huh? Why rush through clearly conflicted, probably worthless evidence about triple vaccinees being fine, and therefore probably quadruples,if it’s so easy to recalibrate the vaccine? Do you think it’s possible they’ve run up against some unforeseen complications with regards to that?

        1. Ignacio

          Why not? — Pfizer’s CEO thinks. Bear in mind they think won’t ever be prosecuted for any responsibility. At some point, though, evidence is piling against their sales pitches.

          They are repeating the same strategy they used for fast approval last year. Do not think, be fearful and run for our vaccines! Never mind if their effect is becoming more transient each 6 months, it is a dream for a manufacturer.

          How about your monthly jab?
          OK, this time only three days bedded after that!

      2. Lee

        Will they be serving Pi with the Omicron? Excuse the Byronic humor.

        “And if I laugh at any mortal thing,
        ’Tis that I may not weep; …”

        1. Basil Pesto

          I wonder if they might skip ‘Pi’ too, on the grounds of it being too homonymically confusing?

          If they don’t, The Sun in the UK will have a field day

    1. Basil Pesto

      What are they playing at when they’ve previously boasted about being able to re-engineer the vaccine for new, emerging variants? Get on with it. How stupid do they think we ahhhhh shit.

  11. Raymond Sim

    I wish everybody would quit being such scared babies, so paralyzed by fear they can’t panic like grown-ass adults with responsibilities ought to.

      1. Raymond Sim

        I think you mistook my meaning.

        A scared baby freezes and clings, counting, as it must, on the adults to panic as appropriate. I wish I saw a lot more panic right now.

        My remark was intended as a humorous way of commending you for battling the scourge of obligatory optimism.

        Maybe I should have gone with some sort of Hopium War joke.

        1. LawnDart

          they can’t panic like grown-ass adults with responsibilities ought to.

          I missed it too at first glance, but did a double-take and got a good laugh– thanks, Sim!

  12. Gumnut

    Trying to contrast & compare 3 covid-information source clusters:

    – NC + GM & IM Doc
    – the John Campbell/ Drbeen channels
    – the DarkHorse (the woke-mania is tiresome, science part seems ok)/RoundingTheEarth/Peter Mcclullough bubble

    There is a lot of overlap (non-vax covid measures, both pharmaceutical & non-pharmaceutical), that delta/omicron evade alpha-vax^3 and a lack of precautionary principle applied by powers to be.

    Where I am at a moderate to complete loss to fuse positions of those 3 clusters are:

    – how long does infection acquired immunity protect against severe disease for an otherwise healthy adult?
    6 months, lifetime?

    – does an alpha-spike-mRNA-vax (intra-muscular) at any point reduce the person’s alpha transmission ability?
    Is the evident inability to reduce/stop transmission due to variant change or just intra-muscular narrow-target vax to respiratory virus inevitability/ has a vax mandate with argument to protect others any footing in rationality?

    – (the hardest:) what are mRNA vax risks (aspiration assumed) vs. morbidity/mortality upsides by age?
    Elderly, overweight, immuno-compromised seems straight forward (high covid risk > vax risk), but for an healthy adult or healthy children I am left with (MSM & political madness aside) something between 0-sums game and a mindboggling risk downside to give myself or my children something between lifelong cardio issues and death.


    I know there a lot ‘?’s in the above and this is a comments section, but besides appreciation for any help in answering, I put it to the moderation that my ‘?’s (despite trying to throw a science PhD, 10 years in R&D and too much time reading on this topic) are a comment on the situation in itself.

    1. Jen

      “I know there a lot ‘?’s in the above and this is a comments section, but besides appreciation for any help in answering, I put it to the moderation that my ‘?’s (despite trying to throw a science PhD, 10 years in R&D and too much time reading on this topic) are a comment on the situation in itself.”

      Hear, hear!

      All I have going for me as too much time reading on this topic, and I am utterly befuddled.

      1. Mantid

        Speaking of treatment oriented …. here we are again with yet another variant and CDC (etc.) are saying nothing about treatment, only vaccine talk. The CDC et al could easily say “OK kids, now remember keep those selenium levels high, pump your vitamins D and C, keep that zinc ready and if you think you have it, get that free testing kit and don’t wait – start home treatment right away. If you have more questions, we have thousands of volunteers ready at 1-800-GET-WELL to walk you through our early treatment protocol developed between Harvard, Mayo Clinic, and Johns Hopkins medical centers” …. “Now, back to your local (actually corporate) television station programming.”

    2. Raymond Sim

      The fact that I have ready responses to your questions likewise speaks volumes about the nature of our situation. In no sane world would I undertake to learn any of this stuff at my age after having had a stroke. But here’s my two cents:

      – how long does infection acquired immunity protect against severe disease for an otherwise healthy adult?

      As best I can tell, it’s unknown how much time it’s likely to take for competent immune memory to become established in the wake of the havoc wrought by the virus. Given the waning of neutralizing immunity the question in my mind is “How long do convalescent people need to be protected from reinfection in order to get durable immunity from severe disease?”

      – does an alpha-spike-mRNA-vax (intra-muscular) at any point reduce the person’s alpha transmission ability?

      Since they’ve been documented inducing neutralizing antibodies in nasopharyngial mucus, including antibodies to other variants the individual had been exposed to, I think it’s rational to hope for this. If I were going to be interacting at close quarters with a particularly vulnerable person I’d try to get boosted in hopes of getting that benefit.

      – (the hardest:) what are mRNA vax risks (aspiration assumed) vs. morbidity/mortality upsides by age?

      I’m double-Pfizered and plan to get boosted asap, but I wouldn’t take these vaccines except under the kind of emergency conditions that presently prevail. The appalling truth, in my opinion, is that the present ubiquity of the disease, and the likely perisistence of this situation overwhelm all other considerations.

        1. Yves Smith Post author

          I wouldn’t say a quack, a quack is someone who is selling bogus treatments or products for profit. Campbell doesn’t seem to have any profit motive (then again, I don’t know how much he is making from his YouTube channel). His commentary goes way way beyond his ability to evaluate/vet what he is conveying.

          Re the accent: yes! I’ve said a British accent is worth 10 attributed IQ points.

  13. Mikel

    I’ve thought for the longest that the optimism/positivity industrial complex in the USA has made many borderline infantile in their ability to handle a crisis.

  14. Basil Pesto

    Meanwhile, interesting developments in the English Premier League. The mighty wankers of Tottenham Hotspur have had to postpone their midweek Europa League match, and are looking to do the same for their Premier League match this weekend, because much of their squad has confirmed Covid. Whether it’s Omicron is unknown. The protocol as I understand is that those infected cannot play or train, irregardless of whether they are poorly or not.

    I also don’t know whether the Omicron infectees of Belenenses, whom we discussed a couple of weeks ago, have been poorly or not. Of course, it is nobody’s business and for the player to decide if they want to talk about it.

    I maintain that professional sports, particularly soccer with its shameless free market transfer system, will be very interesting to watch. Reporters seem unable to do the 1+1 = ? legwork with regard to infected players and long covid. The case of Sergio Aguero is of acute interest, imo. But as I’ve pointed out before, known cases of long covid could wreak absolute havoc on the football transfer market system, which is a bubble that has been spiralling out of control for the past 25 years or so, since a multi-millionaire bought Blackburn Rovers (now relegated into obscurity) and bought excellent players at now-quaint record prices and subsequently won the league. It’s utterly implausible that none of the heretofore infected footballers could have Long Covid, but the collective industry will want to make sure people avoid coming to that conclusion… until the end of time basically.

    1. curlydan

      If the Premier League adopts the same policy as the U.S. top soccer league, it’s tough [bleep] for Spurs. The Philadelphia Union had to play NYCFC in a major playoff game last weekend despite having 11 players out with COVID. I don’t think Omicron was involved here. The Union narrowly lost the home match.

    1. ambrit

      Come on over to the Dark Humour Side and consider that the ‘hopium’ ‘projectors’ do know better, and are flat out lying for malign reasons.
      As has been mentioned today in comments, the general public is very much “in the dark.” The mechanisms with which this state of affairs has been engineered can be deduced. The theoretical agendas of those responsible for the Public Ignorance are the stuff from which Conspiracy Theories are made. Do remember that history has shown that what were once demonized as ‘Conspiracy Theories’ have often come to be recognized later as “inconvenient” facts.

  15. Lee

    I have previously commented that the U.S. is relatively fortunate in that it is a wealthy country in which only about 60% of our work force, representing just a third of our total population, are involved in production and delivery of the material necessities (Economic Policy Institute). This would allow us great latitude in more effective public health measures, such as targeted idling with pay much of the work force without causing material privation.

    It has since occurred to me that two-thirds of us are in that regard surplus to requirements, except that we serve as a large pool of reserve labor, thus increasing the expendability of all workers. I have no doubt that greater minds than mine from among our elites have calculated the affordable burn rate of essential workers and cost of replacement versus the continued generation of profits by by materially nonessential labor and have concluded that our current feckless public health measure meet their requirements.

    1. Susan the other

      This reminds me of the most recent Link to Taleb wherein he points out that disregarding the Covid deaths of people over 50, especially those over 75, is tantamount to saying that it’s OK for our national longevity score to drop by 10 points because it only affects the old and useless among us – that this is one very self-defeating way to look at the world. That’s the same mindset as thinking that labor is expendable as long as we keep the economy going with younger, healthier workers. Both are false. Because it’s just a matter of time. Like decay. And worse for labor because if labor is depleted, demand is depleted and a spiral is set in motion that will kill capitalism faster than all the pinko commies combined. It’s one thing to slow human consumption down to a sustainable level, and think, Well this pandemic could serve to turn us around – but it’s an insane neoliberal race-to-the-bottom to think that destroying the social contract can achieve a decent civilization.

  16. lordkoos

    IM Doc states that his hospital “refused to determine whether they had Omicron”.

    WTF kind of science is that???

    1. Earl Erland

      Curious: does his/her hospital have the ability to find what is being referred to as “S drop out”. Does anyone? Or has medical testing relied too much on a modern day anti viral Maginot (Pfizer) line?

      1. Yves Smith Post author

        My understanding from GM is that this is pretty easy and suggests that the officials didn’t want to be bothered asking whoever did the testing to check. I don’t know for certain but my sense is his hospital is small and therefore does not run many labs in house, so (*gah*) an outside lab might want more $ for the additional information. Or it could be entirely political: We are in Flyover, we don’t want to know until we have to know.

  17. King

    In July there was data and discussion that J&J seemed to me holding up better than the mRNA vaccines. Now there is a recommendation to get an mRNA booster 2 months after J&J. I guess the only thing I can really take from this is that all statements are subject to change. On one hand this is how science works and on the other such changes need a lot more work to maintain trust than our propagandists see fit to indulge us with.

    1. Jen

      If I recall correctly J&J’s data pointed to longer efficacy, whereas the 2 month recommendation came out of the FDA’s recommendations regarding boosters. J&J recommended boostering after 6 months. FDA says “nah, 2 months.”

      As a J&J recipient, I’m left with the dilemma of deciding whether to believe the drug company that is presently looking to evade their massive talc liabilities buy turfing them to a separate legal entity and filing for bankruptcy, or a government agency that recently approved an Alzheimer’s drug that at best has no clinical benefit despite being the most expensive drug ever approved.

      Neither seems like the right answer.

    2. Yves Smith Post author

      Sadly, and I got J&J, a very large scale study out of the VA indicated its protection fell much faster than the other vaccines. Admittedly this is a male-skewed sample.

      The proportionate reduction in infection associated with vaccination declined for all vaccine types, with the largest declines for Janssen followed by Pfizer-BioNTech and Moderna (Figure 1).Specifically, in March, protection against infection was: 88% (95% CI, 87% to 89%) for Janssen; 92% (95% CI, 92% to 93%) for Moderna; and 91% (95% CI, 91% to 92%) for Pfizer-BioNTech. By August, protection against infection had declined to: 3% (95% CI, -7% to 12%) for Janssen; 64% (95% CI, 62%-66%) for Moderna; and 50% (95% CI, 47% to 52%) for Pfizer-BioNTech.

      1. Jen

        Yes, but to me the real question is does it continue to provide some defense against severe disease? And do any of these vaccines do anything to protect against long covid?

        At this point, I’m assuming vaccines only provide limited protection against transmission unless/until the COVID brain trust at NC has data saying otherwise.

  18. Blue Duck

    So what’s the plan here for us Joe Q Schmucks in the public? What can I do over the next few weeks to prepare for myself, my physician spouse and our three young kids?

    1. GM

      The protection efficiency of serious PPE is not affected much by viral evolution.

      That is the personal plan for those who are paying attention.

      The plan for the rest is mass infection and whoever survives without too much damage should thank his luck.

      1. saywhat?

        should thank his luck. GM

        Except luck has no agency.

        Otoh, I find prayer to/faith in the God of the Bible to often result in tangible blessing.

        Just saying …

      2. Joe Well

        I am stocking up on N95s and bona-fide KN95s (cheaper, more lightweight). Any other PPE?

        Eating and drinking has become a big challenge now that it’s usually too cold to eat outside. I wish there were PPE for that.

        I am also looking into the different nasal sprays that have been discussed in comments on other posts, like Povidone Iodine-saline mixture.

        1. Beth

          I won’t mention the name of the nose spray, but I’ve been ordering one from Israel for myself and my family. Phase 2 trials published (killed a lot of covid in the nares) and Phase 3 with 12,000 subjects just started. The active ingredient is Nitric Oxide. Interestingly, NO by inhalation is also being investigated for treatment of a very resistant pulmonary mycobacterium infection. (I think NC did a piece on the nose sprays a while back.)

    2. Janie

      No expertise here, just random thoughts.

      *Install an attic fan or other ventilation system.
      *Lay in a backstock of essentials.
      *Order outdoor games (croquet, petanque, frisbee golf) and indoor games and crafts using arithmetic and other skills. If they’re 8 or more, learn bridge together.
      *Teach fractions by making 1/3 of a cookie recipe etc
      *Isolate; make masks fun (decorate them).
      *Read to each other; play charades.
      * Learn a simple inexpensive musical instrument (form a rhythm band with instruments from wood blocks, add bells, use a chopstick for a baton).

      Best of luck. Parenting is a full-time job, but it’s the most rewarding job you’ll ever have.

  19. Lambert Strether

    Let me hoist a comment I made elsewhere:

    That depends on the non-pharmaceutical interventions you are using, since as we have discovered, the vaccines do not prevent transmission (nor could they, being delivered intramuscularly). Since Covid is airborne, masks and ventilation, as Yves said. Ideally the masks would have frames, so air doesn’t leak in and out of the sides.

    To that I would being able to measure CO2 to be sure how much of other people’s air you are breathing, and avoiding 3-C situations, like Christmas Parties. If you must go to a party, I would go so far as to avoid singers, and avoid especially people with loud voices who do a lot circulating to other people, doing anything possible to avoid increasing a potential dose. I also spray my throat [Povidone] and nose [Carrageenan] with after encountering other people. (Both have anti-viral properties.)

    The essential thing is to have a strategy that takes account of how Covid is transmitted, and to be disciplined about sticking to that strategy.

    I can’t make a strong recommendation for your kid because I don’t know their situation. I would seriously consider looking into the ventilation system in your school. (California requires schools to have a plan for dealing with Covid: I don’t know about your state.) Consider getting a CO2 meter like Aranet4 and smuggling into the classroon if need be, If the school, heaven forfend, is relying on Plexiglass and wiping down surfaces, get together with other parents and get that fixed. Consider having a work day and building Corsi boxes for the classrooms, if they do not have HEPA filters.

    Hope this helps.

  20. bob

    The US response is awful. I had to get something at Walgreens the other day. It wasn’t covid related. I went to a pharmacy, the only pharmacy in a smaller town in upstate NY. Walgreens.

    There was a line at the Rx counter. I waited for a good 15 minutes while 2 people behind the counter were wrestling with the computer trying to get the insurance card to go through the computer.

    This was the only place in that town that was doing boosters, i heard from someone waiting. It was around dinner time and there were 4 other people waiting to be vaxed. It seemed they had passed the computer test of their insurance before I got there. There were also forms to be filled out for the people waiting. 15 minutes at the counter and then a few more forms in the waiting area.

    They could only be vaxed by one of the people fighting the computer.

    Just a giant shitshow. I heard someone else saying the same thing about a different walgreens on a podcast. Giant line and no one getting vaxed because the computer didn’t think they deserved it.

    How can we not get people vaxed and also make health insurance companies more money? Just keep it up!

    How can Walgreens be the place to be for boosters? Who made that policy choice?

    1. bob

      Just heard another story-

      Woman was reluctant to get a vaccine. Work was making it very difficult. She spoke with her doctor. They agreed she should get the vax.

      First available appointment is on December 23rd.

      1. Joe Well

        Very hard to get an appointment at CVS here in Boston and even harder to get tested.

        You have to do a little research for vaccine clinics outside of pharmacies.

        1. bob

          All of the locations within 25 miles of me now A) need an appointment and B) you need to contact the location to make an appointment. I’m sure that is quick, or as quick as dec 23. Walgreens is the only entity promising appointments via that website. Maybe part of the reason they’re so backed up?

          Why do you need to do any f’ing reaserch? How much have the feds and the states and the local govs spent to date on vaccines? Just give them away already. Don’t give them to another gatekeeper. This is insane.

    2. Medbh

      We had a similar experience with trying to get a flu shot, although it was more the fault of the insurance company than Walgreens. I have 4 kids and was trying to get them the flu shot like we did last year at the Walgreens that’s 6 blocks from our house. Walgreens says our insurance no longer allows for pharmacy-based flu vaccines, and we have to pay for it ourselves or schedule an appointment at an approved location.

      I call our clinic, and they confirm that our insurance will only pay for a flu shot if we get it at an in-network location, we have to schedule the appointments in advance, and we can only schedule 2 appointments at a time (so we’d have to make 3 different trips out there to get our whole family).

      Seems such a penny wise/pound foolish thing for the insurance company. There’s already low update for the flu shot, and you’re going to make me schedule 6 appointments and drive to the other side of town 3 times to get it done?! The entire health care insurance system should be burned to the ground.

  21. William Hunter Duncan

    It was GM as I recall who said a week ago, consider yourself unvaccinated. I’m no scientist in the materialist sense, but if I interpret the cards right they said quite clearly, Omicron is going to run through the vaccinated like fire, and their pretensions of superiority and plans of oppression will come to an end. Which is not wishful thinking, as I am vaccinated, and my parents are elderly. But it could be just, I don’t know what else is going to pour cold water on the PMC, the Media and Fauci & Company.

  22. Tom Stone

    Fauci has spent a long and profitable career always accepting responsibility and never the blame.

    1. rowlf

      Anthony Fauci seems to be the Wayne LaPierre (NRA CEO) of the pharmaceutical industry. I can’t see any difference in either person’s fear marketing and product promotion.

    2. MonkeyBusiness

      According to Gail Tverberg whose articles are sometimes posted here on NC, Fauci might be the Antichrist. Here’s the quote: “I could imagine Anthony Fauci being the Antichrist.”

      Coming from Gail, this was a bit surprising since she usually just talks about how it’s impossible to have infinite growth in a finite world, and I believe she’s been vaccinated.

  23. AlexS

    I find the doom and gloom of commentariat here mildly entertaining when it comes to covid. You do realize that the vast majority has moved on and is not paying too much attention to the fear porn? The US response has been awful, serious PPE, stock up on supplies, etc etc etc. And all of this is against the backdrop of being cynical about vaccines (perfectly understandable tho)? This is literally the toxic milieu of the late Soviet Union’s middle class that I grew up a part of. Cheer up.

    2 pro tips from the investment world:
    1. selling pessimism is way more profitable than buying it.
    2. betting on black swans is also a crappy investment strategy – unless you manage to get a self congratulatory book deal out of it that is.

    1. The Rev Kev

      In the dark and in the gloom
      they said
      ‘Cheer up! It could be worse!”
      They were right.
      I did. And it was.

      1. Joe Well

        Everyone is smiling and I got a frown,
        Why should I smile as they toss me around?
        I’m told the issue is inside my head,
        as they make a world that is withered and dead.

        Charlie the Unicorn, from the October 2021 finale episode

    2. Joe Well

      I feel bad for the people, like you, who are trying to deal with their covid anxieties, or any anxieties, through avoidance or denial. That never works.

      Today I cheered myself up with a visit to an art museum. Thanks to the fact that I take this seriously, I wore an N95 mask instead of the flimsy cloth masks most are wearing. I also chose a less crowded weekday to visit and ate before I went, so not tempted to unmask at the museum cafe. I truly enjoyed myself because I handled the risks rationally rather than pushing my anxiety into a corner and letting it grow.

      1. AlexS

        Good one, Joe. Your own neuroses and anxieties that were probably always latent but sadly far from socially acceptable – are now suddenly the mark of sophistication and worldliness. You remind me of my grandma – she survived 3 years of bombing/shelling during World War 2, and for the rest of her life she was reluctant not to take cover whenever she heard a plane flying overhead. She certainly did not let her anxieties grow in a corner!

  24. Joe Well

    A biostatician on Twitter brings up an important point and illustrates it with a hand drawn chart:

    “A new variant may appear milder even with no change in underlying virulence. This can occur because, when calculating the fraction of cases that are severe, the denominator now includes many re-infections that had previously been averted…

    So when I look at data out of South Africa or elsewhere, I am thinking not just about the proportion of cases that are severe, but also the sheer number of severe cases, which demonstrates the public health impact of the variant.”

  25. Mikeyjoe

    Thank you very much for postiing this NC.
    The talking heads in the US originally said that it would take two weeks to study the data regarding Omicron. But within days they were saying Omicron symptoms are mild and the vaccine works against it.
    Last night Sky News reported covid-19 cases in the UK are doubling every 2.5 days

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